Trimet v. Wilkinson

An employer's denial of a Worker's Compensation claim involving a combined condition must be preceded by written notice of acceptance of the combined condition to the employee.

Trimet, Wilkinson's employer, appealed an order from the Worker's Compensation Board (the Board), finding that Trimet had not satisfactorily accepted Wilkinson’s claim for a “combined condition.” Trimet extended Wilkinson a denial letter in 2008 that the Board found procedurally invalid because it did not expressly accept Wilkinson’s claim of a combined condition before denying it. Trimet argued that there was no so-called magic set of words needed, nor any statute that pointed towards a particular manner by which acceptance needed to be made. In addition, Trimet urged that the Board lacked substantial evidence to support their order that the letter lacked adequate acceptance of the combined condition. The Court of Appeals responded to both of Trimet’s assignments of error by concluding that the letter did not: (1) specifically identify the ailments that attributed to the combined condition; (2) clearly note the date of when the ailments merged to make the combined condition; and (3) specify when the combined condition became compensable. Therefore, there was no proper acceptance of the combined condition, and thus, Trimet’s denial was correctly invalidated. Affirmed.