Kiltow v. SAIF

A decision by the Workers' Compensation Appellate Review Unit that an insurer prematurely closed a claim does not have a preclusive effect on the Court of Appeals or the Workers' Compensation Board. Furthermore, an insurer does not act unlawfully by removing a condition from a claim if it is determined that the condition was never part of the compensable injury.

Claimant had an accepted claim for a combined condition of preexisting diabetes mellitus and a work-related foot injury. On appeal before the Workers' Compensation Board, claimant successfully argued that he did not suffer from a combined condition because the preexisting diabetes merely made claimant more susceptible to the foot injury, and the only compensable injury was claimant's work-related foot injury. After hearing, Claimant appealed the disability award to the Appellate Review Unit (ARU), which inexplicably included diabetes as a compensable condition when determining proper compensation. Subsequently, SAIF accepted claimant's condition as a compensable, work-related foot injury--entirely removing diabetes from the acceptance. Claimant appealed this order, arguing that the ARU's decision that diabetes was part of the accepted claim was final and precluded review before the Workers' Compensation Board and this Court. SAIF argued that the ARU's determination was such that it did not have a preclusive effect, and further argued that it was merely following the ALJ's order by removing diabetes from the list of accepted conditions. The Court determined that, because the ARU was not final, it did not have a preclusive effect. Furthermore, the Court determined that SAIF acted lawfully by accepting only the work-related foot injury as compensable. Affirmed.