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Aug 21, 2013

Colorado: Hotels and Restaurants Are Not “Medical Providers”

A Colorado appellate court recently held that hotels and restaurants that a workers’ compensation claimant patronized during authorized travel to obtain treatment by a specialist were not “medical providers” as defined by § 8–42–101(4), C.R.S. (2012). Accordingly, the carrier need not advance those particular costs associated with the travel; it was required only to reimburse claimant after-the-fact [see Winter v. Industrial Claim Appeals Office, 2013 COA 126, 2013 Colo. App. LEXIS 1284 (Aug. 15, 2013)]. Using an “ordinary, everyday” meaning of the term “health care service,” the court indicated that it connoted only those services provided to “maintain or restore health.”

Claimant had suffered a compensable knee injury. A resident of Trinidad, Colorado, he was required to travel to Vail to see an authorized specialist. While the carrier initially prepaid claimant’s round-trip mileage, hotel room, and meals, after claimant’s third appointment with the specialist, it advanced only the cost of claimant’s round-trip mileage. The court indicated that while it recognized the potential harshness of the result, particularly for a claimant who simply could not afford to advance substantial costs for lodging and meals in advance of reimbursement by an insurer, courts could not rewrite statutory or administrative rules under the guise of interpretation.