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Sound Advice Hearing v. CiGNA

Court of Workers Compensation of Montana

September 26, 1994

SOUND ADVICE HEARING, Appellant,
v.
CIGNA, Respondent.

          DECISION AND ORDER ON APPEAL

          MIKE McCARTER JUDGE.

         Petitioner, Sound Advice Hearing (Sound Advice), appeals from findings of fact, conclusions of law, and order entered by the Montana Department of Labor and Industry (Department) on March 11, 1994. The order dismissed Sound Advice's request for a contested case hearing based on a lack of jurisdiction.

         Factual and Procedural Background

         Sound Advice is a business licensed to dispense hearing aids. It apparently dispensed hearing aids to workers' compensation claimants employed, or previously employed, by Atlantic Richfield, which is apparently insured by CIGNA. The Court uses the word "apparently" because the proceeding below was commenced through sketchy correspondence. No formal pleadings were filed and no hearing was ever held.

         A dispute arose between Sound Advice and CIGNA concerning payment for hearing aids. Following a prehearing conference, a hearing examiner formulated the following issues to be addressed at a hearing:

1. Can the Insurer require three estimates following advice from an insured or provider indicating an insured's need for a hearing aid?
2. Does claimant at this time owe the petitioner [Sound Advice] for any hearing aides [sic] provided claimants insured by the Insurer?
3. Has the Insurer's claim processing been inappropriate?

(Notice of Hearing (January 11, 1994).)

         On February 7, 1994, the matter came on for hearing before a Department hearing examiner. At the commencement of the hearing CIGNA moved to dismiss for lack of jurisdiction and lack of standing. The hearing was cancelled and the parties were provided an opportunity to brief the jurisdictional issue.

         Both parties submitted briefs. Thereafter, on March 11, 1994, the hearing examiner entered the order dismissing the proceeding. The hearing examiner determined that Sound Advice is not a "medical provider" and that the Department therefore lacked jurisdiction over the dispute. Sound Advice then appealed to this Court.

         Discussion

         The sole issue before this Court is whether the Department has jurisdiction to hear the dispute between Sound Advice and CIGNA.

         This Court's own jurisdiction in this matter is pursuant to section 39-71-204(3), MCA, which provides for an appeal to the Workers' Compensation Judge from any order of the Department. The section provides, "If a party is aggrieved by a department order, the party may appeal the dispute to the workers' compensation judge." Section 39-71-2401(3), MCA, also authorizes this Court to hear this appeal. It ...


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