Alaska Supreme Court clarifies regulatory meaning of ‘medical reports’

The Alaska Supreme Court on Friday ruled that the term “medical reports” is not limited to records prepared in the ordinary course of business.

As documented in Woodell v. Alaska Regional Hospital, Kade Woodell was working as a nurse at Alaska Regional Hospital in September 2018 when he developed a Clostridioides difficile infection after caring for an infected patient.

In January 2019, Mr. Woodell reported the infection to the hospital in writing as an employment-related injury. Alaska Regional arranged an employer’s medical evaluation in May 2019. The examining doctor initially said he could not rule out the reported work exposure as a cause of the infection. However, after an Alaska Regional employee sent the doctor a note saying Mr. Woodell did not care for any of the four patients who had a C. diff infection, the doctor said there was no evidence supporting Mr. Woodell’s claim that he contracted the infection at work.

The Workers’ Compensation Board found that Mr. Woodell had been exposed to C. diff while working for Alaska Regional and that the hospital had actual knowledge of the exposure as of September 2018. The Workers’ Compensation Appeals Commission granted review and then remanded for the board to issue findings on credibility.

On remand, the board denied Alaska Regional’s petition for review, saying it found Mr. Woodell the most credible witness. The commission affirmed.

In September 2019, Mr. Woodell reported continuing symptoms and another positive test for C. diff. He filed an amended written claim that added a request for permanent total disability benefits and also filed a medical summary form with a letter from one of his doctors.

Alaska Regional filed a request to cross-examine the doctor several days later.

The board held a hearing on the merits of Mr. Woodell’s claim in August 2020. The day before the hearing, he emailed the board copies of six letters from his doctors linking his C. diff. to his employment at Alaska Regional.

At the hearing, Alaska Regional asked the board to exclude the letters, saying one had not previously been filed, and the others were “all subject to our request for cross-examination.”

The board ruled that Alaska Regional had waived its right to have the doctors present for cross-examination by not requesting it within 10 days of Mr. Woodell’s affidavit of readiness for hearing, as required by state law.

The board issued a decision, again finding that Woodell’s C. diff. infection was employment-related. The board found that he was entitled to temporary total disability and medical benefits.

Alaska Regional appealed, contending that the board improperly admitted the doctors’ opinion letters over its objection and that the letter were “not medical records within the hearsay exception.”

The commission agreed with Alaska Regional that the timeliness of its request to cross-examine the doctors was governed by state law, and it issued a decision remanding the matter to the board to allow Alaska Regional to cross-examine the authors of the opinion letters.

A different panel of the board heard the matter on remand and denied all of Mr. Woodell’s claims on the merits. Mr. Woodell appealed, and the commission affirmed.

The Alaska Supreme Court said it agreed with the board’s broader interpretation of the phrase “medical reports.” Defining the phrase to mean written medical opinions prepared for litigation is more consistent with the ordinary meaning of the phrase than the commission’s interpretation, which defined it as only medical documents that satisfy a hearsay exception.

Finding that the doctors’ opinion letters were medical reports, the high court said the board did not abuse its discretion and that the board’s determination that the requests did not preserve Alaska Regional’s cross-examination rights was consistent with the board’s regulations and prior decisions.

In reversing and remanding, the court ordered the case remanded to the commission to send to the board with instructions to reinstate the 2020 award of compensation and for further proceedings consistent with the decision.

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