Blue Mesa Forest v. Lopez, 96CA0436

Decision Date24 October 1996
Docket NumberNo. 96CA0436,96CA0436
Citation928 P.2d 831
PartiesBLUE MESA FOREST and Colorado Compensation Insurance Authority, Petitioners, v. Romolo L. LOPEZ and The Industrial Claim Appeals Office of the State of Colorado, Respondents. . III
CourtColorado Court of Appeals

Brandee L. DeFalco, Denver, for Petitioners.

Robert E. Krute, Montrose, for Respondent Romolo L. Lopez.

No Appearance for respondent The Industrial Claim Appeals Office.

Opinion by Judge JONES.

Blue Mesa Forest and its insurer, the Colorado Compensation Insurance Authority, (collectively CCIA) seek review of a final order of the Industrial Claim Appeals Panel which required them to pay temporary total disability (TTD) benefits to Romolo L. Lopez (claimant). We affirm.

The facts are undisputed. Claimant sustained an admitted occupational disease which resulted in problems to his upper extremities. The authorized treating physician issued a report stating the claimant reached maximum medical improvement (MMI) on March 9, 1994. Based upon this report, the CCIA terminated claimant's TTD benefits, and in a summary order, the Administrative Law Judge (ALJ) denied TTD benefits after the date of MMI until and unless claimant was successful in obtaining an independent medical examination (IME) under the provisions of § 8-42-107(8)(b), C.R.S. (1996 Cum.Supp.).

Claimant did not obtain an IME but, rather, continued to receive treatment by his authorized treating physician. Eventually, the authorized treating physician referred claimant to an orthopedic specialist. The specialist opined that claimant had reached MMI on December 1, 1994, and the authorized treating physician, after reviewing the specialist's reports, agreed with and deferred to this later date of MMI.

Finding that the authorized treating physician had effectively retracted his first opinion concerning MMI and had adopted the specialist's opinion, the ALJ determined that the authorized treating physician's opinion was that claimant had reached MMI on December 1, 1994. The ALJ concluded that the parties were bound by this opinion of the authorized treating physician and, consequently, concluded that claimant was entitled to TTD benefits through December 1, 1994. The Panel affirmed.

The CCIA contends that once an authorized treating physician places a claimant at MMI, the IME provision in § 8-42-107(8)(b) is the exclusive means to challenge that first determination of MMI. Therefore, the CCIA argues, the ALJ is bound by the authorized treating physician's first determination as to MMI. We disagree.

Temporary disability benefits cease when, inter alia, the claimant reaches MMI. Sections 8-42-105(3)(a) and 8-42-106(2)(a), C.R.S. (1996 Cum.Supp.).

The determination of MMI for purposes of terminating temporary disability benefits is governed by § 8-42-107(8)(b), which provides that the initial determination of MMI shall be made by an authorized treating physician. Aren Design, Inc. v. Becerra, 897 P.2d 902 (Colo.App.1995).

If either party disputes the determination of MMI, the claimant must undergo an IME. Colorado AFL-CIO v. Donlon, 914 P.2d 396 (Colo.App.1995); Burns v. Robinson Dairy, Inc., 911 P.2d 661 (Colo.App.1995).

However, an IME is not a prerequisite to the ALJ's resolution of a factual dispute concerning which physician is an authorized treating physician within the meaning of § 8-42-107(8)(b), whether the...

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11 cases
  • In re Marriage of Chalat
    • United States
    • Colorado Supreme Court
    • May 16, 2005
  • McGee v. JD LUMBER
    • United States
    • Idaho Supreme Court
    • December 22, 2000
    ... ... Idaho Forest Indus., 98 Idaho 784, 786, 572 P.2d 887, 889 (1977) ... 539, 905 P.2d 548, 549 (1995) ; see also Blue ... 539, 905 P.2d 548, 549 (1995) ; see also Blue Mesa ... Lopez ... ...
  • Meza v. Indus. Claim Appeals Office of State
    • United States
    • Colorado Court of Appeals
    • May 9, 2013
    ... ... See Blue Mesa Forest v. Lopez, 928 P.2d 831, 833 (Colo.App.1996) ... ...
  • Burren v. Indus. Claim Appeals Office of Colo.
    • United States
    • Colorado Court of Appeals
    • March 7, 2019
    ... ... See, e.g. , Blue Mesa Forest v. Lopez , 928 P.2d 831, 833 (Colo. App. 1996) ... ...
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1 books & journal articles
  • Update on Colorado Appellate Decisions in Workers' Compensation Law
    • United States
    • Colorado Bar Association Colorado Lawyer No. 32-3, March 2003
    • Invalid date
    ...28. Id. at 1163. 29. Id. at 1164. 30. Town of Igancio, 32 Colo.Law.. 179 (Jan. 2003) (App. No. 01CA2024, annc'd 11/7/02). 31. Blue Mesa, 928 P.2d 831 (Colo.App. 32. Generally, a DIME is a jurisdictional prerequisite to any hearing to determine MMI. See Story v. Indust. Claim Appeals Office,......

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