Sigala v. Atencio's Market

• Decision Date: 12 May 2008
• Docket Number: No. 07SC73.,07SC73.
• Citation: 184 P.3d 40
• Parties: Eva SIGALA, Petitioner v. ATENCIO'S MARKET; Royal & SunAlliance; and Industrial Claim Appeals Office, Respondents.
• Court: Colorado Supreme Court

184 P.3d 40

Eva SIGALA, Petitioner v. ATENCIO'S MARKET; Royal & SunAlliance; and Industrial Claim Appeals Office, Respondents.

No. 07SC73.

Supreme Court of Colorado, En Banc.

May 12, 2008.

Koncilja & Koncilja, P.C. Lawrence D. Saunders Pueblo, CO, for Petitioner.

Dworkin, Chambers, Williams, York, Benson & Evans, P.C. Gregory K. Chambers, C. Sandra Pyun, Denver, CO, for Respondents, Atencio's Market and Royal & SunAlliance.

John W. Suthers, Attorney General, Laurie Rottersman, Assistant Attorney General, Labor and Personnel Unit, State Services Section, Denver, CO, for Respondent Industrial Claim Appeals Office.

William J. MacDonald, Denver, CO, for Amicus Curiae, Workers Compensation Education Association.

Justice BENDER delivered the Opinion of the Court.

I. Introduction

This workers' compensation case requires us to review the court of appeals' opinion in Sigala v. Industrial Claim Appeals Office, 159 P.3d 785 (Colo.App.2006), in which the court held that the claimant, Sigala, is not entitled to temporary total disability benefits for the period of suspension because the term "suspend" as it is used in the temporary total disability benefits provision, § 8-42-105(2)(c), C.R.S. (2007), of the Workers' Compensation Act contemplates "a forfeiture" of those benefits for the period of suspension.¹ Based on our conclusion that the term "suspend" as it is used in the temporary total disability benefits provision means to stop temporarily and not to bar or exclude, we hold that Sigala is entitled to receive the benefits withheld by her employer during the period of suspension. As such, we reverse the judgment of the court of appeals and remand the case to that court to be returned to the Industrial Claim Appeals Office for entry of judgment in favor of Sigala.

II. Factual Background and Procedural History

The parties have stipulated to the facts of this case. Petitioner-Claimant Eva Sigala sustained a compensable injury, for which Respondent-Employer Atencio's Market admitted liability and paid Sigala temporary total disability benefits through Colorado's workers' compensation system. Under the temporary total disability benefits provision of Colorado's Workers' Compensation Act, a claimant must attend scheduled appointments with his or her attending physician. § 8-42-105(2)(c). If a claimant fails to attend an appointment with his or her attending physician, then the statute requires the employer to notify the claimant that his or her temporary total disability benefits may be suspended if the claimant fails to attend a rescheduled appointment. Id. If a claimant fails to attend the rescheduled appointment, then the statute permits an employer to suspend payment of temporary total disability benefits until the claimant attends a subsequent rescheduled appointment. Id.

Sigala missed an appointment with her attending physician on March 15, 2004. Pursuant to the statute, Atencio's Market sent Sigala a certified letter notifying her that it could suspend her temporary total disability benefits if she failed to attend a rescheduled appointment on March 30, 2004. Sigala failed to attend the rescheduled appointment, and Atencio's Market stopped payment of her benefits on that date. When Sigala finally attended an appointment with her attending physician on June 1, 2004, Atencio's Market promptly reinstated her benefits.

Sigala then requested payment of the benefits withheld by Atencio's Market during the period of suspension, March 30 to June 1, 2004. The parties proceeded to a hearing where an administrative law judge concluded that the term "suspend" as it is used in the temporary total disability benefits provision does not contemplate retroactive payment of suspended benefits, but rather results in a permanent loss of the benefits during the period of suspension. The Industrial Claim Appeals Office affirmed the ALJ's order.

The court of appeals affirmed the ICAO's decision. Sigala, 159 P.3d at 789. It reasoned that the temporary total disability benefits provision was "deliberately enacted with a view to establishing a more rigorous sanction for a claimant's failure to attend an examination by the `attending physician' than applies when the claimant misses appointments with other medical evaluators or providers." Id. at 788. Hence, the court of appeals concluded that the term "suspend" as it is used in the statute means "a forfeiture" of temporary total disability benefits for the period of suspension. Id. at 789.

Sigala petitioned this court for certiorari review, arguing that the term "suspend" as it is used in the statute means to withhold benefits temporarily, such that the suspended benefits accrue and are paid to the claimant once he or she attends an appointment with his or her attending physician. We granted her petition.

III. Analysis

The outcome of this case of first impression turns on the meaning of the term "suspend" as it is used in the temporary total disability benefits provision of the Workers' Compensation Act, which states:

If an employee fails to appear at an appointment with the employee's attending physician, the insurer or self-insured employer shall notify the employee by certified mail that temporary disability benefits may be suspended after the employee fails to appear at a rescheduled appointment. If the employee fails to appear at a rescheduled appointment, the insurer or self-insured employer may, without a prior hearing, suspend payment of the temporary disability benefits to the employee until the employee appears at a subsequent rescheduled appointment.

§ 8-42-105(2)(c) (emphasis added).

Sigala argues that the term "suspend" as it is used in the statute means to withhold temporarily. She contends that when the legislature intends to permanently deprive a claimant of benefits it does not use the term "suspend," but rather uses more forceful terms in phrases such as "shall be barred," "shall forfeit all right to compensation," and "shall not be able to recover, recoup, or otherwise be retroactively entitled to any of the benefits." Atencio's Market argues for the opposite construction. It maintains that the court of appeals correctly interpreted the term to mean a permanent forfeiture of temporary total disability benefits for the period of suspension and construed the statute consistently with the legislative intent underlying the 1991 revision of Colorado's Workers' Compensation Act.

An agency's conclusions of law are reviewed de novo. Davison v. Indus. Claim Appeals Office, 84 P.3d 1023, 1029 (Colo. 2004). Although a reviewing court gives some deference to an agency's reasonable construction of a statute, the agency's interpretation will be overturned on appeal if it is "clearly erroneous, arbitrary, or otherwise not in accordance with the law." Id.; see also Magnetic Eng'g, Inc. v. Indus. Claim Appeals Office, 5 P.3d 385, 389 (Colo.App. 2000).

In construing the term "suspend" as it is used in the temporary total disability benefits provision, we must adhere to the well-established rules of statutory construction. Our primary goal is to give effect to the intent of the legislature. Davison, 84 P.3d at 1029. To accomplish that goal, the terms of a statute should be given their plain and ordinary meaning. Id.

The term "suspend" means either "to stop temporarily," as Sigala argues, or "to bar or exclude as a penalty," as Atencio's Market contends. Webster's New World College Dictionary 1348 (3d ed.1996); see also Black's Law Dictionary 1460 (7th ed.1999) (defining the term "suspend" to mean "to interrupt; postpone; defer"). Neither the temporary total disability benefits provision nor any other statute in the Workers' Compensation Act defines the term "suspend," and whether the term means to stop payment of benefits temporarily, or to bar or exclude benefits permanently is not obvious. See § 8-42-105(2)(c). If statutory language is fairly susceptible to more than one meaning, as the term "suspend" is here, then the language is ambiguous, and we may resort to other aids in statutory construction, including the legislative declaration and the consequences of various constructions. See Davison, 84 P.3d at 1029.

As stated in the Act's legislative declaration, the General Assembly intended for the Workers' Compensation Act to "be interpreted so as to assure the quick and efficient delivery of disability and medical benefits to injured workers at a reasonable cost to employers, without the necessity of any litigation . . . ." § 8-40-102, C.R.S. (2007). Thus, a primary purpose of the Workers' Compensation Act is to compensate injured workers "regardless of fault." Colo. Springs Disposal v. Indus. Claim Appeals Office, 58 P.3d 1061, 1063 (Colo.App.2002). In a previous case, we noted that the Workers' Compensation Act "is intended to be remedial and beneficial in purpose, and should be liberally construed in order to accomplish these goals." Davison, 84 P.3d at 1029 (internal quotation marks omitted).

The temporary total disability benefits provision was enacted in 1991 as part of the General Assembly's general revision of the Workers' Compensation Act. See ch. 219, sec. 13, § 8-42-105(2)(c), 1991 Colo. Sess. Laws 219, 1305-06; see also John G. Salmon & Francine R. Salazar, 1991 Update on Workers' Compensation Law, 20 Colo. Law. 2223, 2228 (Nov.1991). Prior to the enactment of the temporary total disability benefits provision, a claimant's failure to attend an appointment with an attending physician was subject to sanctions under what is now section 8-43-404(3), C.R.S. (2007). See id. That provision of the Workers' Compensation Act governs penalties and enforcement when a claimant refuses to submit to a medical examination or evaluation. § 8-43-404(3); see Bacon v. Indus. Claim Appeals Office, 746 P.2d 74, 75 (Colo.App.1987) (holding that a claimant's benefits were rightly suspended under what is now section 8-43-404(3) when the claimant refused to cooperate with a...