United Airlines v. Indus. Claim Appeals Office of State

• Decision Date: 28 March 2013
• Docket Number: Court of Appeals No. 12CA1443
• Parties: UNITED AIRLINES, Petitioner, v. INDUSTRIAL CLAIM APPEALS OFFICE OF THE STATE OF COLORADO and Angela Jones, Respondents.
• Court: Colorado Court of Appeals

312 P.3d 235

UNITED AIRLINES, Petitioner,

v.INDUSTRIAL CLAIM APPEALS OFFICE OF THE STATE OF COLORADO and Angela Jones, Respondents.

Court of Appeals No. 12CA1443

Colorado Court of Appeals,

Div. IV.

Announced March 28, 2013

Industrial Claim Appeals Office of the State of Colorado, WC No. 4–733–270.

Ritsema & Lyon, P.C., Lynn P. Lyon, Michael M. Maglieri, Denver, Colorado, for Petitioner.

No Appearance for Respondent Industrial Claim Appeals Office.

Alvarado, LaForett & Martinez Tenreiro, LLC, Elsa Martinez Tenreiro, Denver, Colorado, for Respondent Angela Jones.

Opinion by JUDGE WEBB

¶ 1 In this workers' compensation action, self-insured employer, United Airlines (employer), seeks review of a final order of the Industrial Claim Appeals Office (Panel), affirming the order of an administrative law judge (ALJ) that denied employer's request for reimbursement of temporary total disability (TTD) benefits in excess of the $75,000 statutory cap. We conclude that the cap does not apply to benefits paid before a worker reaches maximum medical improvement (MMI) or is released to work. Therefore, we affirm.

I. Background

¶ 2 All dispositive facts are undisputed. After claimant, Angela Jones, sustained a compensable injury in 2007, employer admitted liability for TTD benefits. Claimant's TTD benefits ceased when she was released to return to work in May 2011, by which time she had been paid $99,483.14. Shortly thereafter, a physician performed a division-sponsored independent medical examination and placed claimant at MMI with a permanent impairment of five percent of the whole person.

¶ 3 Relying on section 8–42–107.5, C.R.S.2012, which caps combined TTD and permanent disability benefits at $75,000 for a claimant whose impairment rating is twenty-five percent or less of the whole person, employer sought to recover the $24,483.14 it had paid in excess of the cap as an overpayment. Claimant responded that she had not received an overpayment because under section 8–42–105(3), C.R.S.2012, employer was required to continue paying TTD benefits until she was released to work.

¶ 4 The ALJ concluded that the cap did not apply so long as claimant was entitled to receive TTD benefits. Consequently, because claimant had not received an overpayment, she was not required to repay employer the amount she had received above the cap. The Panel agreed.

II. Law

¶ 5 This case presents only an issue of statutory interpretation.

A. Scope of Review

¶ 6 If a provision of the Workers' Compensation Act (Act) is clear, “we interpret the statute according to its plain and ordinary meaning.” Davison v. Indus. Claim Appeals Office, 84 P.3d 1023, 1029 (Colo.2004). In addition, “when examining a statute's plain language, we give effect to every word and render none superfluous ... because ‘[w]e do not presume that the legislature used language idly and with no intent that meaning should be given to its language.’ ” Colo. Water Conservation Bd. v. Upper Gunnison River Water Conservancy Dist., 109 P.3d 585, 597 (Colo.2005) (quoting Carlson v. Ferris, 85 P.3d 504, 509 (Colo.2003)).

¶ 7 This court is not bound by the Panel's interpretation, Olivas–Soto v. Indus. Claim Appeals Office, 143 P.3d 1178, 1180 (Colo.App.2006), and we review statutory construction de novo. Ray v. Indus. Claim Appeals Office, 124 P.3d 891, 893 (Colo.App.2005), aff'd, 145 P.3d 661 (Colo.2006). However, we give deference to the Panel's reasonable interpretations of the statute it administers. Sanco Indus. v. Stefanski, 147 P.3d 5, 8 (Colo.2006); Dillard v. Indus. Claim Appeals Office, 121 P.3d 301, 304 (Colo.App.2005), aff'd, 134 P.3d 407 (Colo.2006). Thus, the Panel's interpretation will be set aside only “if it is inconsistent with the clear language of the statute or with the legislative intent.” Support, Inc. v. Indus. Claim Appeals Office, 968 P.2d 174, 175 (Colo.App.1998).

B. Relevant Provisions of the Act

¶ 8 The Act limits the total disability benefits that a claimant whose permanent impairment rating is less than twenty-six percent may receive:

No claimant whose impairment rating is twenty-five percent or less may receive more than seventy-five thousand dollars from combined temporary disability payments and permanent partial disability payments.

§ 8–42–107.5.

¶ 9 The Act does not provide that a claimant's benefits cease when that ceiling is reached. To the contrary, it specifies that benefits must continue until one of the following conditions is met:

(3) Temporary total disability benefits shall continue until the first occurrence of any one of the following:

(a) The employee reaches maximum medical improvement;

(b) The employee returns to regular or modified employment;

(c) The attending physician gives the employee a written release to return to regular employment; or

(d)(I) The attending physician gives the employee a written release to return to modified employment, such employment is offered to the employee in writing, and the employee fails to begin such employment.

§ 8–42–105(3).

¶ 10 Under the Act:

“Overpayment” means money received by a claimant that exceeds the amount that should have been paid, or which the claimant was not entitled to receive, or which results in duplicate benefits because of offsets that reduce disability or death benefits payable under said articles. For an overpayment to result, it is not necessary that the overpayment exist at the time the claimant received disability or death benefits under said articles.

§ 8–40–201(15.5), C.R.S.2012.

III. Applicability of the Cap

¶ 11 Employer first contends the ALJ misinterpreted the Act in concluding that claimant had not been overpaid. Employer concedes that the Act does not permit discontinuing TTD benefits before one of the conditions in section 8–42–105(3) is met, but argues that to avoid a conflict with the cap, benefits paid in excess of the cap still must be repaid once the claimant's entitlement to TTD benefits has ended. We consider these arguments separately and reject them both.

A. Claimant Did Not Receive an Overpayment of Benefits

¶ 12 Although claimant received benefits exceeding the cap, the circumstances do not satisfy other elements of the definition of overpayment. The relevant phrase—“money received”—limits overpayment to sums exceeding“the amount that should have been paid.” § 8–40–201(15.5) (emphasis added). Here, because claimant received only benefits to which she was entitled, the $24,483.14 she received above the cap did not constitute an overpayment. SeeCooper v. Indus. Claim Appeals Office, 109 P.3d 1056, 1059 (Colo.App.2005) (once authorized lump sum had been paid as “required by statute ... it ‘became a vested right’ ” (quoting McBride v. Indus. Comm'n, 97 Colo. 166, 172, 49 P.2d 386, 389 (1935))); Rocky Mountain Cardiology v. Indus. Claim Appeals Office, 94 P.3d 1182, 1186 (Colo.App.2004) (because temporary disability was owing as a matter of law until ALJ granted prospective relief, disputed payment did not constitute overpayment).

¶ 13 This interpretation is consistent with the absence of any reference to the cap among the conditions that terminate TTD benefits under section 8–42–105(3). SeeHenderson v. City of Fort Morgan, 277 P.3d 853, 855 (Colo.App.2011) (“Had the legislature intended to prescribe a voting procedure ... it could have said so plainly.”); see alsoBd. of Educ. v. Spurlin, 141 Colo. 508, 522, 349 P.2d 357, 364 (1960) (“the express mention of a person or thing ... impliedly excludes other persons or things not mentioned”). It is also consistent with the absence of a cross-reference in section 8–42–107.5 to section 8–42–105(3). SeeNededog v. Colo. Dep't of Health Care Policy & Fin., 98 P.3d 960, 964 (Colo.App.2004) (noting absence of cross-reference).

¶ 14 In addition, section 8–42–107.5 caps “combined” temporary and permanent payments at $75,000. The legislature's use of “combined” suggests that, to reach the cap, a claimant must have received both temporary and permanent benefits. Here, the benefits claimant received were solely for her temporary disability; because she exceeded the cap before an award of permanent benefits was made, none of the benefits paid to her was compensation for permanent impairment. Thus, she never received combined permanent and temporary benefits exceeding the cap.

¶ 15 Employer's citation of Donald B. Murphy Contractors, Inc. v. Industrial Claim Appeals Office, 916 P.2d 611 (Colo.App.1995), and Rogan v. Industrial Claim Appeals Office, 91 P.3d 414 (Colo.App.2003), does not require a different outcome. In Donald B. Murphy, the employer was permitted to offset permanent partial disability (PPD) benefits that had already been paid to the claimant, up to the statutory cap, against TTD benefits that he might receive after his claim was reopened. Similarly, in Rogan, the claimant was denied additional TTD benefits because he had already received both TTD and PPD benefits. Thus, unlike the pending case, each claimant's combined PPD and TTD benefits had reached the cap when the claimant sought additional TTD benefits. Neither case addresses whether the claimants would be entitled to additional TTD benefits if, as here, those benefits, when calculated exclusive of their permanent benefits, reached the statutory cap.

B. Claimant Need Not Repay Benefits Exceeding the Cap

¶ 16 Urging that a conflict can be avoided between section 8–42–105(3) and the cap by requiring repayment of excess benefits, employer points out that, if the legislature had intended to permit claimants to keep payments in excess of the cap, it would have said so in the Act. Even if this argument is not precluded by the foregoing interpretation of section 8–42–105(3), it also fails for the following three reasons.

¶ 17 First, although the legislature did not include a provision expressly allowing claimants who receive TTD benefits of more than $75,000 to keep the excess, it also did not specify that such benefits must be repaid. Nor did it list the repayment...