Opinion
W.C. No. 4-708-574.
January 4, 2008.
ORDER
The respondents seek review of an order of Administrative Law Judge Cannici (ALJ) dated July 19, 2007 that determined that the claimant suffered a compensable injury and found the respondents financially responsible for all of the claimant's reasonable and necessary medical treatment that is related to his industrial injury. The ALJ reserved any issues not resolved by the order for future determination. We dismiss the petition to review without prejudice.
A hearing was held on a number of the issues including compensability and medical benefits. Following the hearing the ALJ entered an order finding the claim compensable and making a general award requiring the provision of reasonable and necessary medical benefits that were related to the industrial injury. In the conclusions of law section of his order the ALJ noted that the employer failed to refer the claimant for treatment or designate an authorized treating physician and that, therefore, the right of selection had passed to the claimant. The ALJ found that based on the familiarity of Dr. Baer and Dr. Briggs with the claimant's condition, they were designated as authorized treating physicians.
The respondents filed a petition to review arguing that the ALJ erred in denying them an opportunity to show good cause for late endorsement of witnesses. The respondents contend that the denial of late endorsement constituted an abuse of discretion and a denial of due process.
Under § 8-43-301(2), C.R.S. 2007, a party dissatisfied with an order "which requires any party to pay a penalty or benefits or denies a claimant a benefit or penalty," may file a petition to review. Orders, which do not require the payment of benefits or penalties, or deny the claimant benefits or penalties, are interlocutory and not subject to review. Natkin Co. v. Eubanks, 775 P.2d 88 (Colo.App. 1989). Furthermore, orders, which determine liability for benefits, without determining the amount of benefits, do not award or deny benefits as contemplated by this statute, and consequently, are not subject to review. Oxford Chemicals, Inc. v. Richardson, 782 P.2d 843 (Colo.App. 1989) (order may be partially final and reviewable and partially interlocutory); CF I Steel Corp. v. Industrial Commission, 731 P.2d 144 (Colo.App. 1986).
We have previously held that orders determining compensability and containing only a general award of medical benefits are interlocutory, unless the record reveals that specific medical benefits were at issue. See, e. .g,. Gonzales v. Public Service Co. of Colorado, W.C. No. 4-131-978 (May 14, 1996); Tilton v. ABC Turf Care, W.C. No. 3-105-542 (August 18, 1994). Here, although the ALJ determined that the claimant had sustained a compensable injury, the ALJ only ordered the respondents to pay for reasonable and necessary medical treatment that is related to his industrial injury, reserving other issues for future determination.
The claimant has cited Bestway Concrete v. Panel 984 P.2d 680 (Col. App. 1999) for the proposition that an order that respondents are responsible for paying medical benefits is final for purposes of appeal. In our view the claimant's reliance on Bestway is misplaced. In Bestway the court noted that the Panel's order finally and conclusively directed the employer to pay temporary total disability benefits to the claimant for the period from April 15, 1996 to August 5, 1997. Under those circumstances the court concluded that the order they were asked to review was one that directed the employer to pay benefits and was, therefore, a final order for purposes of review. Here, the ALJ only ordered the respondents to pay all of the claimant's "reasonable and necessary medical treatment" that was related to his industrial injury. The finding that Dr. Baer and Dr. Briggs are authorized, but without a specific corresponding award or denial of payment for their treatment, is not a final order for purposes of appellate review.
The claimant also cites American Express v. Industrial Commission 712 P.2d 1132 (Colo.App. 1985), which generally provides that payment of medical expenses constitutes the payment of compensation under the act and a petition may be filed on any order requiring the payment of benefits. However, as we read the order the ALJ only decided authorization regarding Dr. Baer and Dr. Briggs. "Authorization" refers to the physician's legal authority to treat, and is distinct from whether treatment is "reasonable and necessary" within the meaning of § 8-42-101(1)(a), C.R.S. 2007. Mason Jar Restaurant v. Industrial Claim Appeals Office, 862 P.2d 1026 (Colo.App. 1993). A finding that treatment is "authorized" is not itself a "medical benefit." One Hour Cleaners v. Industrial Claim Appeals Office, 914 P.2d 501 (Colo.App. 1995). Accordingly, we have previously held that an order which determines a physician's "authorization," but does not award or deny payment for that physician's treatment, is not a final order for purposes of appellate review. See Matthews v. United Parcel Service, W.C. No. 4-325-652 (December 15, 1997); Fernandez v. City and County of Denver, W.C. No. 4-122-784 (February 7, 1996); Churchill v. Goodyear Tire and Rubber Co., W. C. No. (April 17, 1995). Orders determining the identity of the authorized provider are not final and reviewable unless the reasonableness of the provider's medical treatment is resolved. Rosas v. DDC Interiors, Inc., W.C. No. 4-364-828 (August 18, 1999); Tilton v. ABC Turf Care, supra. The rationale for these decisions is that the respondents maintain the right to contest the reasonableness and necessity for particular medical benefits. E.g. Rosas v. DDC Interiors, Inc., supra; Tilton v. ABC Turf Care, supra; Mockmore v. Joslins W. C. No. 4-343-875 (July 5, 2002). We adhere to our prior conclusions.
There is some ambiguity in the ALJ's order. We note that the ALJ found at one point that "As found, Claimant has established by a preponderance of the evidence that he is entitled to authorized medical treatment that is reasonable and necessary to cure and relieve the effect of his industrial injury. Claimant's need for medical treatment subsequent to September 14, 2006 was designed to alleviate the effects of this industrial injury." We do not read this as determining that specific medical treatment was reasonable and necessary. Certainly in the order portion of his decision the ALJ did not direct the respondents to pay any specific medical benefits, but made only a general award of medical benefits. Under these circumstances the order does not direct the employer or insurer to pay benefits.
IT IS THEREFORE ORDERED that the petition to review the ALJ's order dated July 19, 2007 is dismissed without prejudice.
INDUSTRIAL CLAIM APPEALS PANEL
_______________________ John D. Baird
_______________________ Thomas Schrant
H R REPAIR TOWING INC, Attn: LARRY RAY, PO BOX 604, JOHNSTOWN, CO, 80534 (Employer).
PINNACOL ASSURANCE, Attn: HARVEY D FLEWELLING, ESQ., 7501 E LOWRY BLVD, DENVER, CO, 80230 (Insurer).
MINTZ LAW FIRM, Attn: ERIC STATON, ESQ., 605 PARFET ST STE 102, LAKEWOOD, CO, 80215 (For Claimant).
RITSEMA LYON PC, Attn: DOUGLAS L STRATTON, ESQ., 2629 REDWING ROAD STE 330, FT COLLINS, CO, 80526 (For Respondents).