Opinion
W. C. No. 4-581-156.
January 18, 2007
FINAL ORDER
The claimant seeks review of an order of Administrative Law Judge Martinez (ALJ) dated August 21, 2006, that denied the claimant's request for temporary total disability benefits (TTD) for the period of January 3, 2003 to July 11, 2003. We affirm.
The ALJ's pertinent findings of fact are as follows. The claimant suffered a compensable injury on December 22, 2002, while assigned to work in Russia. The claimant's average weekly wage (AWW) was $2,734 for the expatriate assignment in Russia. The claimant's biweekly "base wage" was $1,453.85. The employer paid the claimant during a period of temporary disability from January 3, 2003 to July 11, 2003, biweekly checks for wages in the amount of his base pay of $1,453.85. The respondents filed an admission in December 2003, admitting compensability for the claim and admitting for TTD benefits beginning July 12, 2003 and continuing after that date at the maximum rate of $659.12. In the "remarks"section of the admission, the respondents stated that the claimant was continued on short-term disability wage benefits funded 100 percent by the employer from the date of injury to July 12, 2003, after which TTD benefits were paid to the claimant. In September 2004, the parties, acknowledging that the claimant had received biweekly payment of wages from January 3, 2002 to July 11, 2003, entered into a stipulation. It was agreed in the stipulation that the insurer would reimburse the employer for the amount that the claimant had received from the employer between January 3, 2003 and July 11, 2003. It was further agreed in the Stipulation that the claimant had no obligation to reimburse any money to either the employer or the insurer, because the payments made were equivalent (to the extent of the TTD rate of $659.12 per week) of TTD benefits, which the claimant would have been receiving had the claim been administered through the workers' compensation carrier. The stipulation was attached to the admission that was filed with the Division of Workers' Compensation in September of 2004. The claimant did not object to the general admission.
The ALJ found that the claimant had been paid for his lost wages for the period of January 3, 2003 to July 11, 2003 and that the claimant agreed in writing that the respondents' obligation to pay TTD benefits has been satisfied. Therefore, the ALJ dismissed the request for an order that the insurer pay the claimant TTD benefits for the period of January 3, 2003 to July 11, 2003. The ALJ reasoned that since the respondents' obligation had been satisfied the claimant was therefore not entitled to be paid additional TTD benefits for that period.
On appeal the claimant agrees that between January 3, 2003 and July 11, 2003 the employer had continued to pay his base wages at the rate of $1,453.85 biweekly or $726.92 a week which exceed the maximum rate for temporary total disability at the time of $659.12. However, the claimant argues that after applicable taxes and payroll deductions the claimant only received approximately $511.21 to $540 net per week. We note that these deductions also appear to included contributions made under the employer's 401(k) plan. Tr. at 4 16. Thus the net amount actually received by the claimant during the period in question was apparently less then the maximum rate of $659.12 a week for which the insurer had admitted. The claimant argues that there is no competent or credible evidence supporting the determination that the claimant was paid all TTD benefits owed from January 3, 2003 to July 11, 2003. We disagree.
The ALJ found, with record support, that the claimant has been paid for his lost wages for the period of January 3, 2003 to July 11, 2003 and that the claimant agreed in writing that the respondents' obligation to paysuch TTD benefits has been satisfied. The admission in question filed in this case provides in the remarks section as follows:
Employer paid claimant his base salary of $1,453.85 bi-weekly as wage continuation from 1/4/03 to 7/11/03 pursuant to C.R.S. 8-42-124, and the temporary disability benefits for that period have been reimbursed to the employer by the insurer, with the consent of all parties, pursuant to C.R.S. 8-42-124. Such wage continuation stopped on 7/11/03, and for that reason, the claimant has been paid by the insurer the amount of $659.12 per week as TTD from 7/12/03 and continuing. This is further explained in the attached Stipulation and Affidavit, which is incorporated by reference.
Exhibit C.
The stipulation referred to in the admission provides that, "Pursuant to the contractual arrangements and practices of the Respondent Employer, claimant was paid the sum of $1,453.85 bi-weekly from January 3, 2003 to July 11, 2003. Such payments were made pursuant to C.R.S. 8-42-124, as a continuation of Claimant's wages above the maximum Temporary total Disability Benefits rate of $659.12 per week then in effect." Exhibit D ¶ 4. The stipulation also provided that, "At this time the parties wish to confirm, agree, and document that the Insurer was obligated to pay Temporary Total Disability Benefits from the date of January 3, 2003, and that such obligation was fully satisfied by the payment of wage continuation benefits to the claimant for the 26, week period stated above." Exhibit D at ¶ 7. The Stipulation further provided that, "In accordance with this Stipulation, the respondent Insurer will file an Amended General Admission of Liability, attaching this Stipulation in fully signed form. Such Amended General Admission will admit for Temporary Total Disability Benefits from January 3, 2003 to July 11, 2003. It is understood in connection with this Amended General Admission that the liability for the payment of such benefits has been fully satisfied by the Respondent Employer's payment of wage continuation benefits to the Claimant for that period, and the subsequent reimbursement described above from the Insurer to the Respondent Employer." Exhibit D at ¶ 8.
We initially noted that the amended general admission of liability entered by the respondents was not a final admission and that the stipulation entered into by the parties did not comply with the statutory requirements of § 8-43-204, C.R.S. 2006. Our courts have consistently held that failure to adhere to the statutory requirements of § 8-43-204 prevents the enforcement of an alleged settlement. Administrative supervision of settlements, which is mandated by the statute, helps to ensure that settlements are fair, clear, understood by the parties, and in accordance with public policy. See Cook v. McLister, 820 P.2d 1167 (Colo.App. 1991); City Market v. Industrial Claim Appeals Office, 800 P.2d 1335 (Colo.App. 1990); Oxford Chemicals, Inc. v. Richardson, 782 P.2d 843 (Colo.App. 1989); Covert v. Navajo Express, Inc., W.C. No. 3-908-058 (December 18, 1995).
However, we do not read the ALJ's order as determining that the stipulation had the binding effect of an order, nor does the ALJ's order "enforce" the stipulation. Rather, the ALJ relied on the stipulation as evidence that the claimant had already been paid for lost wages during the period in question and that the respondents' obligation to pay such TTD benefits had been satisfied. See Schlage Lock v. Lahr, 870 P.2d 615 (Colo.App. 1993) (discussing judicial admissions); See also Sandoval v. Parkview Medical Center W. C. No. 4-501-083 (May 5, 2004) (parties may stipulate to certain facts).
Therefore, because the issue is factual in nature, we must uphold the ALJ's determination if supported by substantial evidence in the record. Section 8-43-301(8), C.R.S. 2006. This standard of review requires us to consider the evidence in a light most favorable to the prevailing party, and to defer to the ALJ's credibility determinations, resolution of conflicts in the evidence, and plausible inferences drawn from the record. Wilson v. Industrial Claim Appeals Office, 81 P.3d 1117 (Colo.App. 2003). Given that the record contains the stipulation attached to the admission, we cannot say that the ALJ's determination that the respondents' obligation to pay TTD benefits for the period in question had been satisfied is not supported by substantial evidence in the record.
IT IS THEREFORE ORDERED that the ALJ's order dated August 21, 2006, is affirmed.
INDUSTRIAL CLAIM APPEALS PANEL
____________________________________ Curt Kriksciun ____________________________________ Thomas Schrant
Matthew McCurry.
Weatherford International, Inc., Chelle McCurry, Houston, TX America International Underwriters, c/o AIG World Source, Letty Lopez, Walnut Glen Tower, Dallas, TX 75231 Withers, Seidman, Rice, P.C., David B. Muller, Esq., Grand Junction, CO 81502 (For Claimant).
Senter, Goldfarb Rice, LLC, William M. Sterck, Esq., Denver, CO 80290 (For Respondents).