Opinion
W.C. No. 4-714-364.
April 13, 2010.
FINAL ORDER
The claimant seeks review of an order of Administrative Law Judge Walsh (ALJ) dated November 17, 2009 that determined that the respondents' final admission of liability was not defective and that it closed the claim. We affirm.
A hearing was held on the sole issue whether the respondents' final admission of liability was valid and whether it closed the claim. Following the hearing the ALJ entered factual findings that for the purposes of this order may be summarized as follows. The claimant sustained a work-related injury and reached maximum medical improvement on May 15, 2007, with no permanent impairment. The insurer's claims adjuster, Lucy Arguello, received the report of maximum medical improvement on June 8, 2007, and filed a final admission of liability on that date. The final admission contained a typographical error in that it was dated May 8, 2007 rather than June 8th. Arguello was unable to correct the copy sent to the Division; however, she retrieved the copies to be sent to the claimant and the parties and wrote in the correct date by hand. The claimant testified that he did not receive a copy of the final admission and therefore could not object to it. However, the ALJ found that he received temporary total disability benefit checks at the same address, and that when they stopped the claimant's wife called to inquire about the reason. The ALJ also found that the claimant received various other correspondence from Arguello, including general admissions, letters demanding that he undergo medical treatment, and other letters. The ALJ found that the claimant received the final admission in June 2007.
Based upon his factual findings, the ALJ concluded that the claim was closed by the final admission of liability and the claimant's failure to object to it. The claimant appealed and argues that the ALJ erred in two respects. Specifically, the claimant states the issues on appeal as (1) whether the ALJ erred in not addressing the issues whether the final admission was valid and whether it closed the claim, and (2) whether the ALJ erred in determining that the claim was closed. As relief the claimant seeks an order ruling that the final admission did not properly close the claim and that it remained open. In the alternative, the claimant requests that the matter be remanded for further proceedings on the issue whether the final admission was valid. Specifically, the claimant requests another hearing "to more fully develop the evidentiary record specifically on the issue of whether the Final Admission can serve to close the claim." Claimant's Brief in Support of Petition to Review at 12-13 (unpaginated). We do not understand the claimant to be arguing that the ALJ erred in determining that the claimant received the final admission of liability and that he did not object. Rather, the thrust of the claimant's argument is that the adjuster's action of striking the incorrect date of the final admission and entering by hand the correct date invalidated the admission so that it did not close the claim. However, we are unpersuaded by this argument.
First, we reject the claimant's argument that the ALJ erred in concluding that the final admission closed the claim. The Workers' Compensation Act and the rules contain the procedures used for the closure of claims. Section 8-43-203 (2)(b)(II), C.R.S. provides that a final admission must notify the claimant of the possible closure of the claim. The statute provides as follows:
An admission of liability for final payment of compensation shall include a statement that this is the final admission by the workers' compensation insurance carrier in the case, that the claimant may contest this admission if the claimant feels entitled to more compensation, to whom the claimant should provide written objection, and notice to the claimant that the case will be automatically closed as to the issues admitted in the final admission if the claimant does not, within thirty days after the date of the final admission, contest the final admission in writing and request a hearing on any disputed issues that are ripe for hearing.
Accordingly, the failure to file a written objection to a final admission and an application for hearing on the disputed issues within 30 days closes the claim on all admitted issues. Dyrkopp v. Industrial Claim Appeals Office 30 P.3d 821 (Colo. App. 2001). Here, it is undisputed that the claimant did not object to the final admission. We agree with the ALJ that the effect of the claimant's failure to file an objection and an application for hearing endorsing any ripe issues was to close the claim. See Olivas-Soto v. Industrial Claim Appeals Office, 143 P.3d 1178 (Colo. App. 2006); Leprino Foods v. Industrial Claim Appeals Office, 134 P.3d 475 (Colo. App. 2005); Peregoy v. Industrial Claim Appeals Office, 87 P.3d 261 (Colo. App. 2004).
One obvious purpose of the procedures set forth in § 8-43-203(2)(b)(II) is to provide the claimant with formal notice of the issues admitted and denied by the respondents, and the bases for those actions, and to permit the claimant to make an informed decision regarding whether to contest the final admission. The statute also provides a mechanism for notifying the claimant of the impending closure of his claim, subject to his right to object on specific disputed issues. Tenorio v. Poudre Valley Hospital, W.C. No. 4-162-954 (March 18, 1999). The purpose of procedures surrounding the filing of final admission is for the respondents to notify the claimant regarding admitted and denied issues and for the claimant to determine whether to permit the claim to close or to contest those issues.
In connection with this argument, we also reject the claimant's contention that the final admission was invalid because on the claimant's copy the claims adjuster struck out the erroneous date and wrote in the correct date by hand. It is true that we have previously ruled that a final admission containing certain deficiencies might fail to close issues effectively because of those deficiencies. For example, the failure to attach the AMA Guides worksheets can vitiate a final admission of liability and relieve the claimant of the duty to object to it. E.g., Sinkey v. Paint Connection Plus, W.C. 4-714-996 (March 2, 2009); McCotter v. U. S. West Communications, Inc., W.C. No. 4-430-792 (March 25, 2002); Siegmund v. Fore Property Company, W.C. No. 4-649-193 (January 30, 2007). In those orders we held that a final admission of liability that does not include the rating physician's entire report, including both the narrative discussion and the ratings worksheets required by Rule 5-5(A) is legally insufficient. However, the rationale for the holding in those cases was that the statute requires medical reports to be filed and "is designed to promote intelligent decision making by claimants" by informing them of the factual predicates for the admission and providing them with a basis to decide whether grounds exist to contest the final admission. McCotter v. U.S. West Communications, Inc., supra.
Here, no similar rationale applies. The final admission received by the claimant fully informed him of the factual predicate for the admission, fully advised him of the issues admitted and denied, and fully promoted intelligent decision making on the claimant's part in determining whether to object to the final admission. Further, the final admission sent to the claimant contained the correct date, albeit in handwritten form, and it cannot reasonably be argued that that could have been the source of any confusion on the part of the claimant. Indeed, the claimant has argued throughout the proceedings that he never received the final admission, which the ALJ rejected as not credible. There has therefore been no contention that the discrepancy between the dates on the final admission filed with the Division and on the one sent to the claimant created any confusion or uncertainty about anything in connection with the final admission. As noted, because the final admission accurately advised the claimant of the issues admitted and denied and of his options regarding objecting to the admission, we are unpersuaded that the hand-written date invalidated the final admission.
The claimant has also argued that because the ALJ did not resolve the question whether the final admission was invalidated by the corrected date, it is necessary to remand the matter to him with instructions to adjudicate that issue. However, in our view, by ruling that the claim was closed by the final admission the ALJ implicitly rejected the argument that the admission was invalid. Because the facts related to the validity of the final admission are undisputed, and because the question whether the admission is valid is one of law given the undisputed facts, it is unnecessary to remand for consideration of that question.
Finally, the claimant requests that we remand the matter "to more fully develop the evidentiary record specifically on the issue of whether the Final Admission can serve to close the claim." However, our review of the record satisfies us that all parties were afforded a full opportunity to present evidence and testimony, to cross-examine adverse witnesses, and to make legal arguments in support of claims and defenses. See Wafford v. Industrial Claim Appeals Office, 907 P.2d 741 (Colo. App. 1995); Nesbit v. Industrial Commission, 43 Colo. App. 398, 607 P.2d 1024 (1979). Under these circumstances, and given that we have found no error in the ALJ's order, a remand to more fully develop the record is not warranted.
IT IS THEREFORE ORDERED that the ALJ's order issued November 17, 2009 is affirmed.
INDUSTRIAL CLAIM APPEALS PANEL
____________________________________ John D. Baird
____________________________________ Curt Kriksciun
ALEX OLGUIN, 1514 N LINDEN AVENUE, TRINIDAD, CO, (Claimant).
RENT A CENTER, TRINIDAD, CO, (Employer).
FIDELITY GUARANTY, Attn: LUCY ARGUELLO, DENVER, CO, (Insurer).
STEVEN U MULLENS, PC, Attn: KIMBERLY ROEPKE WHITING, ESQ., PUEBLO, CO, (For Claimant).
RITSEMA LYON, Attn: KYLE L. THACKER, ESQ., DENVER, CO, (For Respondents).