Recent Colorado Appellate Decisions in Workers' Compensation Cases
| Publication year | 1996 |
| Pages | 119 |
1996, November, Pg. 119. Recent Colorado Appellate Decisions in Workers' Compensation Cases
The August 1996 Colorado Supreme Court case of Mountain City Meat Company v. Oqueda(fn1) is one of the most important decisions ever to have construed the 1991 amendments to the Colorado Workers' Compensation Act. The Supreme Court affirmed the Colorado Court of Appeals,(fn2) holding that where the worker suffers both a scheduled impairment and a whole person impairment as a result of the same industrial accident, the scheduled impairment will be converted to a whole person impairment and combined with the other whole person impairment to determine the worker's total medical impairment rating.
In reaching this conclusion, the Supreme Court held that CRS § 8-42-107(1) was ambiguous:
The court of appeals found the statute to be ambiguous and concluded that a harmonious reading could only be achieved by converting the extremity ratings to whole person ratings utilizing the AMA Guides referenced in the statute. We agree and hold that the whole person methodology must be utilized when the person has sustained both types of injury.(fn3)
CRS § 8-42-107(1) states:
(a) When an injury results in permanent medical impairment, and the employee has an injury or injuries enumerated in the schedule set forth in subsection (2) of this section, the employee shall be limited to medical impairment benefits as specified in subsection (2) of this section.
(b) When an injury results in permanent medical impairment and the employee has an injury or injuries not on the schedule specified in subsection (2) of this section, the employee shall be limited to medical impairment benefits as specified in subsection (8) of this section. [Emphasis added.]
Subsection (8) contains the formula for determining nonscheduled whole person impairment benefits. The court then noted:
All cases of permanent impairment fall into one of two categories: under subsection (1)(a), if all of the employee's injuries are not contained in the schedule set forth in subsection (2), injuries to the person are to be compensated pursuant to subsection (1)(b). The language of both subsections contains language of limitation. When the employee has an injury or injuries that are enumerated in the schedule, then the employee is limited to benefits specified in subsection (2). Likewise, when the employee has an injury or injuries that are not enumerated in the schedule, then the employee is limited to benefits specified in subsection (8). The focus of limitation is not the particular type of injury, but the employee. The purpose of the statute is to limit a person's recovery for the injury or injuries he or she sustained. . . . [T]he ambiguity requiring construction of the statute to effectuate its purpose arises because the employee may be compensated under one subsection or the other, but not both.(fn4)
The court held that the legislative declaration of policy set forth in CRS § 8-40-102(1) was the best guide to legislative intent and the resolution of this ambiguity. Section 8-40-102(1) states:
It is the intent of the general assembly that the "Workers' Compensation Act of Colorado" 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, recognizing that the workers compensation system in Colorado is based on a mutual renunciation of common law rights and defenses by employers and employees alike.
In response to the Colorado Compensation Insurance Authority's ("CCIA") argument that nothing in the statute required conversions to whole person ratings when the worker suffered both scheduled and nonscheduled injuries, the court held that in addition to looking at the declaration of purpose to find legislative intent, it was necessary to construe the statute as a whole and give consistent, harmonious, and sensible effect to all of its parts:
The AMA Guides are incorporated by the statute, and they explicitly contain a table for converting extremity injuries to a whole person rating. Section 8-42-101(3.7) requires that . . . "all physical impairment ratings used under [the Workers' Compensation Act] shall be based on the revised third edition of [the AMA Guides]. . . ." The director of the division of workers compensation . . . was required to promulgate rules establishing a system for the determination of medical impairment rating guidelines for impairment ratings based on the AMA Guides. These rules mandate that "all permanent ratings shall be based upon [the AMA Guides]' and that when determining permanent physical
Compare this holding with Duran v. Industrial Claim Appeals Office,(fn6) which upheld the constitutionality of the scheduled rating system where the only impairment is a scheduled one, and did so without reference to the AMA Guides and the director's rules, both of which require that in every case, extremity impairments be converted to whole impairments.
Oqueda does not offer any relief to workers who suffer from two or more scheduled impairments and no separate whole person impairment. In such situations, benefits for all impairments are paid pursuant to the schedule.
Broadmoor Hotel v. Industrial Claim Appeals Office(fn7) presents another important question concerning the computation of permanent medical impairment benefits. Here, the Court of Appeals held that wages from concurrent employment should be used to compute the temporary total disability ("TTD") rate used in the formula for computing permanent medical impairment benefits, even though the claimant had not missed any work from one of her two jobs.(fn8)
The court in Broadmoor Hotel held that "section 8-42-107(8) requires that payment of medical impairment benefits be based upon the temporary disability rate that claimant would have received if the claimant had been temporarily and totally disabled for more than three working...
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