W.C. No. 4-272-967Industrial Claim Appeals Office.
March 9, 2000
FINAL ORDER
The claimant seeks review of an order of Administrative Law Judge Stuber (ALJ) insofar as it determined the claimant reached maximum medical improvement (MMI) on April 14, 1997, denied the claim for medical impairment benefits, and denied the claim for certain medical benefits including benefits under Grover v. Industrial Commission, 759 P.2d 705 (Colo. 1988). We affirm.
The Division-sponsored independent medical examination (IME) physician opined that the claimant reached MMI for his back injury on April 14, 1997. The Division IME physician assigned a “zero percent” medical impairment rating because of “much amplification of pain behavior” and the absence of “objective findings to support [the claimant’s] subjective complaints.” The ALJ found the claimant failed to overcome the Division IME physician’s determination of MMI, or the impairment rating, by clear and convincing evidence.
The ALJ also found that treatment rendered by Dr. Rook was not reasonable and necessary after the four visits for which the claimant was originally referred. Finally, the ALJ found the claimant failed to prove the need for ongoing medical benefits under Grover.
The claimant filed a timely petition to review, in which he disputes the ALJ’s denial of additional temporary disability benefits, the denial of medical impairment benefits, and the denial of additional medical treatment. However, the petition to review contains only general allegations of error concerning the sufficiency of the evidence and the propriety of the ALJ’s legal conclusions. The claimant did not file a brief in support the petition to review. Thus, the effectiveness of our review is limited.
The claimant was required to prove by clear and convincing evidence that the Division IME incorrectly determined the date of MMI, and incorrectly assessed the “zero percent” impairment rating. Metro Moving and Storage Co. v. Gussert, 914 P.2d 411
(Colo.App. 1995); Postlewait v. Midwest Barricade, 905 P.2d 21
(Colo.App. 1995). Because these issues are factual nature, we must uphold the ALJ’s determinations if supported by substantial evidence in the record. § 8-43-301 (8), C.R.S. 1999.
We have reviewed the ALJ’s findings of fact and conclusions of law concerning MMI and the impairment rating. The ALJ’s comprehensive findings of fact are supported by substantial, albeit conflicting, evidence in the record. Further, the ALJ recognized the applicable legal standards. Consequently, for the reasons stated in the ALJ’s order, we decline to interfere with the date of MMI or the denial of medical impairment benefits.
The question of whether Dr. Rook’s treatment was reasonable and necessary was also one of fact for the ALJ. City of Durango v. Dunagan, 939 P.2d 496 (Colo.App. 1997). Here, the evidence supports the ALJ’s determination that Dr. Rook did not provide any necessary treatment beyond the four visits for which the original referral was made. Similarly, for the reasons stated in the ALJ’s order, the record supports the conclusion that the claimant failed to prove the need for ongoing medical benefits after MMI.
IT IS THEREFORE ORDERED that the ALJ’s order dated May 17, 1999, is affirmed.
INDUSTRIAL CLAIM APPEALS PANEL ________________________________ David Cain ________________________________ Kathy E. Dean
NOTICE
This Order is final unless an action to modify or vacate this Order is commenced in the Colorado Court of Appeals, 2 East 14th Avenue, Denver, CO 80203, by filing a petition for review with the Court, within twenty (20) days after the date this Order is mailed, pursuant to § 8-43-301(10) and § 8-43-307, C.R.S. 1999. The appealing party must serve a copy of the petition upon all other parties, including the Industrial Claim Appeals Office, which may be served by mail at 1515 Arapahoe, Tower 3, Suite 350, Denver, CO 80202.
Copies of this decision were mailed March 9, 2000
to the following parties:
Calvin Arrington, 10919 Patterson Ct., Northglenn, CO 80234
Boyd Silkwood, B K Painting, 1417 Jetwing Circle, Colorado Springs, CO 80916
Laurie A. Schoder, Esq., Colorado Compensation Insurance Authority dba Pinnacol Assurance — Interagency Mail
BY: A. Pendroy