W.C. No. 4-625-226.Industrial Claim Appeals Office.
October 19, 2005.
FINAL ORDER
The respondents seek review of an order dated April 28, 2005 of Administrative Law Judge Coughlin (ALJ) that found the claimant had established a compensable claim, was entitled to medical benefits, temporary total disability benefits (TTD) and that Dr. Sunthankar is the claimant’s authorized treating physician (ATP). We dismiss without prejudice the appeal for lack of a final order with reference to Dr. Sunthankar’s status as the claimant’s ATP. The ALJ’s order is otherwise affirmed.
The ALJ’s pertinent findings of fact are as follows. On August 27, 2004 the claimant spent the night clearing heavy pallets for the employer and when she picked up a ten pound box from the floor she felt a sharp pain between her legs, in her groin area, and her right leg was very painful. The claimant was unable to deal with the abdominal and groin pain and the store manager called for an ambulance. The claimant was seen at the emergency room and discharged with a final diagnosis of pelvic pain, musculoskeletal pain and ovarian cyst. The attending physician took her off work until August 31, 2004 and suggested she follow up with her workers’ compensation physician. The physician’s first report from the emergency room dated August 28, 2004 specifically states an initial diagnosis of muscle strain, a work status of unable to return to regular work until 8-31-04, and the injury reported was noted to be work related.
The claimant was seen at another medical facility on March 31, 2004, where she was seen by a physician assistant who took a medical history but without performing a physical exam determined that the claimant had an ovarian cyst which was quite large, and seemed to be the area that most of her pain was initially coming from. The physician assistant determined that “we are going to deny workman’s comp at this time and place her at MMI.”
The claimant also saw her family physician Dr. Sunthankar, who noted that the claimant possibly had an ovarian cyst, and that the claimant had other problems including depression. The claimant eventually returned to work in October 2004.
The respondents introduced into evidence extensive medical records showing that the claimant had a history of cysts and abdominal pain. In addition the respondents introduced a medical report that opined that the claimant did not have a work-related injury since the claimant had a history of very similar symptoms going back as far as 1995 and was episodic since that time.
On review the respondents argue that the order of the ALJ which found that the claimant had suffered a compensable injury is not supported by substantial evidence in the record since there is extensive evidence that the claimant sustained a rupture of a cyst which caused severe abdominal pain and that she had similar problems in the past. The respondents contend that there is no credible evidence to support the ALJ’s finding that the claimant sustained a work-related muscle strain. We disagree.
The question of whether the claimant proved the requisite causal relationship is one of fact for determination by the ALJ. Faulkner v. Industrial Claim Appeals Office, 12 P.3d 844 (Colo.App. 2000). Because these issues are factual in nature, we must uphold the ALJ’s findings if supported by substantial evidence in the record. Section 8-43-301(8), C.R.S. 2005. Substantial evidence is that quantum of probative evidence that would support a reasonable belief in the existence of a fact without regard to conflicting evidence or inferences. Monfort, Inc. v. Rangel, 867 P.2d 122 (Colo.App. 1993) This standard of review requires us to view the evidence in the light most favorable to the prevailing party and to defer to the ALJ’s resolution of conflicts in the evidence, credibility determinations, and plausible inferences drawn from the record. If the record supports two possible inferences, it is the ALJ’s prerogative to determine which inference to draw. Wilson v. Industrial Claim Appeals Office, 81 P.3d 1117 (Colo.App. 2003). Moreover, the ALJ only need enter specific factual findings concerning the evidence she found to be dispositive, and conflicting evidence and inferences are presumed to have been rejected. Magnetic Engineering, Inc. v. Industrial Claim Appeals Office, 5 P.3d 385 (Colo.App. 2000).
Here substantial evidence supports the ALJ’s determinations that the claimant sustained a work-related muscle strain on August 28, 2004. The testimony of the claimant and the reports from the emergency room all support such a finding. Although there was certainly evidence in the record from which the ALJ could have drawn a contrary inference, it was nonetheless a plausible inference from the record that the claimant, despite the existence of other problems, also suffered a muscle strain at work on August 31, 2004. Thus, the ALJ’s finding on compensability is supported by the record and we may not disturb it. See Metro Moving Storage v. Gussert, 914 P.2d 411 (Colo.App. 1995).
The respondents further argue that there was no basis for the ALJ to determine that Dr. Sunthankar became an authorized treating physician. However, in our opinion this portion of the order is interlocutory and not currently reviewable. Under § 8-43-301(2), C.R.S. 2005, 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).
Section 8-42-101(1)(a), C.R.S. 2005, provides that respondents are liable for all emergency and authorized medical treatment which is reasonable and necessary to cure or relieve the effects of the industrial injury. Snyder v. Industrial Claim Appeals Office, 942 P.2d 1337
(Colo.App. 1997). “Authorization” refers to the physician’s legal authority to treat, and is distinct from whether treatment is “reasonable and necessary” within meaning of § 8-42-101(1)(a), C.R.S. 2005. 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). We adhere to our previous conclusions.
Here, the ALJ determined the claimant proved a compensable claim and her entitlement to reasonable and necessary medical benefits. The ALJ also determined that Dr. Sunthankar is the claimant’s ATP. However, the ALJ did not determine what treatment was reasonably necessary, and the parties did not stipulate to the reasonableness of any treatment. Consequently, the order does not award or deny the claimant any particular medical benefit and, is not currently subject to review Director of Division of Labor v. Smith, 725 P.2d 1161 (Colo.App. 1986).
IT IS THEREFORE ORDERED that the respondents’ petition to review the ALJ’s order in so far as it determined Dr. Sunthankar is the claimant’s ATP is dismissed without prejudice.
IT IS FURTHER ORDERED that the ALJ’s order dated April 28, 2005, is otherwise affirmed.
INDUSTRIAL CLAIM APPEALS PANEL
Cynthia T. Bollig, Frederick, CO, Petco, Northglenn, CO, Fidelity
Guaranty Insurance Co., c/o Cheryl Shelby, Specialty Risk Services, Inc., Denver, CO, Thomas C. Thrush, Esq., Denver, CO, (For Claimant).
Tama L. Levine, Esq., Denver, CO, (For Respondents).