W.C. No. 4-426-466.Industrial Claim Appeals Office.
June 10, 2008.
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FINAL ORDER
The claimant seeks review of an order of Administrative Law Judge Jones (ALJ) dated January 7, 2008 that denied the claimant’s request for maintenance medical benefits. We affirm.
The ALJ’s pertinent findings of fact are as follows. The claimant suffered an admitted work injury to his low back in 1999. The claimant was placed at maximum medical improvement on April 6, 2000 and the authorized treating physician recommended that the claimant wean himself from narcotics. The claimant underwent a Division Independent Medical Examination (DIME) and the DIME physician recommended that the claimant should continue his pain medications. The respondents filed a Final Admission consistent with the DIME physician’s opinion regarding impairment and admitted for Grover medical benefits consistent with the authorized treating physician’s opinion. See Grover v. Industrial Commission, 759 P.2d 705 (Colo. 1988). The claimant was treated by a number of physicians many of whom suspected the claimant of drug-seeking behavior and recommended that the claimant be weaned of narcotic medications. In 2007, the claimant’s authorized treating physician opined that the claimant’s medication regime should be limited to anti-inflammatory, non-steroidal medication instead of narcotic pain medications and released the claimant from care. The claimant began treatment at a community health center where he received narcotic pain medication through Medicaid. The claimant was not deemed a credible witness. The ALJ concluded that the claimant failed to sustain his burden of proof to establish by a preponderance of the evidence that he required reasonably necessary and related maintenance medical benefits in the form of narcotic medications.
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On appeal, the claimant contends that the ALJ erred in placing the burden of proof upon the claimant to prove by the preponderance of the evidence that he was entitled to continuing maintenance treatment. The claimant argues that the respondents failed to follow the statutory remedy under § 8-43-303-(2)(b) C.R.S. 2007 to reopen the claim.
The fact that the respondents filed an admission of liability for medical benefits did not amount to an admission that any subsequent medical treatment requested by the claimant was causally related to the industrial injury. On the contrary, the respondents remained free to dispute the cause of the need for particular medical treatment, and the respondents’ election to do so did not shift the burden of proof away from the claimant. See Snyder v. Industrial Claim Appeals Office, 942 P.2d 1337 (Colo.App. 1997); Velarde v. Sunland Construction, W.C. No. 4-412-975 (December 4, 2001); see also, Combs v. Cumulus Media, Inc., W.C. Nos. 4-592-503 4-608-960 (November 13, 2007) (discussing ALJ’s retention of jurisdiction after DIME to determine entitlement to specific medical treatment under preponderance of evidence standard). Therefore, we perceive no error in the ALJ’s placement of the burden of proof.
We agree with the respondents that the ALJ properly recognized that the respondents retain the right to contest liability for specific medical treatment on grounds such treatment is unnecessary, unauthorized or unrelated to the industrial injury. Therefore, the issue of Grover
medical benefits was not “closed,” and no petition to reopen was necessary for the respondents to dispute their liability for specific treatment. Hailemichael v. OEA, Inc., W.C. No. 4-382-985 (November 17, 2004). Applying this principle, we perceive no basis on which to interfere with the ALJ’s order.
IT IS THEREFORE ORDERED that the ALJ’s order issued January 7, 2008 is affirmed.
INDUSTRIAL CLAIM APPEALS PANEL
_______________________ John D. Baird
_______________________ Thomas Schrant
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DAMON GEIST, JOHNSTOWN, CO, (Claimant).
VALLEY BLOCK, INC., LOVELAND, CO, (Employer).
PINNACOL ASSURANCE, Attn: HARVEY D FLEWELLING, ESQ., DENVER, CO, (Insurer).
RING ASSOCIATES, PC, Attn: JESS PEREZ, ESQ., FT, COLLINS, CO, (For Claimant).
RUEGSEGGER SIMONS SMITH STERN, LLC, Attn: DAVID SMITH, ESQ., DENVER, CO, (For Respondents).
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