W.C. No. 3-944-475Industrial Claim Appeals Office.
November, 1996
ORDER OF REMAND
The claimant seeks review of an order of Administrative Law Judge Wheelock (ALJ) dated April 9, 1996. We set aside the order, and remand for further proceedings.
A brief procedural history is necessary to understand the issues on review. The claimant suffered industrial injuries in 1989. However, in a Supplemental Order dated April 15, 1992, former Administrative Law Judge Kubitschek (ALJ Kubitschek) determined that the claimant suffered an intervening, non-industrial injury on November 15, 1989, and denied further disability or medical benefits. ALJ Kubitschek’s Supplemental Order was affirmed on appeal.
On April 7, 1995, the claimant filed a Petition to Reopen the claim, and alleged an “error or mistake” by ALJ Kubitschek in determining that the claimant suffered an intervening injury See§ 8-43-303(1), C.R.S. (1996 Cum. Supp.). By letter dated April 24, 1995, the respondents notified the Division of Workers’ Compensation that the respondents had “voluntarily reopened” the claim. The respondents also paid certain medical benefits.
However, the respondents subsequently asserted that the April 24 letter was mistakenly filed, and objected to reopening the claim. Further, the respondents argued that the claimant was barred from litigating the issue of whether her condition was attributable to an intervening injury under the doctrine of collateral estoppel.
In response, the claimant asserted that the respondents’ April 24 letter and payment of medical benefits reopened the claim, and constituted a “waiver” of the argument that the claimant must establish grounds to reopen the claim. The claimant then applied for a hearing on her claim for further medical and disability benefits.
A pre-hearing order stated that the sole issue before the ALJ was “compensability.” However, the ALJ determined that the claimant was barred from relitigating the issue of “compensability” under the doctrine of collateral estoppel. Therefore, the ALJ vacated the hearing, and effectively denied the claim for additional benefits.
On appeal, the claimant reasserts her “waiver” argument. The claimant further contends that because the respondents voluntarily reopened the claim, the doctrine of collateral estoppel does not apply to the facts of this claim. Therefore, the claimant argues that the ALJ erred in vacating the hearing on that basis. We agree, although for reasons other than those asserted by the claimant.
Collateral estoppel precludes the relitigation of an issue that has been fully litigated and resolved in a separate proceeding involving the party against whom the doctrine is sought to be applied. Lindner Chevrolet v. Industrial Claim Appeals Office, 914 P.2d 496 (Colo.App. 1995). The doctrines of res judicata and law of the case are applicable to preclude the relitigation of an issue in the same or claim or proceeding. El Paso County Department of Social Services v. Donn, 865 P.2d 877 (Colo.App. 1993); Verzuh v. Rouse, 660 P.2d 1301 (Colo.App. 1982).
However, these doctrines are not applicable where a party seeks to reopen the claim as permitted by § 8-43-303(1) of the Workers’ Compensation Act. See Renz v. Larimer County School Dist. Poudre R-1, ___ P.2d ___ (Colo.App. No. 95CA1300, June 27, 1996). This is true because the reopening provisions indicate “a strong legislative policy to the effect that in worker’s compensation cases the goal of achieving a just result overrides the interest of litigants achieving a final resolution of their dispute.” Padilla v. Industrial Commission, 696 P.2d 273 (Colo. 1985); Standard Metals Corp. v. Gallegos, 781 P.2d 142 (Colo.App. 1989). In fact, the reopening provisions expressly contemplate the ALJ’s reconsideration of the claimant’s entitlement to specific benefits, and provide that benefits previously awarded in a final order may be “ended, diminished, maintained or increased,” upon the ALJ’s finding of an error, mistake, or change in the claimant’s condition. Lewis v. Scientific Supply Co., 897 P.2d 905 (Colo.App. 1995).
For example, in Standard Metals Corp. v. Gallegos, supra, the doctrine of res judicata did not preclude claimant from relitigating the issue of whether he suffered a compensable injury, even though the issue was previously litigated and resolved against the claimant. To the contrary, the claimant was allowed to present newly discovered medical evidence in support of his assertion that the prior order mistakenly determined that his renal disease was not related to his work activities.
Because the reopening statute expressly entitles the claimant to request the reopening of a claim based upon an “error or mistake” in the prior award, the ALJ erred in concluding that the claimant was barred from relitigating the issue of whether her condition is causally related to the industrial injury. Rather, the claimant should have been afforded an opportunity to show there was an “error or mistake” which would justify reopening the claim. See Travelers Insurance Co. v. Industrial Commission, 646 P.2d 399, 400 (Colo.App. 1981). Moreover, because the ALJ vacated the hearing prior to allowing the claimant to make such a showing, we cannot say as a matter of law that the ALJ exercised her discretion in declining to reopen the claim. Consequently, the matter must be remanded for further proceedings concerning the claimant’s petition to reopen.
In remanding the matter, we are aware of the claimant’s contention that the claim has been reopened as a result of the respondents’ April 24, and that she is therefore not required to prove an error or mistake which justifies reopening the claim. However, even assuming, arguendo, that the respondents’ April 24 letter constitutes an “admission” that the claim was reopened, that is not dispositive of the claimant’s entitlement to further benefits. The respondents may obtain prospective relief from an improvidently filed admission, and contrary to the claimant’s assertion, that relief is not dependent on proof that the “admission” was fraudulently induced. HLJ Management Group v. Kim, 804 P.2d 250 (Colo.App. 1990); compare Vargo v. Industrial Commission, 626 P.2d 1164 (Colo.App. 1981) (retroactive relief from an admission of liability may be granted where the admission was induced by fraud).
Insofar as the respondents’ April 24 correspondence may be construed as an admission that there was an error or mistake in the prior order, the respondents sought relief from that “admission.” However, we note that the respondents are not seeking to recover medical benefits that were previously paid. Consequently, the respondents placed the Petition to Reopen, and the alleged error or mistake before the ALJ for resolution HLJ Management Group v. Kim, 804 P.2d at 253.
Accordingly, on remand, the ALJ must determine whether there was an “error or mistake” which warrants reopening this claim and awarding further benefits. Before making this determination, the claimant must be allowed to present evidence or otherwise make a showing in support of her assertion that there was such an “error or mistake.” The ALJ may then determine whether the claimant’s assertions warrant reopening the claim, and if so, permit further proceedings on the claimant’s entitlement to additional benefits. Standard Metals Corp. v. Gallegos supra. Conversely, if the ALJ decides that the claim should not be reopened, there would be no basis for awarding further benefits.
IT IS THEREFORE ORDERED that the ALJ’s order dated April 9, 1996, is set aside, and the matter is remanded to the ALJ for further proceedings consistent with the views expressed herein.
INDUSTRIAL CLAIM APPEALS PANEL
____________________________________ Kathy E. Dean
____________________________________ Bill Whitacre
Copies of this decision were mailed November 5, 1996 to the following parties:
Janice Geuder, 1128 W. Colorado, #12, Colorado Springs, CO 80904
National Union Fire Ins. of Pit., American Int. Adj. Co., P.O. Box 32130, Phoenix, AZ 85018
Patty Enloe, Crawford Co., P.O. Box 6502, Englewood, CO 80155-6502
James E. Freemeyer, Esq., 1660 Downing St., Denver, CO 80218-1529 (For the Claimant)
Lynda S. Newbold, Esq., 1777 S. Harrison, #1110, Denver, CO 80210 (For the Respondents)
BY: _______________________