W.C. No. 4-577-620.Industrial Claim Appeals Office.
September 13, 2004.
FINAL ORDER
The claimant seeks review of an order of Administrative Law Judge Harr (ALJ) which denied medical benefits and penalties. We affirm.
In March 2003 the claimant sustained an admitted strain injury to his left shoulder. In April 2003 the claimant began psychological counseling with Dr. Whitefeather for a post-traumatic stress disorder. The ALJ determined the claimant was not referred to Dr. Whitefeather in the normal progression of treatment by an authorized treating physician (ATP). Therefore, the ALJ determined Dr. Whitefeather’s treatment is not compensable in this claim.
The ALJ also found the claimant failed to prove the respondent precluded the ATPs from referring the claimant to Dr. Whitefeather. Therefore, the ALJ found no violation of §8-43-503(3), C.R.S. 2003 and denied the request for penalties.
The claimant’s Petition to Review contains only general allegations of error. See § 8-43-301(8), C.R.S. 2003. Further, the claimant has not filed a brief in support of the Petition to Review. Consequently, the effectiveness of our review is limited Ortiz v. Industrial Commission, 734 P.2d 642 (Colo.App. 1986).
A respondent is liable for all authorized medical treatment which is reasonable and necessary to cure or relieve the effects of the industrial injury. Sims v. Industrial Claim Appeals Office, 797 P.2d 777 (Colo.App. 1990). “Authorization” refers to the physician’s legal status to treat the injury at the respondent’s expense. Popke v. Industrial Claim Appeals Office, 944 P.2d 677 (Colo.App. 1997). A physician who commences to treat the industrial injury upon a referral made in the “normal progression of authorized treatment” becomes an authorized treating physician. Bestway Concrete v. Industrial Claim Appeals Office, 984 P.2d 680 (Colo.App. 1999); Greager v. Industrial Commission, 701 P.2d 168 (Colo.App. 1985).
The determination of whether there has been a referral in the “normal progression of authorized treatment” is a question of fact for resolution by the ALJ. City of Durango v. Dunagan, 939 P.2d 496 (Colo.App. 1997); Suetrack USA v. Industrial Claim Appeals Office, 902 P.2d 854 (Colo.App. 1995). We are bound by the ALJ’s determinations if supported by substantial evidence and plausible inferences drawn from the record. Section 8-4-301(8), C.R.S. 2003; Suetrack USA v. Industrial Claim Appeals Office, supra.
Under § 8-43-301(8) we are precluded from disturbing the ALJ’s order unless the ALJ’s findings of fact are insufficient to permit appellate review, the ALJ has not resolved conflicts in the evidence, the record does not support the ALJ’s findings, the findings do not support the order, or the order is not supported by the applicable law.
Here, the ALJ’s findings are sufficient to permit appellate review, and the findings indicate that the ALJ resolved the pertinent conflicts in the evidence. See Riddle v. Ampex Corp., 839 P.2d 489 (Colo.App. 1992). Further, there is substantial evidence in the medical records and the claimant’s testimony to support the ALJ’s finding that none of the ATPs referred the claimant to Dr. Whitefeather for psychological treatment. Therefore, the ALJ properly determined that Dr. Whitefeather is not an ATP and the respondent is not liable for Dr. Whitefeather’s treatment. See Sims v. Industrial Claim Appeals Office, supra.
We also reject the claimant’s contention the ALJ erred in failing to impose penalties for a violation of § 8-43-503(3). That statute provides that employers and insurers “shall not dictate to any physician the type or duration of treatment or degree of physical impairment.” However, the respondent may challenge the reasonableness and necessity for proposed medical treatment and require the claimant to prove the treatment is related to the industrial injury. Snyder v. Industrial Claim Appeals Office, 942 P.2d 1337 (Colo.App. 1997). Consequently, a respondent’s failure voluntarily to concede a causal relationship between the industrial injury and a request for particular treatment does not render the respondent subject to penalties for a violation of § 8-43-503(3). BCW Enterprises v. Industrial Claim Appeals Office, 964 P.2d 533 (Colo.App. 1997) Industrial Commission v. Continental Investment Co., 85 Colo. 475, 277 P. 303 (1929).
Here, the ALJ determined the respondent resisted payment for Dr. Whitefeather’s psychological treatment on grounds that no ATP had recommended psychological treatment for the industrial injury or referred the claimant to Dr. Whitefeather. The claimant’s contentions notwithstanding, the record supports the ALJ’s implicit determination that the ATPs exercised their independent judgment in refusing the claimant’s request for a referral to Dr. Whitefeather and that respondent did not affirmatively prevent the ATPs from making the requested referral. Therefore, we may not disturb the ALJ’s finding that the claimant failed to prove a violation of § 8-43-503(3), which would allow the imposition of penalties.
IT IS THEREFORE ORDERED that the ALJ’s order dated, January 13, 2004, is affirmed.
INDUSTRIAL CLAIM APPEALS PANEL
____________________________________ Kathy E. Dean
____________________________________ Robert M. Socolofsky
Tony Halford, Fraser, CO, Winter Park Resorts, Winter Park, CO, Brandee Haycock, L.W.P. Claims Solutions, Inc., Salt Lake City, UT, and Patricia Jean Clisham, Esq. and Keith E. Mottram, Esq., Larimer St., Denver, CO, (For Respondents).