W.C. No. 4-426-677Industrial Claim Appeals Office.
December 31, 2002
FINAL ORDER
The claimant seeks review of an order of Administrative Law Judge Klein (ALJ) which denied her petition to reopen a full and final settlement. We affirm.
The claimant suffered a compensable back injury. In June 1999 the claimant was evaluated by Dr. Cohen, who is a licensed psychotherapist. On July 9, 2001, the claimant filed a complaint against Dr. Cohen with the Colorado Department of Regulatory Agencies (Department). The claimant alleged unethical conduct by Dr. Cohen. In particular, the claimant alleged Dr. Cohen intentionally misdiagnosed her mental condition as nonwork- related to relieve the respondents of liability for mental impairment benefits. The claimant also alleged Dr. Cohen’s misleading evaluation was relied upon by those entities entrusted “with her emotional, and financial fate” which resulted in financial devastation to her and her children. The Department initiated an investigation of Dr. Cohen. In November 2001, Dr. Cohen stipulated to the existence of evidence he violated his professional license in the treatment of patients, not limited to the claimant.
In the interim, the claimant entered into a full and final settlement in which she waived all rights to further workers’ compensation benefits in exchange for a lump sum payment of $4,000. The settlement was approved by the Division of Workers’ Compensation on September 10, 2001. The settlement expressly waived the right to reopen the claim except on proof of fraud or a mutual mistake of material fact.
In April 2002, the claimant petitioned to reopen the settlement agreement on the grounds of error, mistake or fraud. The claimant moved for summary judgment reopening the claim. The respondents moved for summary judgment denying the petition to reopen.
Under C.R.C.P. 56 an ALJ may enter summary judgment where there are no disputed issues of material fact and the moving party is entitled to judgment as a matter of law. Nova v. Industrial Claim Appeals Office, 754 P.2d 800 (Colo.App. 1988) (C.R.C.P. apply insofar as not inconsistent with the procedural or statutory provisions of the Workers’ Compensation Act); Morphew v. Ridge Crane Service, Inc., 902 P.2d 848 (Colo.App. 1995). Accordingly, where the pertinent facts are undisputed, an ALJ may dispose of an issue without conducting a hearing. See Service Supply Co. v. Vallejos, 169 Colo. 14, 452 P.2d 387 (1969).
The ALJ determined that as a matter of law the record was insufficient to establish the settlement agreement was predicated on fraud or a mutual mistake of material fact. Consequently, the ALJ entered an order granting the respondents’ motion for summary judgment and denying the petition to reopen.
On review the claimant concedes the ALJ properly resolved the matter by summary judgment. However, the claimant contends the record compels the conclusion the settlement was based upon a mutual mistake concerning the accuracy of Dr. Cohen’s opinions. Further, the claimant contends she suspected but did not know Dr. Cohen’s evaluation failed to comply with applicable mental health standards until the Department completed its investigation and she was unable to secure vital evidence to conclusively prove Dr. Cohen’s unethical conduct prior to the date she entered into the settlement. Under these circumstances, the claimant argues the ALJ erred in denying her motion for summary judgment. We perceive no error in the ALJ’s determination.
I.
To reopen the claim on grounds of “fraud,” the claimant must prove that the respondents made false representations which the claimant relied upon to settle the claim. Morrison v. Goodspeed, 100 Colo. 470, 68 P.2d 458
(Colo. 1937); 8 A. Larson, Workmens’ Compensation Law, § 131.05(1)(b), at 131-57 (2000). Whether the claimant has sustained his burden of proof is a question of fact for resolution by the ALJ. Thus, we must uphold the ALJ’s finding if supported by substantial evidence in the record. Section 8-43-301(8), C.R.S. 2002.
Assuming, arguendo, the respondents represented that they relied on Dr. Cohen’s opinions to conclude the claimant’s mental condition was not related to the employment, the record supports the ALJ’s determination that the claimant did not rely on those representations to settle the case. To the contrary, at least 2 months prior to the date the claimant entered into the settlement, she filed a complaint against Dr. Cohen in which she accused him of misdiagnosing her condition for the purpose of aiding the respondents in avoiding liability for workers’ compensation benefits. Under these circumstances, the ALJ did not err in finding that as a matter of law the claimant could not establish the settlement was predicated on fraud.
II.
A mutual mistake of fact is one that relates to an assumption on which the settlement is made and is common to both parties to an agreement. See Cary v. Chevron U.S.A., Inc., 867 P.2d 117 (Colo.App. 1993). As stated above, the claimant voiced her objection to Dr. Cohen’s opinions in July 2001 when she accused Dr. Cohen of misdiagnosing her condition. Thus, the record supports the ALJ’s determination that the claimant did not mistakenly rely on Dr. Cohen’s opinions to settle the case. Consequently, the ALJ did not err in finding that as a matter of law the claimant could not establish the mutuality of a mistake concerning the accuracy of Dr. Cohen’s opinions on causation.
Moreover, the issue is not whether the claimant had sufficient proof to conclusively establish her believe that Dr. Cohen’s opinions were unreliable. The issue is whether the claimant entered into the settlement based upon a mistaken assumption that Dr. Cohen was correct. Indeed, the claimant was not required to settle the claim. She could have refused to settle the claim until the outcome of the Department’s investigation. Thus, it is immaterial the claimant’s suspicions were not validated until Dr. Cohen confessed to the professional violations.
IT IS THEREFORE ORDERED that the ALJ’s order dated October 1, 2002, is affirmed.
INDUSTRIAL CLAIM APPEALS PANEL
____________________________________ Kathy E. Dean
____________________________________ Robert M. Socolofsky
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. 2002. 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 December 31, 2002 to the following parties:
Artis A. Harrison, 4884 Chandler Ct., Denver, CO 80239
James Crockett, Denver Water Department, 1600 W. 12th Ave., Denver, CO 80254
Twin City Fire Insurance Co., c/o Diana Gelbart, The Hartford, P. O. Box 4626, Houston, TX 77210-4626
D. Dale Sadler, Esq., 5251 DTC Pkwy., #690, Greenwood Village, CO 80111 (For Claimant)
Patricia Jean Clisham, Esq. and Keith E. Mottram, Esq., 1200 17th St., #1700, Denver, CO 80202 (For Respondents)
BY: A. Hurtado