W.C. Nos. 4-380-649, 4-385-916.Industrial Claim Appeals Office.
November 22, 1999.
FINAL ORDER.
The claimant seeks review of an order of Administrative Law Judge Martinez (ALJ) which denied his request for additional medical and temporary disability benefits. We affirm.
The claimant suffered compensable low back injuries on February 18, 1998, and July 9, 1998. On August 4, 1998, Dr. Stagg placed the claimant at maximum medical improvement (MMI) with no permanent impairment. Thereafter, the claimant became employed as a custodian for another employer.
The claimant requested a Division-sponsored independent medical examination (IME) under the provisions of § 8-42-107(8), C.R.S. 1999, to dispute Dr. Stagg’s opinions. In a report dated December 15, 1998, the IME physician, Dr. Patterson, agreed with Dr. Stagg’s finding of MMI but rated the claimant’s permanent low back impairment as 14 percent whole person impairment. Dr. Patterson also indicated that the claimant is capable of performing the duties required of his employment as a custodian.
The claimant testified that his condition worsened on December 30, 1998, when he squatted to pick up a light trash bag at home. (Tr. pp. 9, 10). As a result, the claimant was doubled over with pain and unable to get up.
In February 1998, the claimant began treating with Dr. Sillix for complaints of low back pain. Dr. Sillix removed the claimant from work and recommended additional treatment. Relying on Dr. Sillix’s opinions, the claimant requested additional medical treatment and temporary disability benefits retroactive to December 30, 1997.
The ALJ found that the claimant’s request for additional temporary disability benefits was a constructive challenge to Dr. Patterson’s finding of MMI. However, the ALJ found that the claimant failed to overcome Dr. Patterson’s opinions by “clear and convincing evidence” as required by § 8-42-107(8)(c), C.R.S. 1999. The ALJ also found that even if the claimant was not required to overcome Dr. Patterson’s opinions, the December 30 incident constituted a new, non-industrial injury and the claimant failed to prove by a preponderance of evidence that the December 30 injury is causally related to the previous industrial injuries. In so doing, the ALJ gave the greatest weight to the medical opinions of Dr. Patterson. Therefore, the ALJ denied and dismissed the claims for additional medical and temporary disability benefits.
The claimant contends, inter alia, that the only evidence in the record concerning the “cause” of the December 30 injury is the unrefuted opinions of Dr. Sillix. Therefore, the claimant contends the record does not support the ALJ’s finding that he failed to establish a causal connection between his symptomatology and the industrial injuries. We disagree.
The respondents are liable for the natural and proximate results of the industrial injury. Vanadium Corp. of America v. Sargent, 134 Colo. 555, 307 P.2d 454 (Colo. 1957). However, the ALJ is not required to find the requisite causal relationship merely because the subsequent injury might not have occurred if the claimant had retained all of his former physical powers after the industrial injury. See Post Printing and Publishing Co. v. Erickson, 94 Colo. 382, 30 P.2d 327 (1934). Rather, it is presumed that the award of permanent disability benefits fully compensated the claimant for the residual effects of the original industrial injury. Id. at 328.
Furthermore, it is the claimant’ s burden to prove that his disability and need for treatment are causally related to the industrial injury. Snyder v. Industrial Claim Appeals Office, 942 P.2d 1337 (Colo.App. 1997). Whether a claimant sustained his burden of proof is a question of fact for resolution by the ALJ, and we must uphold the ALJ’s determination if supported by substantial evidence in the record. Standard Metals Corp. v. Ball, supra; F.R. Orr Construction v. Rinta, 717 P.2d 965
(Colo.App. 1985). Under the substantial evidence standard, we must defer to the ALJ’s credibility determinations, except in extreme circumstances. See Halliburton Services v. Miller, 720 P.2d 571
(Colo. 1986) (ALJ’s credibility determinations are binding unless the testimony is so rebutted by hard, certain evidence that as a matter of law the ALJ would err in crediting the testimony). Further, the ALJ is not required to credit expert medical evidence even if unrefuted. See Casa Bonita Restaurant v. Industrial Commission, 624 P.2d 1340 (Colo.App. 1981). Rather, the weight to be afforded unrefuted medical evidence is solely within the ALJ’s prerogative. See Delta Drywall v. Industrial Claim Appeals Office, 868 P.2d 1155 (Colo.App. 1993).
It is clear from the ALJ’s findings of fact that he was not persuaded by Dr. Sillix’s opinions concerning a causal connection between the industrial injuries and the claimant’s symptomatology after December 30, 1998. (Finding of Fact 9); General Cable Co. v. Industrial Claim Appeals Office, 878 P.2d 118 (Colo.App. 1994) (ALJ not required to make findings of fact on every piece of evidence, just those found persuasive). Furthermore, we are not persuaded that the ALJ was compelled to credit Dr. Sillix’s opinion.
On February 4, 1999, the claimant’s counsel asked Dr. Sillix whether the claimant “has suffered a worsening of his condition from his work-related injuries of February 18, 1998 and/or July 9, 1998?” Dr. Sillix answered “yes.” However, Dr. Sillix did not provide any explanation of this opinion. Under these circumstances, the ALJ could, and did, find that Dr. Sillix’s conclusionary opinion was not sufficiently definite to support the finding of a causal connection between the industrial injuries and the claimant’s worsened condition. This particularly true since the ALJ credited Dr. Patterson’s opinion that the claimant was capable of performing his regular job as a custodian despite permanent impairment caused by the injury. Moreover, the ALJ’s findings support the denial of benefits. Section 8-41-301(1)(c), C.R.S. 1999.
Because the claimant failed to present persuasive evidence that December 30 injury was the natural consequence of the industrial injuries, it is immaterial whether Dr. Patterson’s report directly refutes Dr. Sillix’s opinions. Furthermore, in view of our disposition it is unnecessary to consider whether the ALJ erred in requiring the claimant to overcome Dr. Patterson’s opinions by clear and convincing evidence.
IT IS THEREFORE ORDERED that the ALJ’s order dated July 9, 1999, is affirmed.
INDUSTRIAL CLAIM APPEALS PANEL
_____________________________ David Cain
_____________________________ Kathy E. Dean
NOTICE This Order is final unless an action to modify or vacate thisOrder is commenced in the Colorado Court of Appeals, 2 East 14thAvenue, Denver, CO 80203, by filing a petition for review with thecourt, with service of a copy of the petition upon the IndustrialClaim Appeals Office and all other parties, within twenty (20)days after the date this Order is mailed, pursuant to section8-43-301(10) and 307, C.R.S. 1999.
Copies of this decision were mailed November 22, 1999 to the following parties:
Raul Paz, 489 32 Rd., #4, Clifton, CO 81520.
Western Freight Handlers, Inc., P.O. Box 1626, Grand Junction, CO 81502-1626.
Susan Warren, I.M.E. Unit, Division of Workers’ Compensation — Interagency Mail.
Michael J. Steiner, Esq., Colorado Compensation Insurance Authority d/b/a Pinnacol Assurance — Interagency Mail (For Respondents).
Richard T. Gurley, Esq., 200 Grand Ave., #315, Grand Junction, CO 81501 (For Claimant).
David L. Smith, Esq., 600 17th St., #1600N, Denver, CO 80202.
BY: A. Pendroy