W.C. No. 4-310-783Industrial Claim Appeals Office.
March 7, 2000
FINAL ORDER
The respondent seeks review of an order of Administrative Law Judge Erickson (ALJ Erickson) which awarded the claimant medical benefits. The respondent contends the ALJ erroneously refused to apply the doctrine of collateral estoppel. The respondent further argues the ALJ failed to resolve conflicts in the evidence concerning the issue of causation. We affirm.
In August 1996 the claimant sustained a compensable back injury while employed by the respondent. The claimant was placed at maximum medical improvement (MMI) on December 23, 1996, and given an 18 percent whole person impairment rating. The respondents filed a final admission of liability, but the claimant filed a timely objection.
On January 6, 1998, a hearing was held before ALJ Stuber. The record lacks a transcript of the January 6 proceedings, but does contain ALJ Stuber’s summary order entered on January 8, 1998. Paragraph 1 of the summary order states that the final admission of liability did not close the claim with respect to medical benefits because the claimant filed a timely objection. Paragraph 2 of the order states the claimant proved his entitlement to ongoing medical benefits after MMI pursuant t Grover v. Industrial Commission, 759 P.2d 705 (Colo. 1998), and ordered the respondent to pay for treatment provided by Dr. Janssen and Dr. Malpiede, D.C. from March through July 1997. However, paragraph 4 of the order finds that the respondent is not liable for “bills of Dr. Janssen and Dr. Malpiede after July 1997.” In support of this finding, ALJ Stuber stated that in September 1997 the claimant “suffered a new aggravation of his long-standing back pain either at work or at home while painting.” No party appealed ALJ Stuber’s summary order by requesting specific findings of fact and conclusions of law.
In April 1999, the claimant filed an application for hearing seeking additional medical benefits in the form of chiropractic treatment provided by Dr. Malpiede. The claimant testified that in February 1999 he needed chiropractic care to treat ongoing pain attributable to the August 1996 injury. The claimant acknowledged that after December 1996 he suffered at least three exacerbations of his condition which were attributable to intervening injuries. However, the claimant also testified that each of the exacerbations was temporary and that his level of pain always returned to that which existed immediately after he was placed at MMI in December 1996. The claimant also submitted the February 16, 1999, report of Dr. Malpiede, which states the claimant’s need for chiropractic treatment is attributable to the August 1996 industrial injury despite the intervening exacerbation in September 1997.
ALJ Erickson found the claimant’s need for chiropractic treatment commencing in February 1999 was causally related to the 1986 industrial injury. In support, the ALJ credited the claimant’s testimony that “his condition returned to the December 23, 1996 (MMI) level after each of the exacerbation/aggravation incidents.” The ALJ also credited the report of Dr. Malpiede, and found the respondent presented “no credible medical evidence to contradict” the claimant’s evidence.
ALJ Erickson also rejected the respondent’s argument the claim for medical benefits was “closed” by the claimant’s failure to appeal ALJ Stuber’s January 8, 1998, summary order. ALJ Erickson interpreted the summary order as awarding Grover-style medical benefits, but reserving to the respondent the right to contest the “relatedness of any requested treatment to the August 1996 injury.”
I.
On review, the respondent contends ALJ Erickson erred in determining that the claim for medical benefits was not “closed” by the claimant’s failure to seek review of ALJ Stuber’s summary order. The respondent argues that ALJ Stuber’s summary order determined that after September 1997 the claimant’s need for medical treatment was not causally related to the August 1986 industrial injury. Therefore, the respondent reasons that the doctrine of collateral estoppel precluded ALJ Erickson from relitigating the cause of the claimant’s need for treatment in February 1999. We disagree.
The doctrine of collateral estoppel is applicable in workers’ compensation proceedings. The doctrine bars relitigation of an issue if the issue is identical to one actually and necessarily adjudicated at a prior proceeding, the party against whom the estoppel is asserted was a party to or in privity with a party to the prior proceeding, there was a final judgment in the prior proceeding, and the party against whom estoppel is asserted had a full and fair opportunity to litigate the issue in the prior proceeding. Cooper v. Industrial Claim Appeals Office, ___ P.2d ___ (Colo.App. No. 98CA1343, October 28, 1999); M M Management Co. v. Industrial Claim Appeals Office, 979 P.2d 574 (Colo.App. 1998). Collateral estoppel may bar relitigation of a determination that a particular condition was caused by an industrial injury. However, the causation issue should not be confused with, and is not conclusive of, questions involving the nature and extent of disability. Cooper v. Industrial Claim Appeals Office, supra.
Here, we agree with the claimant that the issue decided by ALJ Erickson was not one actually decided nor necessarily adjudicated by ALJ Stuber. ALJ Stuber’s order awarded medical benefits pursuant to Grover v. Industrial Commission. Unde Grover, an ALJ may enter a “general award” for ongoing medical benefits which are reasonable and necessary to relieve the claimant’s condition or prevent future deterioration. Stollmeyer v. Industrial Claim Appeals Office, 916 P.2d 609 (Colo.App. 1995). However, the respondents remain free to dispute claims for particular medical treatments on the ground that the treatments are unrelated to the industrial injury. Grover v. Industrial Commission, 759 P.2d at 712.
The respondent’s argument notwithstanding, ALJ Erickson could plausibly interpret ALJ Stuber’s summary order as granting a “general award” of Grover medical benefits for the 1996 injury, while also determining that the specific treatments which the claimant received after July 1997 were necessitated by the intervening injury in September 1997. Moreover, the issue before ALJ Erickson was not identical to that considered by ALJ Stuber. ALJ Erickson was required to determine whether, in view of all the evidence available, the treatment which the claimant needed in 1999 was attributable to the 1986 injury or to any of the subsequent aggravations. Although ALJ Stuber determined that the “chain of causation” was broken in September 1997, he was not required to determine, nor could he have determined, whether the claimant’s condition would subsequently return to pre-aggravation levels. As recognized in Cooper v. Industrial Claim Appeals Office, supra, a determination that a particular condition was caused by an industrial injury is not the equivalent of determining the nature and extent of the disability. In this case, ALJ Stuber’s determination that there was an intervening aggravation in 1997 does not determine the duration of the aggravation or the length of time treatment would be needed for the aggravation. Neither did ALJ Stuber’s summary order purport to prohibit a subsequent determination that the claimant needs additional Grover-style treatment for the 1996 industrial injury.
It follows that the doctrine of collateral estoppel did not prohibit ALJ Erickson from awarding additional medical benefits commencing in February 1999. PALJ Muramoto’s May 21, 1999, order does not affect this result. PALJ Muramoto merely determined the claim was closed to the extent the issues were “decided” by ALJ Stuber. As we have held, ALJ Stuber did not purport to foreclose the claimant’s right to Grover-style medical benefits on a permanent basis.
II.
The respondent next contends the ALJ’s findings of fact are insufficient to permit appellate review concerning the cause of the claimant’s need for treatment in February 1999. Specifically, the respondent disputes the ALJ’s finding that it presented “no credible medical evidence” to dispute the conclusion that the claimant’s need for treatment was caused by the August 1996 injury. The respondent further asserts the ALJ failed to resolve a conflict in the evidence between the report of Dr. Malpiede and Dr. Primack’s report dated October 15, 1997. We find no error.
The question of whether the claimant proved his need for medical treatment was causally related to the August 1996 industrial injury was one of fact for determination by the ALJ. Consequently, we are required to defer to the ALJ’s resolution of conflicts in the evidence, his credibility determinations, and the plausible inferences he drew from the evidence. Wal-Mart Stores, Inc., v. Industrial Claim Appeals Office, 989 P.2d 251 (Colo.App. 1999); § 8-43-301(8), C.R.S. 1999. The weight and credibility to be accorded expert medical opinion on the issue of causation is a matter solely within the province of the ALJ as fact finder Rockwell International v. Turnbull, 802 P.2d 1182 (Colo.App. 1990).
Further, we note the ALJ is not held to a crystalline standard in expressing findings of fact and conclusions of law. The ALJ need not make findings of fact concerning every piece of evidence so long as he enters findings regarding the evidence which he determines to be dispositive of the issues. Riddle v. Ampex Corp., 839 P.2d 489 (Colo.App. 1992). Further, the ALJ is not required to detail the reasons behind credibility determinations. Wells v. Del Norte School District C.-7, 753 P.2d 770 (Colo.App. 1987).
Contrary to the respondent’s contention, the ALJ adequately resolved the conflict in the evidence on the issue of causation. The ALJ explicitly credited the claimant’s testimony and the report of Dr. Malpiede. Moreover, the ALJ explicitly discredited conflicting medical evidence. Thus, the ALJ implicitly discredited the report of Dr. Primack.
The respondent’s reliance on Hall v. Industrial Claim Appeals Office, 757 P.2d 1132 (Colo.App. 1988), is misplaced. In that case, the ALJ found there was “no evidence” concerning causation. Contrary to this finding, the record contained the opinion of a physician on the issue of causation. Consequently, the court held that an ALJ’s finding of “no evidence” on the issue of causation may not be converted into an implicit finding of “no credible evidence.” Unlike the situation in Hall, ALJ Erickson made explicit credibility determinations and found there was “n credible medical” testimony to support the respondent’s position. (Emphasis added). Consequently, substantial, albeit conflicting, evidence supports the ALJ’s determination that the 1996 industrial injury caused the need for treatment in 1999.
IT IS THEREFORE ORDERED that ALJ Erickson’s order dated September 22, 1999, is affirmed.
INDUSTRIAL CLAIM APPEALS PANEL ________________________________ David Cain ________________________________ 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. 1999. 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 March 7, 2000 to the following parties:
Keith Robert Pettera, 12565 W. 29th Ave., Lakewood, CO 80215
Kristen M. McKeon, King Soopers, Inc., P. O. Box 5567 T. A., Denver, CO 80217-5567
Neil D. O’Toole, Esq., 226 W. 12th Ave., Denver, CO 80204-3625 (For Claimant)
Thomas O. McBride, Esq., 1410 Grant St., #C206, Denver, CO 80203 (For Respondent)
BY: A. Pendroy