W.C. No. 4-567-322.Industrial Claim Appeals Office.
September 3, 2004.
FINAL ORDER
The respondent seeks review of an order of Administrative Law Judge Felter (ALJ) which awarded medical benefits. We affirm.
The claimant suffered an admitted low back injury on December 17, 2002. The claimant was initially treated by Dr. Polanco who placed the claimant at maximum medical improvement (MMI) and released the claimant from treatment on January 8, 2003. The claimant’s low back pain symptoms continued. Consequently, the claimant sought additional treatment on his own from several different providers. The claimant told one provider he suffered a new back injury in March 2003 while lifting a refrigerator. The claimant told another provider he suffered a new back injury while moving a hot water heater. The claimant admitted he fabricated the refrigerator and hot water heater injuries because he had been released from treatment by Dr. Polanco and had no documentation to prove he needed additional treatment for the December 2002 injury. Therefore, he stated he made up the new injuries to explain his request for treatment. (Tr. p. 21).
The respondent subsequently agreed the claimant was not at MMI. Dr. Polanco then referred the claimant to Dr. Brown who diagnosed a herniated disc at L4-5. Dr. Brown attributed the herniation to the December 2002 industrial injury and recommended surgery. The respondent denied liability and took the position the surgery was necessitated by the natural progression of a 2001 industrial injury or a subsequent, intervening injury.
Crediting the claimant’s testimony concerning the December 2002 industrial injury and the opinions of Dr. Brown, the ALJ determined it was more probable than not the claimant’s need for surgery was a natural progression of the December 2002 industrial injury. Therefore, the ALJ ordered the respondent to pay the cost of treatment for the herniated disc including the surgery recommended by Dr. Brown.
On review the respondent contends the claimant’s history of fabricating injuries to obtain medical treatment renders his testimony about the December 2002 industrial injury incredible as a matter of law. Further, the respondent contends the ALJ’s order is contrary to overwhelming evidence in the medical reports of Dr. Polanco and the MRI studies. We reject these arguments.
Section 8-42-101(1), C.R.S. 2002, requires the employer to provide medical benefits to cure or relieve the effects of the industrial injury. See Snyder v. Industrial Claim Appeals Office, 942 P.2d 1337
(Colo.App. 1997). Whether the claimant has proven a causal relationship between the industrial injury and the medical condition for which he seeks benefits is a question of fact for the ALJ. City of Durango v. Dunagan, 939 P.2d 496 (Colo.App. 1997). Because the question is factual in nature, we must uphold the ALJ’s determination if supported by substantial evidence in the record. Section 8-43-301(8), C.R.S. 2003. This standard requires us to review the evidence in the light most favorable to the prevailing party, and accept the ALJ’s resolution of conflicts in the evidence, and the plausible inferences which he drew from the evidence. Industrial Commission v. Royal Indemnity Co., 124 Colo. 210, 236 P.2d 293 (1951); Metro Moving Storage Co. v. Gussert, 914 P.2d 411 (Colo.App. 1995). Further, the ALJ’s credibility determinations from conflicting evidence are binding except in extreme circumstances where the testimony of a particular witness, although direct and unequivocal, is “so overwhelmingly rebutted by hard, certain evidence directly contrary” that a fact finder would err as a matter of law in believing the witness. Halliburton Services v. Miller, 720 P.2d 71 (Colo. 1986).
Although the claimant fabricated the refrigerator and hot water heater injuries, the psychiatric evaluation by Dr. Marten amply supports the ALJ’s finding that the claimant did so based on a mistaken assumption he could only obtain additional treatment for the December 2002 injury if he reported a new injury. Further, the ALJ found there was no corroboration that the claimant suffered any new injury in March 2003 either lifting a refrigerator or hot water heater.
The claimant’s testimony that the industrial injury caused his worsened condition and ultimately the need for surgery is supported evidence the claimant was capable of performing heavy labor until the industrial injury but not after that date. The claimant’s testimony is also consistent with the medical opinions of Dr. Brown. Under these circumstances, we cannot say the ALJ erred as a matter of law in rejecting the respondent’s contention that the claimant’s propensity to lie overwhelmingly tainted the claimant’s testimony concerning the industrial injury.
The respondents are obviously dissatisfied with the ALJ’s credibility determinations. However, based upon this record we cannot say as a matter of law that the ALJ erroneously credited the claimant’s testimony concerning the onset of his symptoms.
Admittedly, the evidence was susceptible to highly conflicting conclusions, but nevertheless Dr. Brown’s testimony provided substantial support for the ALJ’s determination that the claimant’s need for additional medical treatment is causally related to the industrial injury. We may not reweigh the evidence on review and decline the respondent’s request to do so. See General Cable Co. v. Industrial Claim Appeals Office, 878 P.2d 118 (Colo.App. 1994). Therefore, we need not address the evidence the respondent relied upon which, if credited, might support a contrary result.
IT IS THEREFORE ORDERED that the ALJ’s order dated, February 23, 2004, is affirmed.
INDUSTRIAL CLAIM APPEALS PANEL
____________________________________ David Cain
____________________________________ Kathy E. Dean
Russell Salas, Colorado Springs, CO, Labor Ready, Tacoma, WA, ACE, Portland, OR, Steven R. Waldmann, Esq., Colorado Springs, CO, (For Claimant).
Richard A. Bovarnick, Esq. and Chad A. Atkins, Esq., Denver, CO, (For Respondent).