W.C. No. 4-258-334Industrial Claim Appeals Office.
February 20, 1997
FINAL ORDER
The claimant seeks review of a final order of Administrative Law Judge Wells (ALJ), which denied his claim for medical benefits. We affirm.
The claimant sustained a compensable back injury in June 1995. The claimant was treated by several physicians at Emergicare, including Dr. Stone. Ultimately, Dr. Stone opined that the claimant reached maximum medical improvement (MMI) on November 16, 1995.
However, in September 1995, Dr. Stone referred the claimant to a clinical psychologist, Dr. Evans, for treatment of depression. In a report dated September 26, 1995, Dr. Evans opined that the claimant was undergoing “significant emotional distress” attributable to a “combination of his injury, his inability to work, the loss of income to the family and the diagnosis and treatment of his son for cancer.” Dr. Evans recommended that the claimant receive treatment “to provide some coping skills for him to deal with his pain and distress.”
Thereafter, Dr. Evans provided treatment to the claimant at somewhat irregular intervals. However, on January 19, 1996, the respondent-insurer notified Dr. Evans that it would not pay for any treatment because it needed a “medical report or office notes to determine relatedness.”
In March 1996, the claimant underwent an independent medical examination (IME) by Dr. Hine. Dr. Hine agreed that the claimant had reached MMI on November 16, 1995, and found neither “neurological nor psychiatric impairment,” despite a diagnosis of “mild depression.”
The claimant underwent a separate IME by Dr. Gutterman, a psychiatrist, on April 9, 1996. Dr. Gutterman stated that he could not find any “psychiatric or psychological difficulties related” to the industrial injury, though the claimant exhibited “difficulties with pain” which were not of a psychological or psychiatric etiology. Dr. Gutterman also noted that he was “unable to state with certainty that this patient had any prior, brief psychological sequelae related to his employment injury.”
Under these circumstances, the ALJ found that a preponderance of the evidence established that the claimant’s psychological problems were not causally related to the industrial injury. In support of this determination, the ALJ relied on the opinions of Dr. Evans, Dr. Hine, and Dr. Gutterman. Therefore, the ALJ denied the claim for payment of Dr. Evans’ medical bills.
On review, the claimant contends the ALJ’s order denying payment for the treatment rendered by Dr. Evans is unsupported by the record. The claimant argues that the ALJ “relied solely” upon the opinions of Dr. Gutterman, and Dr. Gutterman could not state whether the claimant had any injury-related psychological problems prior to the date of Dr. Gutterman’s April 1996 examination. Moreover, the claimant asserts that other evidence, including the reports of Dr. Evans, establishes that the claimant’s need for psychological treatment was related to the industrial injury. We are not persuaded.
It is the ALJ’s province, as the fact finder, to determine whether the need for medical treatment is causally connected to an industrial injury. Further, the claimant has the burden of proof to establish causation. See Snyder v. Industrial Claim Appeals Office, ___ P.2d ___ (Colo.App. No. 96CA0679, February 6, 1997); Williams v. Industrial Commission, 723 P.2d 749 (Colo.App. 1986).
Moreover, the question of whether the claimant satisfied his burden of proof to establish causation is one of fact for resolution by the ALJ. F. R. Orr Construction v. Rinta, 717 P.2d 965 (Colo.App. 1985). Consequently, we must uphold the ALJ’s order if supported by substantial evidence in the record. Section 8-43-301(8), C.R.S. (1996 Cum. Supp.). In this regard, we must defer to the ALJ’s credibility determinations and his resolution of conflicts in the expert medical evidence Rockwell International v. Turnbull, 802 P.2d 1182
(Colo.App. 1990).
Initially, we disagree with the claimant’s assertion that the ALJ relied “solely” on the opinions of Dr. Gutterman when he found that the claimant failed to prove a causal relationship between the injury and the need for psychological treatment. To the contrary, the ALJ also relied on the reports of Dr. Evans and Dr. Hine. In particular, the ALJ relied on the reports of Dr. Evans in finding that, between September 1995 and April 1996, the claimant was experiencing family stress unrelated to the industrial injury.
Further, we disagree with the claimant’s assertion that Dr. Gutterman’s opinion was incompetent with respect to the claimant’s condition prior to April 1996. To the contrary, Dr. Gutterman’s report indicates that he reviewed the claimant’s medical history, including pertinent documents from Dr. Evans and Dr. Stone. After examining these documents and interviewing the claimant, Dr. Gutterman indicated that he could not “state with certainty” that the claimant ever had any psychological sequelae attributable to the industrial injury.
It is true that the record contains some evidence, including some reports of Dr. Stone and Dr. Evans, which suggests that the claimant needs psychological treatment as a result of the injury. However, we cannot interfere with the ALJ’s assessment of the weight and inferences to be drawn from the medical testimony.
IT IS THEREFORE ORDERED that the ALJ’s order dated June 10, 1996, is affirmed.
INDUSTRIAL CLAIM APPEALS PANEL
___________________________________ David Cain
___________________________________ Bill Whitacre
NOTICE
This Order is final unless an action to modify or vacate the Order is commenced in the Colorado Court of Appeals, 2 East 14th Avenue, Denver, Colorado 80203, by filing a petition to review with the court, with service of a copy of the petition upon the Industrial Claim Appeals Office and all other parties, within twenty (20) days after the date the Order was mailed, pursuant to §§ 8-43-301(10) and 307, C. R. S. (1996 Cum. Supp.).
Copies of this decision were mailed February 20, 1997
to the following parties:
Alonzo E. Trujillo, 639 Sequdia Dr., Colorado Springs, CO 80910
Frazee Construction Co., 2855 E. Las Vegas St., Colorado Springs, CO 80906-1596
Colorado Compensation Insurance Authority, Attn: Carolyn Boyd, Esq. (Interagency Mail)
Steven R. Waldmann, Esq., 303 S. Circle Dr., Ste. 203, Colorado Springs, CO 80910-3000 (For the Claimant)
By: __________________________________________________