Summary
holding uncontested FAL automatically closed claim and barred further claims for benefits absent reopening of award
Summary of this case from Feeley v. Industrial Claim Appeals Office of the StateOpinion
No. 00CA1180
April 12, 2001 Certiorari Granted September 10, 2001
Industrial Claim Appeals Office of the State of Colorado W.C. No. 4-287-760
ORDER AFFIRMED
David Lichtenstein, Denver, CO, for Petitioner
Ken Salazar, Attorney General, Mark W. Gerganoff, Assistant Attorney General, Denver, CO, for Respondent Industrial Claim Appeals Office
Curt Kriksciun, Denver, CO, for Respondents Denver School District No. 1 and Colorado Compensation Insurance Authority
Donna Dyrkopp (claimant) seeks review of a final order of the Industrial Claim Appeals Office (Panel) holding that her claim had been closed by a prior award granting her permanent partial disability benefits. We affirm.
Claimant suffered a compensable back injury in February 1996, and received medical and temporary disability benefits. On February 3, 1997, the Denver School District, by its insurer, the Colorado Compensation Insurance Authority (collectively employer), filed a final admission that contained language, in bold print, that "All benefits or penalties not admitted below are hereby specifically denied." Below this statement, an "x" was placed in the spaces next to "Medical to Date," "TTD," and "Working Unit," which was rated at 23 percent. No "x" was placed next to the space designated for "Permanent Total Disability." The "General Remarks" section contained an explanation of the benefit calculation of permanent partial disability pursuant to statute based upon a 23 percent rating.
Claimant did not object to the final admission within 60 days, and the case was automatically closed as provided by the applicable version of the statute currently codified at § 8-43-203(2)(b)(II), C.R.S. 2000.See Colo. Sess. Laws 1998, ch. 313 at 1431 (reducing time for objection from 60 to 30 days and renumbering the statute). A few days after the final admission was filed, claimant applied for, and received, a lump sum payment of the unpaid permanent impairment benefits.
Thereafter, claimant sought additional benefits and filed a petition to reopen. At the hearing, she argued, in part, that her claim had not been previously closed. The Administrative Law Judge (ALJ) concluded, however, as pertinent here, that the final admission closed all issues, including permanent total disability benefits. The ALJ also concluded that claimant failed to establish a basis for her claim to be reopened. On review, the Panel affirmed.
Claimant contends that a final admission, which admits liability for permanent partial disability benefits, but not for permanent total disability benefits, is insufficient to close a claim for permanent total disability benefits. She argues that to decide otherwise is to rewrite the statute and to deprive a claimant of fair notice of her rights. We disagree.
An uncontested final admission of liability automatically closes a case "as to the issues admitted in the final admission." Section 8-43-203(2)(b)(II), C.R.S. 2000. Section 8-43-203(2)(b)(II) is part of a statutory scheme designed to promote, encourage, and ensure prompt payment of compensation to an injured worker without the necessity of a formal administrative determination in cases not presenting a legitimate controversy. Cibola Construction v. Industrial Claim Appeals Office, 971 P.2d 666 (Colo.App. 1998).
We agree with the Panel that the language "as to the issues admitted" in § 8-43-203(2)(b)(II) does not mean only those "issues" on which an employer agrees to pay benefits. Rather, consistent with the intent of the General Assembly, the phrase must be interpreted as referring to issues on which the employer affirmatively takes a position, either by agreeing to pay benefits or by denying liability to pay benefits.
Thus, as pertinent here, because permanent partial disability benefits and permanent total disability benefits both compensate for a claimant's permanent loss of earning capacity, an admission for permanent partial benefits constituted an implicit denial of liability for permanent total disability benefits. See Waymire v. Industrial Claim Appeals Office, 924 P.2d 1168 (Colo.App. 1996). In Waymire, the division rejected the argument that medical impairment benefits were qualitatively different from permanent partial or permanent total disability benefits because there were different methods for calculating those benefits.
Here, employer did not admit payment of permanent total disability benefits. According to the admonition in the notice, then, such benefits were specifically denied. The reverse side of the final admission notified claimant that she was required to write a letter to the division stating her objection if she disagreed with the "amount or type of benefits" that the employer agreed to pay. Since claimant failed to file a timely written objection to benefits calculated upon a working unit, she waived the right to seek permanent total disability benefits. See Brunetti v. Industrial Commission, 670 P.2d 1246 (Colo.App. 1983).
Claimant testified that she did not object to the final admission of liability because she expected that she would return to work. In addition, claimant did not testify that the admission was confusing or that she was not informed of her rights.
We agree with the Panel that claimant was not excused from objecting to the final admission because she proceeded pro se. A pro se litigant is presumed to have knowledge of the applicable statutes and must be prepared to accept the consequences of her own mistakes if she elects to represent herself, even if the case is not litigated. See Manka v. Martin, 200 Colo. 260, 614 P.2d 875 (1980).
Furthermore, claimant's argument that a finding of waiver would necessarily close a case regarding not only admitted issues, but also other issues not addressed in a final admission, is unfounded. See Dalco Industries, Inc. v. Garcia, 867 P.2d 156 (Colo.App. 1993) (admission of liability did not automatically close issue of penalties for untimely filing of admission).
The order is affirmed.
JUDGE NIETO concurs.
JUDGE MARQUEZ dissents.