Opinion
W.C. No. 4-535-529.
January 18, 2006.
FINAL ORDER
The claimant seeks review of an order dated July 8, 2005 of Administrative Law Judge Jones (ALJ) that denied the claimant's claim for mileage reimbursement in connection with his travels to medical appointments. We affirm the order on grounds other than those relied upon by the ALJ.
A hearing was held at which the sole issue was the claimant's entitlement to reimbursement for mileage expenses attendant to his travel to medical appointments. Following the hearing the ALJ entered factual findings that may be summarized as follows. The claimant was injured on February 5, 2002 and on July 13, 2004 the respondents filed a final admission of liability. The claimant objected to the final admission and applied for a hearing, which was set for July 7, 2005. On March 2, 2005 the claimant submitted to the insurer a request for mileage reimbursement for 9761 miles allegedly traveled to and from medical appointments between January 3, 2002 and October 14, 2004. The insurer denied the request on the ground that it did not comply with former Rule of Procedure XVI(K)(1)(a).
The ALJ concluded that Rule XVI(K)(1)(a) is applicable to requests for mileage reimbursement. The rule requires that bills be submitted within one hundred twenty days of the date of service. Because the claimant did not comply with that requirement, the ALJ denied the request for reimbursement of mileage expenses.
On appeal the claimant contends that the ALJ erred in applying Rule XVI(K)(1)(a) to requests for mileage reimbursement. Initially, we note that the rule only requires "providers" to submit medical bills within one hundred and twenty days, and it is highly questionable whether a claimant traveling to a medical appointment falls within the definition of a "provider." Nonetheless, it is not necessary for us to reach the issue of whether the rule requires mileage reimbursements to be submitted within one hundred and twenty days of the date of the transportation. We conclude that the mileage reimbursement was properly denied because any claim for medical benefits was closed. The award of medical benefits is therefore precluded absent a petition to reopen.
The issue of mileage was closed by the final admission when the claimant failed to apply for a hearing on the issue within thirty days. Section 8-43-203(2)(b)(II), C.R.S. 2005 provides that a final admission must contain a statement that a claim will automatically be closed as to the issues admitted, "if the claimant does not, within thirty days after the date of the final admission, contest the final admission in writing and request a hearing on any disputed issues that are ripe for hearing." We have previously noted that the courts have treated provisions for objecting to and contesting a final admission, including determinations of MMI and PPD, as jurisdictional. Roddam v. Rocky Mountain Recycling, W.C. No. 4-367-003 (January 24, 2005) (citing Town of Ignacio v. Industrial Claim Appeals Office, 70 P.3d 513 (Colo.App. 2002); Dalco Industries, Inc. v. Garcia, 867 P.2d 156 (Colo.App. 1993).) In Peregoy v. Industrial Claim Appeals Office, 87 P.3d 261 (Colo.App. 2004) the court stated that "we conclude that a claimant has thirty days after the date an employer files an FAL to file an application for hearing. . . ." Peregoy, 87 P.3d at 264. If the claimant does not do so, the issues admitted in the final admission are closed. Id. See also Berg v. Industrial Claim Appeals Office, ___ P.3d ___ (Colo.App. No. 04CA1130, August 11, 2005) (case automatically closes unless claimant files an objection to the final admission within thirty days and requests a hearing on any disputed issues that are ripe).
It is undisputed in this case that the application for hearing was not filed within thirty days of the date of the final admission. Moreover, we disagree with the claimant's argument that the issue of mileage reimbursement was not "ripe" for adjudication until the request was denied by the insurer. Mileage expenses to and from authorized medical treatment are a compensable medical benefit. Sigman Meat Co. v. Industrial Claim Appeals Office, 761 P.2d 265 (Colo.App. 1988). The respondents' final admission admitted liability for medical benefits and advised the claimant that he was required to file an application for hearing on any disputed issues. At that point, any claim for further medical benefits was required to be advanced through these procedures. See Dyrkopp v. Industrial Claim Appeals Office, 30 P.3d 821 (Colo.App. 2001). When the claimant failed to file the application for hearing within thirty days, the "admitted issue" of medical benefits closed. Accordingly, the ALJ did not err in denying the request for reimbursement of mileage expenses.
IT IS THEREFORE ORDERED that the ALJ's order dated July 8, 2005, is affirmed.
INDUSTRIAL CLAIM APPEALS PANEL
____________________________________ Curt Kriksciun
____________________________________ Thomas Schrant
David Newbrey, Papillion, NE, Valley Excavating, Inc., Boulder, CO, Legal Department, Pinnacol Assurance — Interagency Mail Jess M. Perez, Esq., Fort Collins, CO, (For Claimant).
Douglas P. Ruegsegger, Esq. and Michele Stark Carey, Esq., Denver, CO, (For Respondents).