In re Ontiveros, W.C. 4-985-669

Sep 27, 2018

OUTCOME: Claim for additional benefits denied

In re Wagner, W.C. 5-020-897

Sep 10, 2018

OUTCOME: Claim denied and dismissed

Claimant was a 62 year old airport shuttle driver for employer who fell onto her knee while unloading a passenger’s luggage. Claimant began receiving conservative treatment for a knee sprain and retur ... ned to modified duty work. Due to ongoing symptoms, claimant was eventually referred to an orthopedic surgeon who determined claimant did need surgery but concluded the need for surgery was not work-related. An independent medical examination agreed that the need for surgery was not work-related. The IME also determined that at most the claimant had sustained a minor strain as a result of the work incident and did not need any further treatment. Respondents denied liability for the claim entirely based upon the opinion from the IME. Several months later claimant was removed from work by her primary care doctor and sought requested on medical benefits and lost time benefits. The administrative law judge credited the opinions of respondents’ expert and found that any minor strain or sprain claimant may have sustained in the initial incident did not require work restrictions and would have resolved completely a few weeks after the incident. The ALJ further determined that any lost time claimant suffered after beginning treatment with her primary care physician was not due to the work incident. Relying on Harmen-Bergstedt, Inc. v. Loofbourrow, 320 P.3d 327 (Colo. 2014), the ALJ found that claimant had failed to prove a compensable claim because the injury had not resulted in any lost time and denied the claim for compensation.

In re Kinney, WC 4-975-644-02

Apr 11, 2018

OUTCOME: Increase in benefits denied

The claimant was a truck driver who entered into a shipping contract with the employer and worked from September 20, 2014 through December 31, 2014. The claims representative calculated the average we ... ekly by dividing claimant's total earnings by the total number of days in the contract period and then multiplied that by seven to yield a total AWW of $773.19. The claimant sought to increase his AWW based on only the days he actually worked during the time period and requested that his AWW be increased to $4,375. Respondents obtained Claimant’s tax records from 2013 and 2014 which reflected earnings consistent with the admitted AWW, not the increased amount alleged by Claimant. I successfully argued that under Claimant’s theory, his annual salary would have been $227,000, which was not consistent with the prior tax records. The administrative law judge found that the AWW requested by claimant was inconsistent with his actual earnings during the relevant time period preceding his injury and that the admitted AWW of $773.19 represented a fair approximation of his actual wage loss.

In re Oliphant, W.C. No. 5-006-696

Sep 27, 2017

OUTCOME: Claim denied and dismissed