Opinion
W.C. Nos. 4-536-855 4-589-624.
August 10, 2004.
FINAL ORDER
Automatic Data Processing Inc. (ADP) and its insurer, Liberty Mutual Insurance Company (hereinafter the ADP respondents), seek review of an order of Administrative Law Judge Harr (ALJ) which reopened the claim in W.C. No. 4-536-855 and dismissed the claim in W.C. No. 4-589-624. The ADP respondents contend the respondent-employer, Liberty Mutual Insurance Company (Liberty), is liable for the claimant's medical benefits, and therefore argue the ALJ erroneously dismissed W.C. No. 4-589-624. We disagree, and therefore affirm the ALJ's order.
The claimant began working for ADP in 1994. In W.C. No. 4-536-855, the ADP respondents admitted the claimant suffered an occupational disease to her upper extremities in January 2001.
The claimant began working for Liberty on June 3, 2002. The ALJ found the claimant's job duties at Liberty were far less stressful than the work at ADP.
The claimant reached maximum medical improvement in July 2002, and the claim was subsequently closed by the ADP respondents filing of an uncontested Final Admission of Liability. In February 2003, the claimant reported a worsening of condition. Consequently, the claimant petitioned to reopen the claim in W.C. No. 4-536-855. The claimant also filed a workers' compensation claim against Liberty, which was delineated as W.C. No. 4-589-624.
The ALJ found the claimant proved a worsened condition caused by a natural progression of the 2001 occupational disease. The ALJ also found the Liberty employment did not cause a substantial permanent aggravation of the underlying occupational disease. Therefore, the ALJ dismissed the claim against Liberty.
On review, the ADP respondents do not contest the ALJ's finding that Liberty is not responsible for compensation due on account of the occupational disease. Rather, the ADP respondents contend the ALJ misapplied the law in failing to hold Liberty responsible for the claimant's medical benefits. We perceive no reversible error.
Where the claimant has successive employment, liability for compensation due on account of an occupational disease is governed by the "last injurious exposure" rule. Section 8-41-304(1), C.R.S. 2003. Under that rule, the employer in whose employment the claimant is "last injuriously exposed to the hazards of such disease and suffered a substantial, permanent aggravation" is solely responsible for the injury without contribution from any other employer. Ortiz v. Charles J. Murphy Company, 964 P.2d 595 (Colo.App. 1998).
As argued by the ADP respondents, § 8-41-304(1) does not govern the determination of liability for medical benefits in a claim based upon an occupational disease, because in the context of that statute, the term "compensation" does not include "medical benefits." Royal Globe Insurance Co. Collins, 723 P.2d 731 (Colo. 1986). Rather, the insurer on the risk at the time the medical expenses are incurred is liable for those medical benefits. Royal Globe Insurance Co. Collins, supra. The insurer "on the risk" when medical expenses are "incurred" is the carrier which insured the employer whose conditions of employment were the proximate cause of the need for treatment. University Park Care Center v. Industrial Claim Appeals Office, 43 P.3d 637 (Colo.App. 2001). However, whether an employment caused the need for medical treatment is a question of fact for resolution by the ALJ. We must uphold the ALJ's findings of fact if supported by substantial evidence and plausible inferences drawn from the record. University Park Care Center v. Industrial Claim Appeals Office, 43 P.3d 637 (Colo.App. 2001); Dover Elevator Co. v. Industrial Claim Appeals Office, 961 P.2d 1141 (Colo.App. 1998). Further, the ALJ's findings are sufficient if the basis of the order is apparent. Magnetic Engineering, Inc. v. Industrial Claim Appeals Office, 5 P.3d 385 (Colo.App. 2000).
Here, the ALJ expressly recognized that the "last injurious exposure" rule only applies to "compensation" type benefits. ( See Conclusions of Law Part B, page 8). Consequently, the ALJ considered separately the issues of which employer is responsible for the claimant's compensation and medical benefits.
Concerning compensation-type benefits, the ALJ determined the ADP respondents failed to prove the claimant's condition was substantially and permanently aggravated by her employment at Liberty. The record fails to support the ADP respondents' contention the ALJ applied the same burden of proof concerning liability for medical benefits. To the contrary, the ALJ determined the ADP respondents are responsible for the cost of future treatment because the proximate cause of the need for medical treatment was the natural progression of the original disease. ( See Conclusions of Law Part C, page 9). Thus, the ALJ's order does not reflect a misapplication of the proper legal standard.
The ADP respondents further contend the record compelled a finding that the Liberty employment caused the need for additional medical treatment because the claimant was employed by Liberty when she reached MMI from the 2001 injury. We are not persuaded that evidence is dispositive of Liberty's liability for the claimant's medical benefits, and conclude there is substantial evidence in the record that the claimant's condition worsened with any activity and not as a result of her employment duties at Liberty. Further, that evidence supports the ALJ's finding that the Liberty employment did not cause the need for medical treatment.
IT IS THEREFORE ORDERED that the ALJ's order dated March 4, 2004, is affirmed.
INDUSTRIAL CLAIM APPEALS PANEL
____________________________________ Kathy E. Dean
____________________________________ Bill Whitacre
Susan K. Will, Aurora, CO, Automatic Data Processing, Inc., Aurora, CO, Monica Reince, Liberty Mutual Insurance Company, Irving, TX, Kerry L. Sullivan, Esq., Denver, CO, (For Claimant).
Patricia Jean Clisham, Esq., Denver, CO, (For Respondents).
Cindy Slevin, Esq. and Dawn Watts, Esq., Denver, CO, (For Respondent Liberty Mutual Insurance Company).