Case Name: HIRE QUEST, LLC, d/b/a Trojan Labor; and Ace American Insurance Company, Petitioners, v. INDUSTRIAL CLAIM APPEALS OFFICE OF the STATE of Colorado and Jimmy Lassiter, Respondents
Court: Colorado Court of Appeals
Jurisdiction: Colorado
Decision Date: 2011-09-15
Citations: 264 P.3d 632
Docket Number: No. 10CA2450
Parties: HIRE QUEST, LLC, d/b/a Trojan Labor; and Ace American Insurance Company, Petitioners, v. INDUSTRIAL CLAIM APPEALS OFFICE OF the STATE of Colorado and Jimmy Lassiter, Respondents.
Judges: Judge KAPELKE concurs.
Reporter: Pacific Reporter 3d
Volume: 264
Pages: 632–637

Head Matter:
HIRE QUEST, LLC, d/b/a Trojan Labor; and Ace American Insurance Company, Petitioners, v. INDUSTRIAL CLAIM APPEALS OFFICE OF the STATE of Colorado and Jimmy Lassiter, Respondents.
No. 10CA2450.
Colorado Court of Appeals, Div. VII.
Sept. 15, 2011.
Rehearing Denied Oct. 27, 2011.
Thomas Pollart & Miller LLC, Douglas A. Thomas, Heather J. Smith, Greenwood Village, Colorado, for Petitioners.
No Appearance for Respondent Industrial Claim Appeals Office.
Franklin D. Azar & Associates, John M. Connell, Aurora, Colorado, for Respondent Jimmy Lassiter,
Sitting by assignment of the Chief Justice under provisions of Colo. Const. art. VI, § 5(3), and § 24-51-1105, C.R.S.2011.

Opinion:
Opinion by
Judge GABRIEL.
In this workers' compensation proceeding, Hire Quest, LLC and its insurer, Ace American Insurance (collectively employer), seek review of a final order of the Industrial Claim Appeals Office (Panel) determining that claimant Jimmy Lassiter is entitled to ongoing medical treatment after the date of maximum medical improvement (MMI). Because we perceive no error in the Panel's conclusion that claimant did not waive his entitlement to such benefits, we affirm.
I. Background
In 2007, claimant sustained work-related injuries in a motor vehicle accident. The treating physician determined that claimant was at MMI in 2008, and a physician performing a division-sponsored independent medical examination (DIME) agreed. The DIME physician also issued an impairment rating and recommended further treatment.
Employer filed an application for a hearing on the issues of (1) permanent partial disability (PPD) benefits, (2) a penalty for an alleged safety rule violation by claimant (namely, his failure to wear a seatbelt in violation of employer's policy), and (8) overcoming the DIME physician's impairment rating. Claimant responded to this application and listed the issues to be determined as the safety rule violation, the alleged overpayment of benefits by employer, and overcoming the DIME physician's impairment rating. Employer, however, subsequently withdrew the issue of overcoming the DIME, leaving for determination at the hearing only the issues of a reduction of benefits based on the safety rule violation and a credit for previously paid temporary disability benefits.
In a 2009 order, the ALJ ordered employer to pay PPD benefits based on the DIME physician's uncontested rating. The ALJ, however, denied a reduction for the alleged safety rule violation, finding that employer had failed to prove such a violation, but agreed that employer was entitled to a credit for previously paid temporary disability ben efits. The ALJ also stated, "Issues not expressly decided herein are reserved to the parties for future determination." This order was not appealed.
The ALJ's reservation clause became the issue of protracted litigation when claimant later filed an application for a hearing on the issue of his entitlement to ongoing medical benefits after MMI (Grover medical benefits). See Grover v. Indus. Comm'n, 759 P.2d 705, 711 (Colo.1988) (concluding that "future medical benefits may be entered" if "future medical treatment will be reasonably necessary to relieve the injured worker from the effects of the work-related injury or occupational disease"). Claimant argued that because the DIME physician recommended further medical treatment and employer never filed a final admission of liability (FAL) taking a position on that recommendation, Grover medical benefits could be awarded despite claimant's failure to raise the issue earlier.
Employer responded that claimant was not entitled to Grover medical benefits because, as pertinent here, (1) claimant's claim was closed after the 2009 order became final and no petition to reopen had been filed, and (2) by failing to request Grover medical benefits when the issue of PPD benefits was heard, claimant waived his right to those benefits.
A second ALJ agreed with employer that claimant had waived his right to pursue @rover medical benefits by failing to raise that issue at the hearing concerning PPD benefits. This ALJ also concluded that (1) employer was not required to file an FAL under the cireumstances of this case, and (2) the first ALJ's reservation clause was "mere surplus" because the 2009 order addressed PPD benefits and applicable case law "require[d] a claimant to litigate the issue of Grover medical benefits in connection with an award of PPD benefits."
Claimant appealed, and the Panel affirmed as to the ALJ's determination that employer was not required to file an FAL. The Panel, however, set aside the ALJ's finding that claimant had waived his right to Grover medical benefits. The Panel recognized the general rule that such benefits must be requested at the time permanent disability is determined and that claimant did not do so. The Panel concluded, however, that the reservation clause in the ALJ's 2009 order preserved claimant's right to seek Grover medical benefits, In so holding, the Panel disagreed with the second ALJ's characterization of the reservation clause as "mere surplus," stating, "We presume the intent [of the first ALJ] was to reserve unresolved issues such as entitlement to Grover medical benefits." The Panel thus remanded the case to the second ALJ to determine claimant's entitlement to such benefits.
On remand, the second ALJ awarded claimant Grover medical benefits. Relying on the medical evidence presented, including the opinions of the treating physician and the DIME physician, the ALJ found that "future medical treatment will be reasonably necessary to alleviate and prevent deterioration of [claimant's] condition." Employer appealed, and the Panel affirmed.
Employer now appeals the Panel's order affirming the award of Grover medical benefits to claimant.
II. Discussion
Employer contends that the Panel erred in rejecting its contention that claimant waived the issue of Grover medical benefits. Specifically, as pertinent here, employer asserts that (1) claimant waived his right to receive Grover medical benefits by failing to request them when the issue of permanent disability was heard, and (2) the issue of Grover medical benefits was never raised at the initial hearing and thus, could not have been reserved. We are not persuaded.
A. Applicable Law and Standard of Review
"[The right to future medical benefits may be waived if not requested at the time permanent disability is heard." Hanna v. Print Expediters Inc., 77 P.3d 863, 866 (Colo.App.2003). A claim may be litigated without reopening, however, if "an ALJ's award of benefits expressly reserves other issues for future determination." Id.
Generally, whether a party has waived his or her rights is a question of fact. In re Marriage of Robbins, 8 P.3d 625, 630 (Colo.App.2000). When an ALJ's factual findings are supported by substantial evidence, we are bound by them. See § 8-43-308, C.R.S.2010; Paint Connection Plus v. Indus. Claim Appeals Office, 240 P.3d 429, 431 (Colo.App.2010). An agency's decision that misconstrues or misapplies the law, however, is not binding. Paint Connection Plus, 240 P.3d at 431. We review de novo questions of law or the application of law to undisputed facts. See Camp Bird Colo., Inc. v. Bd. of Cnty. Commrs., 215 P.3d 1277, 1281 (Colo.App.2009).
B. Application
Applying these principles here, we reject each of employer's above-noted assertions in turn.
1. Alleged Waiver Under Hanna
With respect to employer's contention that under Hanna, claimant waived his claim for Grover medical benefits by not requesting them at the time permanent disability was heard, employer does not dispute that a claim may be litigated without reopening when an ALJ's award of benefits expressly reserves other issues for future determination. Hanna, 77 P.3d at 866.
Here, as noted above, and unlike in Han-ma, the first ALJ's order specifically stated, "Issues not expressly decided herein are reserved to the parties for future determination." Moreover, it is undisputed that the issue of Grover medical benefits was not expressly decided in the first ALJ's order. Accordingly, under the clear and unambiguous language of that order, the issue of Grover medical benefits was reserved for future determination and therefore not waived by claimant. Cf. Munoz v. Indus. Claim Appeals Office, - P.3d -, -, 2011 WL 1797229 (Colo.App.2011) (holding that the claimant could not knowingly waive a DIME when the DIME process was stayed).
Notwithstanding the foregoing, employer asserts that the reservation clause was ineffective because (1) it was "mere surplus" and "generic," and (2) it failed to refer expressly to Grover medical benefits. Again, we are not persuaded.
As to the first of these contentions, we are unwilling to presume that the reservation clause at issue here was "mere surplus," especially given the absence of any evidence in the record indicating that the first ALJ added that clause to his order without any basis for doing so.
As to the second of these contentions, we see nothing in Hanna (or in Brown & Root, Inc. v. Industrial Claim Appeals Office, 833 P.2d 780 (Colo.App.1991), on which Hanna relied) to support employer's contention that a reservation clause must specifically list the issues being reserved. As noted above, in Hanna, 77 P.3d at 866, the division opined that a claim may be litigated without reopening when an ALJ's award of benefits "expressly reserves other issues for future determination." The division, however, did not say that the ALJ was required to specify what issues were being reserved. Although, as employer's counsel noted in oral argument, the division went on to observe that the ALJ order at issue in Honna "did not contain any clause that reserved the issue of medical benefits," id. (emphasis added), we do not interpret that statement as requiring that a reservation clause specify the precise issues reserved. Rather, we view that statement, when read in context, as a factual recitation as to what had occurred in that case.
For these reasons, although we note that it may be better practice for an ALJ, where practicable, to specify any issues that he or she intends to reserve, we are unwilling to engraft such a requirement onto existing law, particularly where neither the General Assembly, our supreme court, nor any prior division of this court has done so. Accordingly, on the facts of this case, we perceive no error in the Panel's determination that the express reservation clause was valid and thus preserved claimant's claim for Grover medical benefits. See El Paso Cnty. Dep't of Soc. Servs. v. Donn, 865 P.2d 877, 879 (Colo.App.1993) ("If an order grants or denies temporary benefits but expressly reserves jurisdiction over other issues, no award has been entered, and thus, no petition to reopen is required."); Brown & Root, Inc., 833 P.2d at 784 (where an ALJ's order "specifically referred to [PPD] benefits and reserved the ALJ's jurisdiction over that issue for further determination," the division could not conclude that the order constituted an award closing the matter, and thus, no petition for reopening was required); see also 17 Douglas R. Phillips & Susan D. Phillips, Colo. Practice Series: Colorado Workers' Comp. Practice & Procedure § 18.8, at 577 (24 ed.2005) (noting that (1) a reservation clause providing that "[all issues not determined are reserved for future determination" should be sufficient to prevent dismissal of other potential benefits after an adjudication, and (2) "if specific issues are to remain open the administrative law judge should list the issues").
2. Reservation of Issue Purportedly Not Raised
With respect to employer's contention that because the Grover medical benefits issue was never raised at the hearing, it could not have been reserved, employer cites no applicable authority to support this assertion, and we have found none. Accordingly, we reject this argument.
III. Conclusion
For these reasons, the order is affirmed. JUDGE KAPELKE concurs.
Judge KAPELKE concurs.
Judge RICHMAN dissents.