Opinion ID: 2518013
Heading Depth: 2
Heading Rank: 1

Heading: Richard Simpson's Claim

Text: Richard Simpson was injured in a work-related motor vehicle accident on April 25, 2000. He filed a workers' compensation claim and began receiving temporary total disability (TTD) benefits on June 6, 2001. Simpson reached maximum medical improvement (MMI) on November 19, 2001, and became eligible for permanent partial disability (PPD) benefits. Even though Simpson reached MMI, he did not return to work. Simpson's condition worsened on May 5, 2004, and the parties agreed to reopen Simpson's claim. Simpson again received TTD benefits until November 19, 2005. The insurer admitted liability for permanent total disability (PTD) benefits commencing on November 19, 2005. The insurer set Simpson's PTD benefits at the maximum rate in effect at the time of his accident. Simpson objected to this rate and requested that the ALJ increase the rate to the maximum rate in effect at the time he became permanently and totally disabled. [2] The ALJ found in favor of the insurer and applied the lower maximum rate in effect at the time of the accident. Simpson appealed the ALJ's decision to the Industrial Claim Appeals Office (ICAO). He argued that sections 8-42-111, 8-42-105, and 8-47-106, C.R.S. (2009), should not limit him ad infinitum to the maximum rate in place at the time of his accident. In other words, Simpson interpreted those provisions as meaning that the limit on workers' compensation benefits should be recalculated each year to reflect changes in the maximum rate. The ICAO panel rejected this argument and affirmed the decision of the ALJ. Simpson appealed the ICAO's decision to the court of appeals. While the case was pending at the court of appeals, we decided Avalanche Industries. The court of appeals requested supplemental briefs to address the effect of Avalanche Industries on Simpson's claim. Like the ICAO panel, the court of appeals rejected Simpson's statutory argument that a claimant's benefits should be recalculated each year to reflect changes in the maximum rate. [3] Simpson, 219 P.3d at 363-64. Nevertheless, the court of appeals gave Simpson some relief based on section III.C. of Avalanche Industries, which held that time of injury could mean time of disablement. The court of appeals held that the applicable limit on workers' compensation benefits was the maximum rate in effect at the claimant's time of injury. Id. Relying on section III.C. of Avalanche Industries, the court of appeals held that a claimant is entitled to have his or her benefits calculated based on the applicable limit in effect at the time of disablement. Id. at 362. Thus, the court of appeals held Simpson might be eligible for a different maximum rate, depending on when Simpson became disabled. That court remanded the case to the ALJ to determine when the time of disablement occurred and what the applicable limit was at that time. Id.