Opinion ID: 4535064
Heading Depth: 1
Heading Rank: 3

Heading: C.A.O. Feb. 25, 2011).

Text: ¶31 In McFadden, the employer and the insurer requested a DIME after none of the ATPs placed the employee at MMI. Id. at . The DIME doctor agreed with the ATPs and found that the employee wasn’t at MMI; however, the employer and insurer challenged the DIME doctor’s opinion under subsection (8)(b)(III), 16 presenting evidence by a third-party physician that the claimant had reached MMI. Id. at –2. The ALJ concluded that the employer and insurer had overcome the DIME doctor’s findings by clear and convincing evidence and placed the claimant at MMI, crediting the employer’s third-party physician’s testimony. Id. ¶32 The ICAO upheld the ALJ’s decision. Id. at . Like the panel that reviewed Burren’s claim, the McFadden panel approved: (1) the ALJ’s reliance on a thirdparty physician’s testimony regarding the employee’s MMI status, id. at ; and (2) the ALJ’s decision to place the claimant at MMI even though neither the DIME doctor nor the ATP had placed the employee at MMI, id. at –3. Thus, McFadden supports allowing an ALJ to place a claimant at MMI as part of the DIME dispute process, even if a third-party physician is the only doctor who found the employee at MMI. ¶33 Because the ICAO administers the Act, this court defers to its reasonable statutory interpretations. Pinnacol Assurance v. Hoff, 2016 CO 53, ¶ 26, 375 P.3d 1214, 1220. And since the McFadden panel’s interpretation of section 8-42-107(8)(b) reasonably aligns with the plain language and structure of the Act, we defer to it today.6 6 Burren asserts that McFadden doesn’t represent the ICAO’s interpretation of section 8-42-107(8)(b), because the employee only challenged whether the ALJ’s decision was supported by substantial evidence, not the ALJ’s interpretation of 17 3. The Legislature’s Intent in Adding the Twenty-Four-Month DIME Provisions ¶34 Finally, by adding the twenty-four-month DIME provisions in section 8-42-107(8)(b)(II) and (III), the legislature contemplated the need for ALJs to resolve an employee’s MMI status at a “hearing” in cases such as Burren’s. The division’s holding would impede that legislative goal. ¶35 Originally, the Act allowed only ATPs to place an employee at MMI. See Ch. 112, sec. 1, § 8-42-107(8)(b), 1996 Colo. Sess. Laws 456, 456–57. If an ATP refused to do so, the Act did not provide employers the opportunity to obtain a second opinion from a neutral, division-sponsored physician. But in 1996 the General Assembly added the twenty-four-month DIME provisions in section 8-42-107(8)(b). See 1996 Colo. Sess. Laws at 457. The legislature also amended section 8-42-107(8)(b)(III) to allow employers to overcome a DIME doctor’s opinion by clear and convincing evidence, thus indicating that section 8-42-107(8)(b) should function to ensure that employers and insurers receive an section 8-42-107(8)(b). True, the employee in McFadden simply argued that the ALJ erred in finding that the employer overcame the DIME doctor’s opinion by clear and convincing evidence. 2011 WL 737114, at . But if the McFadden panel hadn’t construed section 8-42-107(8)(b) to permit an ALJ to credit, over the contrary opinions of an ATP and a DIME doctor, a third-party physician’s testimony that an employee has reached MMI, it wouldn’t have upheld the ALJ’s order. 18 accurate second opinion. See 1996 Colo. Sess. Laws at 457. The division’s holding severely limits the remedial power of these provisions. ¶36 The division relied on this court’s decision in Williams to hold that a claimant must return to the ATP for continued treatment if the ATP and DIME doctor agree that the claimant isn’t at MMI. Burren, ¶¶ 17–18. But in Williams, the employer did not challenge the DIME doctor’s MMI opinion. 147 P.3d at 34–35. Thus, the DIME doctor’s determination that the claimant hadn’t reached MMI retained its presumptive effect. Magnetic Eng’g, 5 P.3d at 387. Here, Destination Maternity not only challenged but overcame the DIME doctor’s opinion by clear and convincing evidence. Therefore, Williams is inapposite. ¶37 The division recognized that its “interpretation of the statute effectively precludes an employer’s ability to challenge a twenty-four-month DIME when the DIME agrees with the ATP that a claimant is not at MMI.” Burren, ¶ 19. The division justified its holding by noting that “prior to the addition of section 8-42-107(8)(b)(II) in 1996, employers were at the mercy of ATPs and had no recourse to challenge perpetual care; treatment simply continued until an ATP placed the claimant at MMI.” Id. ¶38 While the division’s observation is correct, its holding fails to give full effect to the statutory amendments. First, the division’s approach returns the claimant to the ATP for continued treatment, even though the legislature added the twenty- 19 four-month DIME provision to prevent unending care by an ATP when conflicting medical evidence indicates the claimant has reached MMI and two years have passed since the date of injury. See 1996 Colo. Sess. Laws at 457. And, just as the division noted, it would essentially prevent employers from challenging a DIME doctor’s determination that a claimant isn’t at MMI if the ATP also found the claimant isn’t at MMI. Yet courts should avoid statutory constructions that would render certain provisions “without practical effect.” Howard v. People, 2020 CO 15, ¶ 13, 458 P.3d 893, 897 (quoting Roberts v. Bruce, 2018 CO 58, ¶ 9, 420 P.3d 284, 286). Therefore, we avoid such a construction here. ¶39 The division also proposed an alternate solution for employers in this situation—“reinvok[e] the twenty-four-month DIME process at an appropriate time in the future.” Burren, ¶ 19. This suggestion might allow employers to obtain a more accurate second opinion regarding an injured employee’s MMI status, as it would permit the appointment of a new DIME doctor. But nothing in subsection (8)(b)(III) indicates that an employer should be forced to reinvoke the twenty-fourmonth DIME process if it has already overcome the original DIME doctor’s MMI determination. Had the legislature intended the twenty-four-month DIME process to function in that manner, it could’ve said so. It did not, and “[w]e do not add words to the statute.” People v. Diaz, 2015 CO 28, ¶ 12, 347 P.3d 621, 624 (quoting Turbyne v. People, 151 P.3d 563, 567 (Colo. 2007)). Moreover, the division’s 20 suggestion could have the effect of placing employers on a kind of MMI hamster wheel, where they might repeatedly reinvoke the twenty-four-month DIME process without resolution. The language and structure of the statute don’t support a construction that yields that potential outcome. C. Whether an ALJ Can Determine Permanent Impairment ¶40 Burren also argues that we shouldn’t allow an ALJ to place an employee at MMI on these facts because of the effect on a claimant’s permanent impairment rating. More pointedly, Burren contends that only an ATP or a DIME doctor can determine a claimant’s permanent impairment rating, and those physicians cannot provide that rating until placing the claimant at MMI. Thus, allowing an ALJ to place a claimant at MMI in such cases and then determine a claimant’s permanent impairment would deprive claimants of their statutory right to an ATP- or DIME doctor-approved rating and force injured employees to undertake the financially burdensome task of presenting their own evidence regarding permanent impairment. ¶41 We disagree. First, the Act doesn’t specify that only ATPs and twenty-fourmonth DIME doctors may determine a claimant’s permanent impairment rating. ATPs and DIME doctors may calculate a claimant’s impairment rating. See § 8-42-107(8)(b)(III), (c). But so too may any other level-II-accredited physician. 21 § 8-42-101(3.6)(b), C.R.S. (2019); § 8-42-107(8)(c).7 And a level-II-accredited physician may participate in a workers’ compensation case without serving as one of the employee’s ATPs or as a DIME doctor. For example, Dr. Fall (the third-party physician hired by Destination Maternity to examine Burren) is a level-IIaccredited physician and thus qualified to determine Burren’s impairment rating. Yet Dr. Fall served as neither an ATP nor a twenty-four-month DIME doctor in this case. So, we reject Burren’s contention that we should not allow an ALJ to place a claimant at MMI and then address the employee’s impairment rating in cases like this one. ¶42 We also reject Burren’s assertion that allowing an ALJ to determine a claimant’s impairment rating under these circumstances forces an injured employee to undertake the financially burdensome task of producing evidence of impairment from a third-party physician. Both the Act and the procedures of the Division of Workers’ Compensation (the “DWC”) include safeguards that prevent such an outcome. Notably, the statute doesn’t require that an ATP or a twentyfour-month DIME doctor first place an employee at MMI before calculating the 7 The accreditation system functions to “provide physicians with an understanding of the administrative, legal, and medical roles and . . . is accessible to every licensed physician, with consideration of specialty and geographic diversity.” § 8-42-101(3.6)(e). 22 employee’s permanent impairment rating. True, if an ATP or DIME doctor determines that a claimant has reached MMI, then that physician must determine the claimant’s impairment rating. § 8-42-107(8)(b)(III), (c). But nothing in the statute prevents an ATP or DIME doctor from providing a provisional rating for the ALJ to consider at a DIME dispute hearing.8 ¶43 In fact, the DWC specifically directs twenty-four-month DIME doctors to address impairment if requested by the parties, even if the DIME doctor determines the claimant hasn’t reached MMI. Colo. Dep’t of Labor & Emp’t, Div. of Workers’ Compensation Desk Aid #11—Impairment Rating Tips: DIME Panel Physician Notes, 14 (“Remember that a DIME is a legal/medical proceeding and you are being asked to provide specific information. If the party requesting the DIME has 8Burren cites court of appeals caselaw that she contends requires an ATP or DIME doctor to first place the employee at MMI before rating the claimant’s permanent impairment. See Dziewior v. Mich. Gen. Corp., 672 P.2d 1026, 1030 (Colo. App. 1983) (noting that “permanent disability generally cannot be determined until the authorized physicians treating a claimant for work-related injuries advise that they can do nothing further for the claimant”); accord MGM Supply Co. v. Indus. Claim Appeals Office, 62 P.3d 1001, 1005 (Colo. App. 2002). However, the court of appeals decided Dziewior before the General Assembly amended section 8-42-107(8)(b) to include the twenty-four-month DIME dispute provisions, and nothing in the Act prevents a DIME doctor from providing a provisional impairment rating. Accordingly, we decline to interpret section 8-42-107(8)(b) to prevent DIME doctors from providing provisional ratings. 23 asked that impairment be addressed, and if you find the patient not at MMI for that workrelated injury, you should nevertheless provide a rating for that injury.”). ¶44 Here, the DWC directed Dr. Henke, the twenty-four-month DIME doctor who examined Burren, to address permanent impairment. Thus, Dr. Henke should have provided Burren with a provisional impairment rating that she could have introduced at the DIME dispute hearing. Although Dr. Henke failed to provide the rating as requested by Destination Maternity, the DWC again offered both parties the opportunity to solicit a provisional rating from Dr. Henke. In the Division’s letter to Burren notifying her that Dr. Henke did not place her at MMI, the Division stated: “If the physician did not provide a rating, and either or both parties desire that a rating (for informational purposes) be provided, please convey your request to the [Independent Medical Examination] Unit and we will forward it to the physician.” ¶45 Thus, neither the Act nor the DWC’s procedural rules prevented Burren from obtaining a DIME doctor-approved provisional rating, free of charge to her. Burren simply elected not to do so. ¶46 We therefore decline to deprive ALJs of their authority to place an employee at MMI because of the effect on an employee’s permanent impairment rating. Once an ALJ determines an employee has reached MMI, the employee’s 24 permanent impairment rating becomes a question of fact that the ALJ can resolve after considering any conflicting medical evidence regarding impairment.9