Court Opinion

ID: 9576469
Source: CourtListenerOpinion
Date Created: 2023-08-21 21:24:55.415319+00
Date Added: 2024-06-11T13:08:30.085529
License: Public Domain

Judge BRIGGS
specially concurring.
I concur in the majority’s analysis and conclusion. I write separately only to note *266yet another difficulty created when the new system of calculating certain permanent disability benefits was superimposed onto, but did not entirely replace, the earlier system. The difficulty this case illustrates is a potential gap between the end of eligibility for temporary benefits and the beginning of eligibility for permanent benefits.
Under the previous workers’ compensation system, permanent partial disability (PPD) awards for most injuries were calculated based upon a rating of industrial disability, which measured the worker’s loss of earning capacity in the labor market. The calculations took into consideration the injured worker’s general physical condition and mental training, ability, former employment, and education. Duran v. Industrial Claim Appeals Office, 883 P.2d 477 (Colo.1994); Colorado AFL-CIO v. Donlon, 914 P.2d 396 (Colo.App.1995).
The system was both fair and logical. For example, a physical worker with limited abilities and no high school education might suffer a back injury identical to that suffered by a clerical worker with excellent abilities and a college degree. The resulting physical impairments might be identical. However, aside from any difference in the average weekly wage used to calculate benefits, the impact on the earning capacity of the physical worker might be substantially greater because of more limited employment alternatives with the impairment. The former system reflected that reality.
More importantly here, eligibility for temporary and permanent benefits was based on the same concept and the occurrence of a single event, maximum medical improvement (MMI). At that point, entitlement to temporary benefits ceased and permanent benefits were to be determined. See Eastman Kodak Co. v. Industrial Commission, 725 P.2d 107 (Colo.App.1986).
After amendments to the Workers’ Compensation Act in 1991 and 1992, a new system of calculating permanent benefits was superimposed onto the existing system. The Act now requires that benefits for most permanent injuries be calculated based solely on medical impairment, pursuant to the American Medical Association Guides to the Evaluation of Permanent Impairment (3d ed. 1991)(AMA Guides). See § 8h12-107(c), C.R.S.1999; Askew v. Industrial Claim Appeals Office, 927 P.2d 1333 (Colo.1996).
The calculation of permanent benefits no longer takes into consideration the individual worker’s abilities, education, and experience. It therefore does not measure the actual impact on earning capacity. However, as just discussed, identical medical impairments to two workers will generally have a greater impact on the earning capacity of the worker with the more limited ability, education, and experience.
The result is that detrimental financial impact of the new system falls most greatly on those whose earning capacities are most compromised — those most in need of permanent disability benefits. In addition, under the new system even substantially similar injuries can result in substantially different awards, depending on whether the injury is rated under a remaining part of the old system or under the new system. See Duran v. Industrial Claim Appeals Office, supra; Colorado AFL-CIO v. Donlon, supra.
Aside from any concern with the logic or fairness of such a system, difficulties are created by superimposing it upon, but not entirely replacing, the existing system. For example, confusion can result from still basing apportionment of liability for two separate injuries on industrial disability, while basing benefits on medical impairment. See Askew v. Industrial Claim Appeals Office, supra; Waddell v. Industrial Claim Appeals Office, 964 P.2d 552 (Colo.App.1998) (Briggs, J. concurring).
This case illustrates a different difficulty. It arises from the relationship between the system for awarding temporary benefits and the new system of awarding permanent benefits.
Temporary benefits are still based on industrial disability, and eligibility still supposedly ceases when the worker reaches MMI, even if the worker is unable to return to employment with the employer. See § 8^12-105, C.R.S.1999; see also § 8-42-106, C.R.S. 1999 (pertaining to temporary partial disability). The new system also still uses MMI to *267trigger the requirement for the treating physician to make the medical rating upon which permanent benefits, now termed medical impairment benefits, are to be based. See § 8-42-107(c), C.R.S.1999.
However, the treating physician is to make the calculation pursuant to the AMA Guides. See § 8-42-107(e). As this case illustrates, those guides may not permit the calculation of medical impairment benefits for some months after the injured worker has reached MMI.
The result is that there can be a gap in the time between MMI and the calculation of medical impairment benefits. The current statutory scheme does not address this time gap.
It is therefore unclear whether, for example, the employer must continue paying temporary benefits, even though the worker has reached MMI. If not, the injured worker will be deprived of temporary benefits during the hiatus between MMI and the determination of medical impairment benefits. For a worker who has reached MMI but, because of the injury, cannot return to the old employment or quickly find alternative employment, deprivation of any benefits during the hiatus can be devastating.
Force a square peg into a round whole and gaps will surely appear. Hopefully, the General Assembly will fill this critical gap in our current workers’ compensation system.