June 26, 2019

Colorado Court of Appeals: No Right to Reimbursement for Temporary Total Disability Benefits in Excess of Statutory Cap

The Colorado Court of Appeals issued its opinion in United Airlines v. Industrial Claim Appeals Office on Thursday, March 28, 2013.

Workers’ Compensation—$75,000 Statutory Cap for Temporary Total Disability Benefits.

In this workers’ compensation action, United Airlines (employer) sought review of a final order of the Industrial Claim Appeals Office (Panel) affirming the administrative law judge’s (ALJ) denial of employer’s request for reimbursement of temporary total disability (TTD) benefits in excess of the $75,000 statutory cap. The judgment was affirmed.

After claimant sustained a compensable injury in 2007, employer admitted liability for TTD benefits. TTD benefits ceased when claimant was released to return to work in May 2011, by which time she had been paid $99,484.14. Shortly thereafter, a physician performed a division-sponsored independent medical examination and placed claimant at maximum medical improvement (MMI) with a permanent impairment of 5% of the whole person.

Relying on CRS § 8-42-107.5, which caps combined TTD and permanent disability benefits at $75,000 for a claimant whose impairment rating is 25% or less of the whole person, employer sought to recover the $24,483.14 it had paid in excess of the cap. Claimant responded that under CRS § 8-42-105(3), employer was required to continue paying TTD benefits until she was released to work.

The ALJ concluded the cap did not apply as long as claimant was entitled to receive TTD benefits. The Panel agreed and the Court of Appeals affirmed.

The Workers’ Compensation Act (Act) limits the total disability benefits that a claimant whose personal impairment rating is less than 26% may receive. However, the Act provides that benefits continue until one of a number of conditions is met.

Employer argued that benefits paid in excess of the cap must be repaid once claimant’s entitlement to TTD benefits has ended. The Court rejected that contention. Here, claimant received benefits to which she was entitled, and the amount in excess of the cap therefore did not constitute an overpayment.

The Court also found unpersuasive employer’s argument that allowing claimant to keep more than $75,000 in TTD benefits violates equal protection. Equal protection guarantees that similarly situated persons will receive like treatment under the law. Here, no fundamental right is affected or suspect class involved, so a “traditional or rational basis standard of review” applies.

Employer asserted that two classes of claimants are created by the Panel’s decision: those whose benefits will be capped because their benefits had not exceeded the cap when they reached MMI or were released to work, and those whose benefits exceeded the cap before they reached MMI or were released to work. This disparity does not, however, violate equal protection. First, the two classes are not similarly situated. Those claimants who take longer to reach MMI are different from those who take a shorter time. Second, even if they were similarly situated, requiring a claimant to pay back benefits to which she was entitled and needed would create hardships at odds with the purposes of the Act. Proceedings to recover excess payments also could burden the administrative process. These reasons rationally justify the resulting difference in treatment. The order was affirmed.

Summary and full case available here.

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