Claim Closure – When a Final Admission is in the Claimant’s Hand, Objecting and Applying for Hearing Better be the Claimant’s Plan

Even where the Final Admission of Liability (FAL) is mailed to the wrong address, once a tardy copy is provided to the claimant, objecting and applying for hearing has to be done within 30 days or the claim closes.

In Dickens, claimant sought a review of a final order of the Panel of the Industrial Claim Appeals Office (Panel) which affirmed the decision of Administrative Law Judge (ALJ) denying his petition to reopen and dismissing his claim for additional benefits.

Claimant sustained an admitted, compensable injury to his right knee in 2006. In November 2013, the employer filed a FAL based on an August 2013 maximum medical improvement (MMI) date. Neither claimant nor his counsel were properly served the FAL, and claimant did not receive it until April of 2014. Claimant filed an objection within 30 days of receiving the FAL, but did not file an application for hearing until after the 30 day period, and that application did not challenge any of the issues addressed in the FAL. Claimant did not file an Application for Hearing (AFH) addressing those substantive issues until 2017.

The Administrative Law Judge (ALJ) ultimately concluded that claimant’s claim had automatically closed due to his failure to file a timely AFH within thirty days after receipt of the FAL. Claimant petitioned the Panel for review, and the Panel found that where FAL service is deficient, the 30 day period begins the day the FAL is received. The Panel also found that substantial evidence supported the ALJ’s denial and dismissal of claimant’s petition to reopen, and affirmed the ALJ’s order.

The Court of Appeals affirmed the Panel’s order, holding that t when service of an FAL is improper, the 30 day period to both file an objection and an AFH begins to run the date claimant receives the FAL.

Dickens v. Indus. Claim Appeals Office, No. 18CA 1806 (Colo. Ct. App. June 20, 2019)

Would you like to know more? Contact Eric J. Pollart at epollart@pollartmiller.com or 877-259-5693.

 

From the September 2019 Newsletter 

2019-10-02T08:55:15+00:00