In Singh, the claimant was a taxi driver who was injured in a car accident in March 2019. The claimant sustained a neck muscle strain, with no other serious injuries. In May 2019, the claimant’s authorized treatment provider (ATP) found that the claimant’s subjective complaints outweighed the objective findings. The claimant was released to full work duty on June 25, 2019. The claimant met with a psychiatrist and after a few sessions, the psychiatrist placed claimant at MMI on October 14, 2019 and gave him a 5% mental impairment rating. Subsequently, the ATP agreed with a 5% mental impairment rating.
The claimant underwent a Division IME at the request of the respondents in March 2020. After reviewing the claimant’s medical records, the Division IME physician discovered that the claimant had been in a car accident in 2007 and had been treated for back and neck injuries thereafter. The Division IME physician found that many of the physical symptoms the claimant reported after the 2019 accident were pre-existing. However, because she did not review all of the claimant’s medical records, she was unable to apportion the 2007 accident from the 2019 accident. The claimant was given a 16% whole person impairment, which included a 12% spine impairment and 5% mental impairment, which was based on the claimant’s prior psychiatrist’s rating.
Subsequently, after reviewing additional medical records, the claimant’ psychiatrist retracted the prior 5% mental impairment rating and found that the claimant had no mental impairment as a result of the 2019 accident.
Respondents filed for a hearing to overcome the Division IME physician’s 16% whole person rating. The ALJ found that the respondents had overcome the Division IME physician’s whole person impairment rating. In doing so, the ALJ noted that the claimant presented no evidence to contest the psychiatrist’s retraction of the mental impairment. Additionally, the ALJ dismissed the Division IME physician’s whole person impairment rating because she “fail[ed] to consider the clear and uncontroverted evidence that [c]laimant had recovered from his March 3, 2019[,] cervical strain, and that he had returned to his physical baseline by August 2019. The Industrial Claim Appeals Office (the Panel) affirmed, holding that the ALJ’s findings were supported by substantial evidence.
The claimant appealed to the Colorado Court of Appeals (the Court) and argued that the ALJ erred in finding that respondents overcame the Division IME physician’s assessment of permanent impairment. The Court noted that whether a party has overcome the Division IME physician’s opinion is a question of fact and cannot be overturned if there is substantial evidence to support the finding. The Court went on to clarify the “substantial evidence” standard stating that “[s]ubstantial evidence is that which is probative, credible, and competent, such that is warrants a reasonable belief in the existence of a particular fact without regard to contradictory testimony or inference.” (citing Nanez v. ICAO, 2018 COA 162, ¶ 34). The Court further explained that it must consider the evidence with deference to the ALJ and in the light most favorable to the prevailing party.
The Court found that there was substantial evidence to support the findings because the ALJ’s finding that there was no evidence to support the Division IME physician’s mental impairment rating and that the Division IME physician failed to review all of the claimant’s medical records were both supported by evidence in the records.
Singh v. Indus. Claims Appeal Office, 21 CA 0933 (June 30, 2022)
Want to know more? Contact Jenna Eccles at jeccles@pollartmiller.com or 877-259-5693.