Colorado: Maximum Medical Improvement Determination Requires “Appropriate” Expert Medical Evidence

While it is the duty the ALJ to determine the facts, including whether or not an injured worker has reached MMI status, that determination may not be made without the support of appropriate medical evidence, held a Colorado appellate court. Accordingly, where neither the claimant’s treating physician nor an independent physician appointed under the state’s division-sponsored independent medical examination (DIME) process opined that the worker had reached MMI, a determination by the ALJ that she had was without support. The appellate court stressed that it was the ALJ’s job to resolve conflicts. Here there was no conflict to be resolved as both physicians indicated the claimant had not reached MMI.

Thomas A. Robinson, J.D., the Feature National Columnist for the LexisNexis Workers’ Compensation eNewsletter, is co-author of Larson’s Workers’ Compensation Law (LexisNexis).

LexisNexis Online Subscribers: Citations below link to Lexis Advance.

See Burren v. Industrial Claim Appeals Office, 2019 COA 37, 2019 Colo. App. LEXIS 347 (Mar. 7, 2019)

See generally Larson’s Workers’ Compensation Law, § 128.05.

Source: Larson’s Workers’ Compensation Law, the nation’s leading authority on workers’ compensation law

For a more detailed discussion of the case, see