2019 COA 158
Colo. Ct. App.2019Background
- Carold Peoples sustained admitted work injuries in Feb 2010; CDOT paid TTD benefits through MMI in Apr 2013, totaling $83,569.36, which exceeded the statutory cap of $75,000 for combined TTD and PPD benefits.
- Peoples notified CDOT on May 30, 2012 that he had received SSDI; CDOT began offsetting TTD payments and later calculated an overpayment of $17,632.79.
- In Apr 2013 CDOT filed a final admission of liability (FAL) that listed the overpayment, but because Peoples had exceeded the statutory cap he had no future TTD/PPD payments from which CDOT could deduct installments.
- CDOT did not seek an ALJ order for repayment within one year of learning of the overpayment; the FAL closed automatically. The claim was reopened in 2017 and CDOT again listed the same overpayment.
- The ALJ and the Industrial Claim Appeals Office held that listing the overpayment on the 2013 FAL satisfied the Act’s requirement to “attempt to recover” within one year and ordered repayment (crediting a disfigurement award against the overpayment).
- The Colorado Court of Appeals reversed: where no ongoing benefits exist from which to recoup an overpayment, listing the overpayment on a FAL alone is not an “attempt to recover” and the employer must seek an ALJ repayment order within one year of learning of the overpayment.
Issues
| Issue | Plaintiff's Argument (Peoples) | Defendant's Argument (CDOT) | Held |
|---|---|---|---|
| Whether listing an overpayment on a FAL constitutes an “attempt to recover” under § 8-42-113.5(1)(b.5)(I) when claimant has no ongoing benefits | Listing the overpayment on the FAL does not satisfy “attempt to recover” because CDOT had no practicable means to deduct and should have sought an ALJ repayment order within one year | Filing a FAL that identifies the overpayment is an “attempt to recover” and satisfies the one-year statute of limitations | Court: No. Mere listing is not an attempt to recover when no installments can be deducted; employer must seek an ALJ order within one year |
| Whether CDOT was time-barred from recovering the overpayment in 2017 | Yes — statute of limitations expired because CDOT did not attempt actionable recovery within one year | No — the 2013 FAL preserved CDOT’s right to recover later | Court: Yes time-barred; CDOT may not pursue recovery after one year in these circumstances |
| Whether CDOT could credit claimant’s disfigurement award against the overpayment | No — CDOT was barred from recovery, so the credit was improper | Yes — if overpayment recovery is permissible, crediting disfigurement is proper | Court: Credit reversed because recovery was time-barred (did not resolve separate endorsement/timeliness technicality) |
Key Cases Cited
- Lombard v. Colo. Outdoor Educ. Ctr., 187 P.3d 565 (Colo. 2008) (give effect to every word in statutory language)
- Davison v. Indus. Claim Appeals Office, 84 P.3d 1023 (Colo. 2004) (statutes interpreted by plain and ordinary meaning)
- Ray v. Indus. Claim Appeals Office, 124 P.3d 891 (Colo. App. 2005) (review of statutory construction is de novo)
- Support, Inc. v. Indus. Claim Appeals Office, 968 P.2d 174 (Colo. App. 1998) (agency interpretation set aside if inconsistent with clear statute)
- Olivas-Soto v. Indus. Claim Appeals Office, 143 P.3d 1178 (Colo. App. 2006) (FAL automatic closure supports prompt claim resolution)
- Sanco Indus. v. Stefanski, 147 P.3d 5 (Colo. 2006) (Panel decisions entitled to deference but not controlling)