Peitz v. Industrial Claim Appeals Office
2024 COA 102
| Colo. Ct. App. | 2024|
Check TreatmentOpinion Summary
Facts
- Plaintiff Hyper Microsystems Incorporated entered a written agreement with Defendant Legacy Micro, Inc. for the purchase of assets, secured by a Goodwill Note. [lines="13-14"], [lines="41-42"].
- Legacy promised to pay a total of $484,903.58 under the Goodwill Note in 36 monthly installments. [lines="46-50"].
- Starting in November 2018, Legacy failed to make complete payments as required under the Goodwill Note. [lines="88-90"].
- Microsystems filed a breach of contract complaint after Legacy ceased all payments and alleged an oral modification with no valid consideration. [lines="100-106"].
- Legacy claimed an overpayment on a separate Inventory Note, asserting it should offset amounts owed under the Goodwill Note. [lines="175-176"], [lines="470-479"].
Issues
- Whether the oral modification of the Goodwill Note claimed by Legacy is enforceable under Illinois law. [lines="240-243"].
- Whether Legacy's defenses of unclean hands and failure to mitigate its damages are legally valid in response to Microsystems' breach of contract claim. [lines="366-372"], [lines="408-413"].
- Whether Legacy's assertion of an overpayment on the Inventory Note can serve as a valid defense or offset against the Goodwill Note obligations. [lines="174-175"], [lines="470-475"].
Holdings
- The court determined no enforceable oral modification of the Goodwill Note exists due to lack of definite terms and consideration. [lines="362-365"].
- The court ruled that the defenses of unclean hands and failure to mitigate cannot defeat Microsystems' motion for summary judgment as they are legally inapplicable. [lines="406-407"], [lines="433-433"].
- The court found that the claim of an overpayment regarding the Inventory Note does not provide grounds for offset against obligations under the Goodwill Note, dismissing that argument as unsupported. [lines="479-491"].
OPINION
SUMMARY
September 12, 2024
2024COA102
No. 24CA0250, Peitz v. Industrial Claim Appeals Office —
Labor and Industry — Workers’ Compensation — Workers’
Compensation Rules of Procedure — Division Independent
Medical Examination (DIME) — Payments/Fees — Scope of
Evaluation
In this workers’ compensation proceeding, a division of the
court of appeals considers, for the first time, whether Rule 11-5 of
the Workers’ Compensation Rules of Procedure (WCRP), Div. of
Workers’ Comp. Rule 11-5, 7 Code Colo. Regs. 1101-3, prohibits a
physician performing a division independent medical examination
(DIME) from evaluating all aspects of a worker’s injury in
determining whether the worker has obtained maximum medical
improvement (MMI).
WCRP 11-5 establishes a schedule of fees that a physician
may charge for a DIME, based primarily on the designated body
parts and date of injury on the application for a DIME. The division
The summaries of the Colorado Court of Appeals published opinions
constitute no part of the opinion of the division but have been prepared by
the division for the convenience of the reader. The summaries may not be
cited or relied upon as they are not the official language of the division.
Any discrepancy between the language in the summary and in the opinion
should be resolved in favor of the language in the opinion.
rejects respondents’ argument that the number of body parts
selected pursuant to the fee schedule limits the scope of a DIME
physician’s examination to determine MMI.
COLORADO COURT OF APPEALS 2024COA102
Court of Appeals No. 24CA0250
Industrial Claim Appeals Office of the State of Colorado
WC No. 5-142-174
Jason Peitz,
Petitioner,
v.
Industrial Claim Appeals Office, Board of Water Works of Pueblo, and Travelers
Casualty & Surety Co.,
Respondents.
ORDER SET ASIDE AND CASE
REMANDED WITH DIRECTIONS
Division VI
Opinion by JUDGE SCHUTZ
Lipinsky and Taubman*, JJ., concur
Announced September 12, 2024
Michael W. Seckar, P.C., Lawrence D. Saunders, Pueblo, Colorado for Petitioner
No Appearance for Respondent Industrial Claim Appeals Office
Ray Lego and Associates, Jonathan S. Robbins, Centennial, Colorado for
Respondents Board of Water Works of Pueblo and Travelers Casualty & Surety
Co.
*Sitting by assignment of the Chief Justice under provisions of Colo. Const. art.
VI, § 5(3), and § 24-51-1105, C.R.S. 2024.
1
¶ 1 Jason Peitz appeals an order of the Industrial Claim Appeals
Office (Panel) affirming a determination by an administrative law
judge (ALJ) that he had reached maximum medical improvement
(MMI) for all work-related conditions. We set aside the Panel’s order
and remand with directions.
¶ 2 Resolution of this appeal requires us to consider, for the first
time in a published opinion, whether Workers’ Compensation Rule
of Procedure 11-5, Div. of Workers’ Comp. Rule 11-5, 7 Code Colo.
Regs. 1101-3 (WCRP 11-5), requires a physician who is conducting
a division independent medical examination (DIME) under section
8-42-107.2(2)(a)(I), (b)-(c), C.R.S. 2024, to consider only those body
parts designated on the DIME application form. We conclude that,
when assessing whether a claimant is at MMI, a DIME physician
may consider all relevant body parts, even if those body parts were
not designated on the DIME form.
I. Background
¶ 3 In February 2020, Peitz sustained an admitted work-related
injury to his lower back while working as a mechanic for the Board
of Water Works of Pueblo. The next day, Peitz received treatment
from Dr. Terrence Lakin, who completed a “Physician’s Report of
2
Workers’ Compensation Injury.” Dr. Lakin diagnosed Peitz with a
strain of muscle, fascia, and tendon in his lower back.
¶ 4 Dr. Lakin referred Peitz for x-rays and an MRI. The MRI
showed stenosis at lumbar vertebrae 4-5 and degenerative disc
disease. After conservative treatment did not help, in August 2020,
Peitz consulted Dr. Jennifer Kang, an orthopedist, who
recommended injections and, if the symptoms did not resolve in six
months, a lumbar fusion. Thereafter, Peitz received injections,
massage, and chiropractic care.
¶ 5 In October 2020, at the request of the Board of Water Works of
Pueblo and its insurer, Travelers Casualty & Surety Co. (jointly,
respondents), Peitz saw Dr. David Elfenbein for an independent
medical exam (IME). At that time, Peitz’s complaints included right
hip pain, with a burning sensation in his groin. Dr. Elfenbein
opined that the hip issue should be addressed before Peitz received
further treatment for his spine.
¶ 6 One month later, Peitz was referred to Dr. Todd Miner for
evaluation of the hip pain. Dr. Miner diagnosed Peitz with bilateral
advanced hip osteoarthritis and recommended a bilateral hip
replacement, which was performed in December 2020. Dr. Miner
3
evaluated Peitz virtually in April 2021. Peitz reported to Dr. Miner
that his groin and thigh pain had essentially gone away.
¶ 7 Peitz continued to have low back pain, however, and Dr. Kang
performed a lumbar fusion. According to Peitz’s authorized treating
physician (ATP), Dr. George Johnson, Peitz “had some physical
therapy following the surgery but discontinued [it] due to his left
groin pain that has been present since the surgery.”
¶ 8 In July 2022, Peitz filed an “Application for Hearing” (AFH),
checking the box for “medical benefits” as the issue to be
considered. Under the section entitled “other issues to be heard at
this hearing,” Peitz stated that he had “been denied treatment for
his groin and hips which should be covered under this claim.”
¶ 9 On October 18, 2022, an ALJ conducted a hearing at which no
testimony was taken but exhibits were entered, including Peitz’s
medical records and an IME that Dr. Wallace Larson had performed
at respondents’ request in September 2022. In the IME, Dr. Larson
4
opined that Peitz’s left groin pain was likely an idiopathic
1
condition
or related to the hip replacement and was not likely related to the
back surgery.
¶ 10 In a November 2022 order, the ALJ found that Peitz had failed
to prove that his hip or groin symptoms were related to his work
injury. The ALJ found Dr. Larson’s opinion credible and discounted
as “conclusory” the ATP’s opinion that the hip and groin issues were
related to the back surgery. The ALJ therefore denied Peitz’s
request for benefits to cover treatment of his groin or hips and
1
“Idiopathic” is defined as (1) “arising spontaneously or from an
obscure or unknown cause” or (2) “peculiar to the individual.”
Webster’s Third New International Dictionary 1123 (2002). In City
of Brighton v. Rodriguez, 2014 CO 7, the Colorado Supreme Court
stated,
We have never explicitly defined “idiopathic.”
We have, however, used the term consistently
with the leading treatise in the field: “Generally
understood within the workers’ compensation
framework to mean ‘self-originated,’
[idiopathic] injuries usually spring from a
personal risk of the claimant, e.g., heart
disease, epilepsy, and the like. . . . Idiopathic
injuries, therefore, often are not compensable.”
Id. at ¶ 21 n.2 (quoting LexisNexis, Larson’s Workers’ Compensation
Glossary, https://perma.cc/P6EV-TJSF).
5
reserved all other issues for future determination. Peitz did not
appeal that order.
¶ 11 In December 2022, Peitz again saw his ATP. The ATP found
that Peitz was at MMI and assigned a 30% whole person
impairment rating. Respondents sought a DIME. They checked the
boxes for “Region 4: Spine / Lumbar” on the “Notice and
Application” as the body part to be evaluated in the DIME.
¶ 12 Dr. Paul Ogden conducted the DIME in April 2023, diagnosing
Peitz with chronic pain disorder, axial low back pain, and left hip
flexion weakness. Dr. Ogden opined that Peitz was not at MMI
because his chronic pain disorder and left hip pain still needed to
be addressed. Dr. Ogden stated that, to reach MMI, Peitz would
need to be treated for the chronic pain disorder, including
psychosocial evaluations and cognitive behavioral therapy. He
assigned a whole person impairment rating of 27%.
¶ 13 Respondents filed an AFH on May 12, 2023, checking the box
for “other issues,” which they listed as “Overcome DIME, not at
MMI, compensable components.” The same ALJ conducted a
hearing, at which Peitz did not testify but was represented by
counsel. Dr. Larson testified and Dr. Ogden’s deposition was
6
entered into evidence by agreement of the parties. See § 8-43-210,
C.R.S. 2024 (“Depositions may be substituted for testimony upon
good cause shown.”).
¶ 14 Shortly before the hearing, respondents moved for summary
judgment, asserting that, because they did not ask for Peitz’s hip to
be evaluated during the DIME, Dr. Ogden could not address that
body part, relying on WCRP 11-5. Paragraph (A) of WCRP 11-5
provides a schedule for the fees a DIME physician may charge
based on the number of body parts selected, the date of injury, and,
in exceptional circumstances, the number of medical records.
Because respondents only checked the box for examination of the
lumbar spine, they argued that Dr. Ogden erred when he
considered Peitz’s hip condition in assessing whether he was at
MMI.
¶ 15 The ALJ issued an order listing the issues to be addressed at
the hearing as whether respondents overcame the DIME
determination that Peitz was not at MMI and the 27% whole person
impairment rating. The ALJ found that respondents overcame the
DIME determination that Peitz was not at MMI but failed to
overcome the impairment rating.
7
¶ 16 The ALJ’s order included the following conclusions:
[T]he only body part selected by Respondents
for consideration by the DIME [was] the
lumbar spine. Since no other body part was
selected, the DIME doctor’s inclusion of hip
and psychological [conditions] are beyond the
scope of the DIME. As such, the doctor’s
opinions that [Peitz] is not at MMI for hip and
psychological issues for chronic pain cannot be
considered under [section 8-42-107.2(2)(b)].
The ALJ determined that (1) “[t]he parties are bound by the ATP’s
determination that [Peitz] is at MMI for all work-related conditions
except for the lumbar spine”; (2) “[Peitz] is at MMI for the lumbar
spine”; and (3) respondents failed to overcome the DIME’s 27%
impairment rating of Peitz.
¶ 17 Peitz filed a petition with the Panel to review the ALJ’s order,
arguing that the ALJ erred by concluding that Dr. Ogden was
limited in the scope of his medical exam to the lumbar spine
because that was the only body part respondents had selected on
the DIME form. The Panel agreed with Peitz that WCRP 11-5 does
not prevent a DIME physician from evaluating all body parts in
determining MMI, regardless of the particular body parts selected
on the DIME form. In support of this conclusion, the Panel cited its
opinion in Luis v. Spirit Hospitality, W.C. No. 5-131-365, 2023 WL
8
8606393, at *12 (Colo. I.C.A.O. Dec. 4, 2023) (“Rule 11-5 does not
prevent the DIME physician from evaluating any and all body parts
in determining MMI. This is because Rule 11-5 uses the list of body
regions to compute the DIME fee and not to limit the scope of the
DIME evaluation.”).
¶ 18 But the Panel also reasoned that, in this case — unlike Luis —
the same ALJ had made an earlier final adjudication that Peitz’s hip
and groin problems were unrelated to his work injury. The Panel
determined that the ALJ’s initial order was therefore “res judicata as
to the causation of the hip and groin problems.”
2
The Panel
concluded that the ALJ did not err by rejecting the DIME
physician’s opinion on MMI as to body parts that “had already been
determined were not related to the injury.” The Panel added,
“Because the only basis provided by the DIME physician that [Peitz]
2
Although the Panel initially used the phrase “res judicata,” the
context and subsequent discussion indicate it intended to refer to
“issue preclusion.” Like the parties on appeal, we will use the
phrase “issue preclusion,” which is discussed in greater detail
below. See Argus Real Est., Inc. v. E-470 Pub. Highway Auth., 109
P.3d 604, 608 (Colo. 2005) (noting that the use of the terms “res
judicata” and “collateral estoppel” can cause confusion because “res
judicata” was once commonly used to refer to both claim and issue
preclusion).
9
was not at MMI [was] [his] hip and groin issues and psychological
effects therefrom, we perceive no reversible error in the ALJ’s
conclusion that [Peitz] had reached MMI for the spine injury.” Peitz
now appeals the Panel’s decision to this court.
II. Standard of Review and Legal Principles
¶ 19 We may set aside a Panel order if the factual findings are not
sufficient, there are unresolved evidentiary conflicts, the findings do
not support the order or are unsupported by the record, or the
award or denial of benefits is not supported by the law. § 8-43-308,
C.R.S. 2024.
¶ 20 The Workers’ Compensation Act of Colorado (the Act),
§§ 8-40-101 to -47-209, C.R.S. 2024, is the exclusive remedy
available to employees for workplace injuries in Colorado. To
provide care to an injured employee under the Act, the employer or
the employer’s insurer identifies a list of providers from which the
employee selects an ATP. § 8-43-404(5)(a)(I)(A), C.R.S. 2024. After
providing the perceived necessary care, the ATP determines whether
the employee has reached MMI and, if so, the degree of any
permanent impairment. § 8-42-107(8)(b)(I), C.R.S. 2024.
10
¶ 21 If any party disputes the findings or determinations of the
ATP, the party shall request a DIME. See § 8-42-107.2(2)(a)(I), (b).
The DIME physician then examines the claimant and makes an
independent finding of the claimant’s condition. The DIME
physician’s findings may be overcome only by clear and convincing
evidence. § 8-42-107(8)(b)(III).
III. Issues Presented
¶ 22 Peitz raises three issues in this appeal:
• whether the Panel erred by finding that Dr. Ogden’s
opinion that Peitz was not at MMI due to the need for
chronic pain treatment could be ignored because any
need for such treatment was caused solely by his hip and
groin issues;
• whether the Panel erred by finding that issue preclusion
applied because the ALJ made an earlier finding that
Peitz’s hip and groin problems were unrelated to his work
injury; and
• whether the Panel erred by not remanding the case back
to the ALJ after it ruled in his favor on the scope of the
DIME.
11
¶ 23 In their answer brief, respondents assert the same argument
they unsuccessfully presented to the Panel: that WCRP 11-5
prevents the DIME physician, in determining MMI, from evaluating
any body part not designated on the DIME form. In his reply brief,
Peitz notes that respondents failed to make any arguments to rebut
his first two issues on appeal.
IV. Analysis
¶ 24 We first address the parties’ arguments regarding whether
WCRP 11-5 precludes a DIME physician from considering body
parts not designated on the DIME form when assessing whether a
claimant is at MMI. We then address whether the Panel properly
applied the doctrine of issue preclusion. Finally, we address
whether the Panel erred by concluding that Dr. Ogden determined
that Peitz’s need for psychological treatment was based solely on
the pain associated with his hip and groin issues.
A. WCRP 11-5
¶ 25 As noted, Peitz prevailed before the Panel on his interpretation
of WCRP 11-5, but in defending the Panel’s order before this court,
respondents continue to argue that WCRP 11-5 prohibits a DIME
physician from considering any body part not designated when
12
determining if a claimant is at MMI. We elect to address this issue
first.
¶ 26 WCRP 11-5(A) provides a schedule to determine the amount of
fees that a physician may charge for a DIME, based primarily on the
designated body parts and date of injury. Respondents rely on
WCRP 11-5(A) to argue that the Director of the Division of Workers’
Compensation, who promulgates the WCRP, must have meant to
limit the scope of a DIME physician’s examination to the designated
body parts. But the statute addressing DIMEs makes no mention
of any substantive limitation on the examining physician’s
assessment of MMI based on the number of body parts selected on
the DIME form, see § 8-42-107.2, and WCRP 11-5 is also silent on
the matter. We cannot read language into a rule, and we must give
effect to the rule’s plain language. See Smith v. Exec. Custom
Homes, Inc., 230 P.3d 1186, 1191 (Colo. 2010) (court cannot give a
statute a meaning that the plain language does not support);
Woolsey v. Colo. Dep’t of Corr., 66 P.3d 151, 153 (Colo. App. 2002)
(“In construing an administrative rule or regulation, we apply the
same rules of construction as we would in interpreting a statute.”).
13
¶ 27 Respondents argue that, because they selected only the spine
on the DIME form, Dr. Ogden erred by also considering the impact
of Peitz’s hip and groin conditions — and related chronic pain — in
determining whether he was at MMI. In other words, they argue
that the DIME physician should have reviewed only those body
parts that respondents selected. In rejecting this argument, the
Panel concluded that Rule 11-5 uses the list of body parts to
compute the DIME fee, not to limit the scope of the DIME
evaluation.
¶ 28 We agree with the Panel. Nothing in the applicable statute or
rules prohibits a DIME physician from addressing all relevant body
parts when assessing whether a claimant has reached MMI. See
Leprino Foods Co. v. Indus. Claim Appeals Off., 134 P.3d 475, 482-
83 (Colo. App. 2005) (In determining MMI, the DIME physician may
assess, “as a matter of diagnosis, whether the various components
of the claimant’s medical condition are causally related to the
industrial injury.”); see also Martinez v. Indus. Claim Appeals Off.,
176 P.3d 826, 827 (Colo. App. 2007) (same).
¶ 29 At oral argument, the division asked respondents’ counsel to
identify the specific language in WCRP 11-5 supporting their
14
contention that it was intended to limit the number of body parts a
DIME physician may consider when assessing MMI. Respondents’
counsel pointed generally to that portion of the rule referring to the
number of body parts checked on the form, the date of the injury,
and the extent of the medical records. But as previously noted,
these considerations are contained in WCRP 11-5(A), the portion of
the rule used to set the fee that a physician may charge for a DIME.
No language in the rule evinces any intent to preclude a DIME
physician from considering all relevant body parts — checked or
unchecked — that may be related to MMI.
¶ 30 Thus, we hold that, when assessing MMI, a DIME physician
may consider all relevant body parts, even if those body parts were
not designated on the DIME form.
B. Issue Preclusion
¶ 31 Peitz asserts that, after rejecting respondents’ WCRP 11-5
argument, the Panel should have remanded this case to the ALJ.
But respondents assert that Dr. Ogden was precluded from
considering Peitz’s hips and groin, and his related psychological
issues stemming from chronic pain, when determining whether he
15
had reached MMI due to the preclusive effect of the ALJ’s prior
order. We disagree with respondents for multiple reasons.
¶ 32 The purpose of issue preclusion is “to bar relitigation of an
issue.” Madalena v. Zurich Am. Ins. Co., 2023 COA 32, ¶ 21
(quoting Villas at Highland Park Homeowners Ass’n v. Villas at
Highland Park, LLC, 2017 CO 53, ¶ 29). A party seeking to bar
relitigation of an issue must show that
(1) the issue is identical to an issue actually
litigated and necessarily adjudicated in the
prior proceeding; (2) the party against whom
estoppel was sought was a party to or was in
privity with a party to the prior proceeding; (3)
there was a final judgment on the merits in the
prior proceeding; and (4) the party against
whom the doctrine is asserted had a full and
fair opportunity to litigate the issues in the
prior proceeding.
Id. (quoting Villas at Highland Park, ¶ 29).
¶ 33 The same parties appeared at both hearings, so the second
element of issue preclusion was met. But the remaining elements
of issue preclusion were not satisfied.
¶ 34 We agree with Peitz that the Panel erred as a matter of law by
holding that “whether [Peitz’s] ongoing hip and groin symptoms
were causally related to the work-related injury was resolved, by
16
final judgment, against [him] in the ALJ’s order of [November 23,
2022.]” The issue that the ALJ addressed in that order was
whether Peitz had proved entitlement to medical benefits for
treatment to his groin and hips because those issues were related to
his admitted work-related back injury. Nowhere in that order did
the ALJ discuss or determine MMI. Peitz asserts that the issues are
therefore not identical and cites Ortega v. JBS USA, LLC, W.C. No.
4-804-825, 2013 WL 3325150 (Colo. I.C.A.O. June 27, 2013), in
support of his argument.
¶ 35 In Ortega, the Panel reasoned,
The difficulty with the respondents’ position [of
issue preclusion] lies in the extent it would
allow for the prelitigation of the MMI and
impairment rating issues prior to the
application of the DIME process. Those issues
would be determined at a hearing by a
preponderance of the evidence standard. The
statute[,] however, provides that a DIME
determination of those issues is to be reviewed
at a hearing by a clear and convincing
standard. The tactic of litigating those issues,
by either party, as a means of obtaining
advantage in the DIME process is inconsistent
with the aim of the statute.
Id. at *3.
17
¶ 36 The Panel’s reasoning in Ortega is consistent with the analysis
in Sunny Acres Villa, Inc. v. Cooper, 25 P.3d 44 (Colo. 2001), in
which the Colorado Supreme Court held that issue preclusion did
not apply to a determination made at a temporary benefits hearing
because the parties did not have the same incentive to litigate as
they did at a permanent benefits hearing. See id. at 47 (“It is
settled law that a full and fair opportunity to litigate an issue
requires not only the availability of procedures in the earlier
proceeding commensurate with those in the subsequent proceeding,
but also that the party against whom collateral estoppel is asserted
has had the same incentive to vigorously defend itself in the
previous action.”) (citations omitted); see also Holnam, Inc. v. Indus.
Claims Appeals Off., 159 P.3d 795, 799 (Colo. App. 2006)
(recognizing that issue preclusion does not apply when the two
proceedings are subject to different standards of proof).
¶ 37 At the first hearing, Peitz sought medical benefits for
treatment related to his hips and groin. When that request was
denied, he returned to his ATP, who determined he was at MMI and
had a 30% impairment rating. Rather than accept the ATP’s
findings, respondents applied for a DIME. The DIME resulted in a
18
finding that Peitz had not reached MMI, which respondents
challenged at the second hearing.
¶ 38 In our view, the Panel erred by determining that the issue of
whether Peitz could receive benefits for treatment of his hip and
groin was identical to the issues presented at the second hearing,
which respondents’ own AFH described as “Overcome DIME, not at
MMI, compensable components.”
¶ 39 The rationale of Sunny Acres and Ortega supports the
conclusion that issue preclusion does not apply here because
“prelitigation” of the DIME process is inconsistent with the statute,
the issues addressed by the ALJ and DIME physician are not
identical, and Peitz did not have the same information and incentive
to litigate causation prior to the DIME physician’s determination of
MMI. Therefore, the ALJ’s initial resolution of causation in the
treatment context should not be given preclusive effect and thereby
usurp the DIME process for determining MMI.
¶ 40 Moreover, because the first hearing never addressed MMI or
impairment, the ALJ decided it based on the preponderance of
evidence standard. § 8-43-201(1), C.R.S. 2024. At the second
hearing, respondents had to overcome by clear and convincing
19
evidence the conclusion that Peitz was not at MMI.
§ 8-42-107(8)(b)(III); see also Restatement (Second) of Judgments
§ 28(4) (Am. L. Inst. 1982) (application of issue preclusion may be
affected by different burdens of proof).
¶ 41 For these reasons, we hold that the Panel erred by concluding
that issue preclusion barred any portion of Dr. Ogden’s
determination of MMI.
C. Need for Psychological Treatment
¶ 42 Finally, we also agree with Peitz that the Panel erred by
concluding that his need for psychological treatment arose only
from his hip and groin pain. During Dr. Ogden’s deposition, which
was part of the evidentiary record before the ALJ, respondents’
counsel specifically asked Dr. Ogden whether he was
recommending psychological treatment because of Peitz’s hip or
back. Dr. Ogden replied that it was mainly due to Peitz’s back
injury. Respondents’ counsel asked, “Now, the functional
limitations that Mr. Peitz complained of that led you to opine he
needs his chronic pain program are we talking about the left hip or
are we talking about the back?” Dr. Ogden replied, “It’s primarily
the back.” This testimony was consistent with Dr. Ogden’s report,
20
in which he concluded that most of Peitz’s psychological issues from
chronic pain were attributable to his back injury.
¶ 43 Despite the above testimony, as well as Dr. Ogden’s report
documenting that he felt the need for psychological treatment was
mainly associated with Peitz’s back injury, the Panel specifically
said in its order that Dr. Ogden stated that the need for
psychological treatment was solely based on Peitz’s hip and groin
issues. This was a clearly erroneous finding based on the evidence.
As such, we must set it aside. See § 8-43-308.
V. Disposition
¶ 44 We set aside the Panel’s order with instructions to remand this
case to the ALJ to address the issues raised in respondents’ May
12, 2023, AFH, consistent with the conclusions set forth herein.
JUDGE LIPINSKY and JUDGE TAUBMAN concur.
