James Clifton won a denial and dismissal of a claim in Kennel v. Goodwin Septic Tank Services. ALJ Martinez held that neither claimant's compensable automobile accident nor his job duties aggravated or accelerated his carpal tunnel symptoms.

Royce Mueller defeated a claim for benefits in Norman v. Greystone Homes. ALJ Muramoto rejected claimant's assertion that she sustained carpal tunnel syndrome as a result of her computer use at work.

Tiffany Scully successfully argued before ALJ Coughlin in Stampfl v. Regis University that the claimant sustained an aggravation of his admitted low back injury while a subsequent insurer was on the risk.

Ed Hook enjoyed complete victory in Jurado v. Arkansas Valley Regional Medical Center. ALJ Mattoon concluded that claimant staged a fall and injury to get a day off from work, and panicked when she was taken to the emergency room.

Richard Bovarnick experienced three victories. In Collins v. Safeway Stores, Inc., ALJ Felter agreed that where claimant requested a DIME in Denver, but resided in Alamosa, venue for the hearing to overcome the DIME was appropriate in Denver rather than Alamosa. In Pribble v. Wal-Mart, ALJ Martinez denied a claim for medical benefits after ALJ Henk's previous award of benefits was overturned on appeal by Mr. Bovarnick and Harvey Flewelling. In Lavely v. Wal-Mart, ALJ Stuber found claimant's testimony that she slipped and fell at work to be incredible, and he denied and dismissed the claim.

Major Medical Insurance Fund v. ICAO, 02CA1846 (July 31, 2003): Claimant sustained an industrial back injury in 1971. In 1975, she was admitted to the Major Medical Insurance Fund (MMIF or Fund) because her employer's payments for medical bills exceeded the existing cap. The purpose of the Fund is to provide additional financial resources after an employer has paid $20,000 in medical benefits to an injured employee. In 1994, the Division of Workers' Compensation (Division) determined that there had been no request for payment of medical expenses by the Fund since 1976. The Director of the Division issued an order to cease payments from the Fund. The order stated that claimant was not currently receiving medical care related to the industrial injury, and had no need for further medical care. The order stated that claimant was no longer eligible for Fund benefits, and that the claim was closed unless a petition to review was timely filed.
  In 1996, claimant submitted a medication bill to the Fund. The Fund refused to pay, based on the director's 1994 order. Claimant petitioned to reopen the claim. The ALJ found that claimant's current condition was related to the industrial injury, but held that the 1994 order was a final order and that because claimant failed to file a petition for review, the claim was closed. The ALJ held that the petition to reopen was barred by the statute of limitations.
  ICAO set aside the ALJ's order, and found that the Director's order was not final, and was insufficient to close the claim. ICAO set aside the denial of the claim for medical benefits and ordered the Fund to pay for the prescription.
  The court of appeals affirmed. The court rejected the Fund's argument that the Director's order was final, and therefore subject to review by ICAO. The court stated that the determination that claimant did not need benefits was a denial of benefits for purposes of Workers' Compensation Rule of Procedure VI(B)(1), which provides that a party dissatisfied with a denial of Fund benefits may request mediation or apply for a hearing. ICAO correctly held that the Director's order was not a final order subject to appeal. Claimant's failure to seek review of the 1994 order did not close the claim, and the statute of limitations on reopening did not apply. The court concluded that ICAO correctly held that the Fund was liable for the cost of the prescription.

Note:  Summaries and articles should not be relied upon as authoritative for a particular case. Consult your attorneys for advice on the application of all the law to the specific facts of your case or legal problem.