Wolford v. Pinnacol Assurance, 01CA2415 (May 22, 2003): Plaintiff, represented by Ralph Ogden, Esq., sustained physical and emotional injuries when she was assaulted at work. She was awarded temporary total disability (TTD), permanent partial disability (PPD) and future medical benefits. However, it was discovered that claimant was employed during periods for which she received TTD benefits. Plaintiff was charged with willfully making a false statement or representation material to a claim for workers' compensation benefits, which is a felony under the "forfeiture statute," C.R.S. § 8-43-402. Plaintiff pled guilty to the charge, and the trial court sentenced her to six years of probation and required that she pay restitution which included the TTD benefits she received while working. The issue of forfeiture of PPD benefits was not raised in the criminal proceedings.
Plaintiff's employer and its insurer, Pinnacol, filed an amended final admission of liability which asserted that plaintiff's right to any compensation terminated as a result of her conviction. Plaintiff contested the admission, and requested a hearing to determine only whether she was barred from receiving future medical benefits. Ultimately, the Court of Appeals held that claimant did not forfeit her medical benefits because such benefits did not constitute "compensation" within the meaning of the forfeiture statute.
When Pinnacol failed to pay PPD benefits, plaintiff filed an action in district court and requested judgment for the amount of PPD benefits to which she claimed entitlement. Plaintiff also requested a declaration that the forfeiture statute violated her right to be free from double jeopardy and imposition of excessive fines. The trial court granted Pinnacol's motion for summary judgment, and concluded that plaintiff forfeited her right to PPD benefits and that the forfeiture did not constitute double jeopardy or an excessive fine.
The Court of Appeals affirmed. The court held that the forfeiture statute applies to all compensation, not just the benefits that were fraudulently obtained. Thus, PPD benefits were subject to forfeiture here despite the fact that plaintiff fraudulently obtained only TTD benefits. The court also rejected claimant's assertion that the forfeiture statute violated her right against double jeopardy. The court concluded that forfeiture of benefits under § 8-43-402 is a mandatory and automatic criminal sanction constituting part of an offender's sentence.