4-224-505 (1998). RONALD LACEN.

• Case Date: September 17, 1998
• Court: Colorado

Colorado Workers Compensation 1998. 4-224-505 (1998). RONALD LACEN INDUSTRIAL CLAIM APPEALS OFFICEIN THE MATTER OF THE CLAIM OF RONALD LACEN Claimant, v. SPRAY SYSTEMS Employer, and AMERICAN HOME ASSURANCE COMPANY, Insurer, Respondents.W. C. No. 4-224-505FINAL ORDER The claimant seeks review of the final order of Administrative Law Judge Stuber (ALJ), which denied his claim for penalties based on the respondents' failure to pay medical expenses. The claimant contends the respondent-insurer violated a rule of procedure, and therefore, the ALJ erroneously applied the penalty provision found at § 8-43-401(2)(a), C.R.S. 1998, rather than general penalty provision found at § 8-43-304(1), C.R.S. 1998. The claimant further contends that the ALJ misapplied the burden of proof, and that the evidence does not support the ALJ's order. We affirm the ALJ's denial of penalties. The ALJ found that on July 7, 1997, and July 14, 1997, the claimant submitted to the respondent-insurer written requests for reimbursement of travel expenses which he incurred while obtaining authorized medical treatment. The insurer failed to reimburse the claimant for the travel expenses and, in September 1997, the claimant applied for a hearing on the issues of reimbursement of medical expenses and penalties "pursuant to C.R.S. §§ 8-43-304(1) and/or § 8-43-401(2)." At the hearing, the claimant was the only witness. He testified concerning the reasons he incurred the travel expenses. The parties also stipulated that the insurer never responded to the written request for reimbursement. (Tr. p. 20). Under these circumstances, the ALJ held that the insurer is not liable for any penalties on account of its failure timely to pay the medical expenses. Citing Sears v. Penrose Hospital, 942 P.2d 1345 (Colo. App. 1997), the ALJ reasoned that the claim for penalties is controlled by the specific penalty provisions of § 8-43-401(2)(a), not the general penalty provisions of § 8-43-304(1). The ALJ also found that no penalty is appropriate under § 8-43-401(2)(a) because the claimant did not prove that the insurer's failure timely to pay the medical benefits was "willful." In support, the ALJ noted the claimant presented no testimony concerning the reasons for the insurer's inaction. The ALJ reasoned that the mere failure to make the payments as requested "does not...