4-526-295 (2006). Wilson v. GT Interiors (Final Order).

• Case Date: April 03, 2006
• Court: Colorado

Colorado Workers Compensation 2006. 4-526-295 (2006). Wilson v. GT Interiors (Final Order) INDUSTRIAL CLAIM APPEALS OFFICE W. C. No. 4-526-295IN THE MATTER OF THE CLAIM OF DAVID WILSON, Claimant, v. GT INTERIORS, Employer, and TIG INSURANCE, Insurer, Respondents.FINAL ORDER The respondents seek review of an order dated October 13, 2005 of Administrative Law Judge Coughlin (ALJ) that imposed a penalty under § 8-43-304, C.R.S. 2005, for wilful violation of the Workers' Compensation Act and Rule XVI of the Division of Workers' Compensation Rules of Procedure. We affirm. The ALJ's pertinent findings of fact are as follows. The claimant suffered work-related injuries to his leg, hip, spine and pelvis. Postoperative changes in the claimant's anatomy included discrepancy in leg length. This leg length discrepancy affects the claimant's gain, and can cause significant pain and discomfort in the claimant's low back and hip. The claimant was given two prescriptions for specialty shoes to address the claimant's postoperative condition. The claimant had his prescriptions for specialty shoes filled at Pedorthics. On March 11, 2005, the claimant was sent a statement from Pedorthics indicating that medical expenses in the amount of $570.80 were more than 90 days past due. The ALJ drew the inference that the insurer was well aware of the outstanding Pedorthics bills reflected on the March 11, 2005-statement, prior to the issuance of that statement. On August 17, 2005, Pedorthics send a fax to respondents' counsel which stated that they had received payment of $357.52 which they would consider full payment and the balance would be written off but they would require written pre-approval for all future work for the claimant. The ALJ found that Pedorthics was not timely paid and that no rational argument was advanced to explain the insurer's conduct. The ALJ found that the insurer's conduct was not objectively reasonable under the circumstances. The ALJ noted the respondents seemed to acknowledge that a penalty in the amount of $28.60 under § 8-43-401, C.R.S. 2005 could be imposed. The ALJ determined that a penalty in the amount of $286 per day from April 11, 2005 until August 17, 2005, would be appropriate under § 8-43-304. On review, the respondents contend the ALJ's findings of fact are not sufficient for review. The respondents argue...