IN THE MATTER OF THE CLAIM OF: KIM NELSON, Claimant,
QUALITY CORPORATION, Employer,
PINNACOL ASSURANCE, Insurer, Respondents.
W.C. No. 5-022-155-04
Colorado Workers Compensation
Industrial Claim Appeals Office
July 5, 2019
claimant seeks review of an order of Administrative Law Judge
Felter (ALJ) dated May 30, 2018, that denied the
claimant’s petition to reopen and determined that the
claimant had failed to overcome the Division sponsored
independent medical examination (DIME) regarding maximum
medical improvement (MMI) and zero percent permanent medical
impairment. We affirm.
evidentiary hearing took place over three sessions on
November 8, 2017; January 19, 2018; and April 6, 2018. Both
parties appeared and participated with counsel. The
ALJ’s findings of fact are summarized below.
18, 2016, the claimant walked into a handle of a floor safe
which poked into the claimant’s right knee below the
kneecap. She did not fall or injure any other part of her
body at that time. The injury was immediately reported and
the claimant was designated an authorized treating physician
(ATP), Dr. Updike. Dr. Updike evaluated the claimant on July
19, 2016, noting no visible sign of injury. On September 8,
2016, Dr. Updike’s exam findings documented no warmth,
redness, or swelling; diffuse nonfocal tenderness, and
November 4, 2016, Dr. Ogin—a pain management
specialist—noted a possible somatization disorder and
the claimant’s physical exam was benign other than
hypersensitivity. On November 8, 2016, Dr. Updike placed the
claimant at MMI, reporting symptom magnification and delayed
claimant returned to Dr. Ogin for a maintenance care
evaluation on February 22, 2017. Claimant reported allodynia
and altered sensation diffusely throughout her right leg
anteriorly and posteriorly into her calf, foot, and ankle.
Dr. Ogin’s impression was possible neuropathic
pain/CRPS (chronic regional pain syndrome) with minimal
objective findings of anything, and possible somatization
disorder. Dr. Ogin suggested moving ahead with autonomic
testing to fully rule out CRPS. He further indicated that he
suspected the testing would be normal. He postulated that
even if the testing was normal, the claimant would be
resistant to the suggestion that her pain is nonphysical.
physician, Dr. Winslow, evaluated the claimant on March 21,
2017. He noted that although the claimant was complaining of
severe pain, there were no objective findings, no swelling,
no redness, no skin color changes, no palpable temperature
changes, and full range of motion. The doctor commented that
the claimant seems to magnify her symptoms and reactions to
her injuries. Dr. Winslow’s ultimate opinion was that
the claimant did not have CRPS. Rather, she had at most a
right knee contusion. The doctor concluded that the claimant
was at MMI as of November 8, 2016, with no impairment, and no
work restrictions. A corresponding Final Admission of
Liability was filed on July 10, 2017.
maintenance care was admitted, the claimant did not follow-up
with either Dr. Updike or Dr. Ogin. Instead, the claimant
sought evaluation and treatment outside of the WC system. At
hearing, the claimant admitted that she did not provide any
of her new physicians with any of her WC claim related
medical records. On September 20, 2017, Dr. Oh evaluated the
claimant. He did not render a definitive diagnosis. He
referred the claimant to a pain specialist unaware that the
claimant had already been under the care of Dr. Ogin, who is
a pain specialist. On November 27, 2017, the claimant
returned to Dr. Ogin for a maintenance visit. Dr. Ogin
indicated that there was a remote possibility that the
claimant had a neuropathic component to her pain. He
indicated that autonomic testing and thermography were
warranted and reasonable, but that if the testing was
negative, he would not have further recommendations.
respondents obtained a physician advisory review, through Dr.
Raschbacher, of the request for autonomic testing. He...