IN THE MATTER OF THE CLAIM OF: SANTA MARIA VENEGAS, Claimant,
v.
MALDONADOS SERVICES INC, Employer,
and
PINNACOL ASSURANCE, Insurer, Respondents.
W.C. No. 5-067-002-001
Colorado Workers Compensation
Industrial Claim Appeals Office
January 22, 2021
THE
FRICKEY LAW FIRM, Attn: JANET FRICKEY ESQ, (For Claimant)
RUEGSEGGER SIMONS & STERN LLC, Attn: DREW RZEPIENNIK ESQ,
(For Respondents)
FINAL
ORDER
The
claimant seeks review of an order of Administrative Law Judge
Goldman (ALJ) dated February 13, 2020, that found the
permanent impairment rating provided by the Division
sponsored Independent Medical Examination (DIME) had not been
overcome and a portion of the rating would be compensated
according to the schedule of injuries. We affirm the decision
of the ALJ.
The
claimant worked for the employer as a roofer. On January 17,
2018, the claimant was placing material on a steep roof The
rope securing him to the roof broke and he fell 30 feet to
the ground. The claimant sustained injuries to his head, his
right shoulder, his pelvis, his right knee and subsequently a
pulmonary embolism. He underwent two surgeries to repair
multiple injuries to his pelvis and was hospitalized for two
months. Following further conservative treatment the claimant
was noted to have achieved a substantial recovery and was
placed at maximum medical improvement by his treating
physician on December 26. 2018.
The
claimant requested a DIME review of his attending
physician’s impairment rating. Dr. Hughes was selected
to perform the DIME evaluation Dr Hughes agreed with the MMI
date provided and calculated permanent impairment ratings
involving a 6% upper extremity rating for the right shoulder
a 7% whole person rating for bilateral fractures of the rami
bone in the pelvis with an accompanying lumbar range of
motion deficit, and a 7% whole person rating for a fracture
of the acetabular bone in the pelvis derived by measuring
range of motion deficits in the right leg at the hip. These
ratings were combined to indicate a 14% whole person rating
and a 6% extremity rating for a total combined rating of 17%
of the whole person.
The
respondents filed an admission for the DIME ratings. The
claimant submitted an application for hearing requesting
permanent total disability benefits, additional disfigurement
benefits, conversion of extremity ratings to those of the
whole person and a challenge to the impairment ratings
provided by the DIME evaluation. The claimant arranged for a
second opinion examination by Dr. Gellrick and the
respondents secured a similar examination by Dr. Cebrian.
Following a hearing on December 16, 2019, the ALJ determined
the claimant was not entitled to permanent total benefits,
increased the amount of disfigurement benefits and ruled the
permanent impairment rating provided by Dr. Hughes in his
DIME report had not been overcome. The ALJ concluded the
permanent impairment should be compensated on the basis of a
6% upper extremity rating, a 17% lower extremity rating and a
7% whole person rating.
The
claimant appealed only the determinations pertinent to the
permanent impairment ratings.
I.
The
claimant contends Dr. Hughes did not comply with the
directions in the AMA Guides to the Evaluation of Permanent
Impairment (3d edition revised) concerning the rating of the
injuries involving the pelvis. The statute, in §§
8-42-101(3.7) and 8-42-107(8)(c) C.R.S., specifies that all
permanent impairment ratings must be based on the AMA Guides.
The claimant refers to Chapter 3 of the Guides relating to
The Extremities, Spine, and Pelvis.
The
portion of Chapter 3 dealing with impairment of the pelvis,
part 3.4, pg. 101...
