View this article online: https://www.claimsjournal.com/news/west/2008/05/16/90070.htm
The Colorado Supreme Court has ruled that an employer must pay temporary disability benefits to an employee although the employee had been suspended.
According to Sigala vs. Atencio’s Market, Eva Sigala was injured on the job, and her employer, Atencio’s Market, admitted liability and paid Sigala temporary total disability benefits through Colorado’s workers’ compensation system.
Under the temporary total disability benefits provision of Colorado’s Workers’ Compensation Act, a claimant must attend scheduled appointments with his or her attending physician. However, Sigala missed an appointment with her attending physician on March 15, 2004, court documents indicate. Atencio’s Market sent Sigala a certified letter notifying her that it could suspend her temporary total disability benefits if she failed to attend a rescheduled appointment. Sigala failed to attend the rescheduled appointment, and Atencio’s Market stopped payment of her benefits on that date, as state statute permits.
According to court documents, when Sigala finally attended an appointment with her attending physician in June 2004, Atencio’s Market reinstated her benefits. Sigala then requested payment of the benefits that were withheld by Atencio’s Market during the suspension.
The matter was presented to an administrative law judge, who concluded that the term “suspend” as it is used in the temporary total disability benefits provision, “does not contemplate retroactive payment of suspended benefits, but rather results in a permanent loss of the benefits during the period of suspension,” court documents note.
The court of appeals concluded that the term “suspend” as it is used in the statute means “a forfeiture” of temporary total disability benefits for the period of suspension.
Sigala petitioned the Supreme Court for certiorari review, arguing that the term “suspend” as it is used in the statute means to withhold benefits temporarily, such that the suspended benefits accrue and are paid to the claimant once he or she attends an appointment with his or her attending physician.
However, the Supreme Court reversed the decision, holding that the term “suspend” to mean “stop temporarily” and not “bar or exclude.” Accordingly, the court said, temporary total disability benefits that are suspended when a claimant fails to attend a rescheduled appointment with his or her attending physician accrue during the period of suspension and must be paid to the claimant once he or she attends an appointment with the attending physician.
“We agree with Sigala that if the legislature had intended to permanently deprive a claimant of temporary total disability benefits, then it would have used a term such as “bar” or “exclude,” rather than the term “suspend,'” the high court stated.
For more information, visit http://www.courts.state.co.us/supct/opinions/2007/07SC73.pdf.