Colorado Court Says Injuries Sustained En Route to Medical Appointment Not Always Compensable

Relying upon the “quasi-course of employment” concept set forth in Larson’s Workers’ Compensation Law, § 10.05, a division of the Court of Appeals of Colorado affirmed an order of the state’s Industrial Claim Appeals Office (Panel) upholding the decision of an ALJ denying and dismissing a claimant’s claim for benefits for injuries he sustained in a motor vehicle accident on his way to a medical appointment [Salazar v. Industrial Claim Appeals Office, 2022 COA 13, 2022 Colo. App. LEXIS 76 (Jan. 20, 2022)]. The court observed that while the quasi-course of employment doctrine generally extended coverage to injuries sustained while traveling to or from covered medical care for a compensable injury, the subsequent injury was compensable under the doctrine only if the claimant sustained an initial compensable injury [emphasis added]. Because the ALJ’s finding that claimant did not sustain an initial compensable work-related injury was supported by the record evidence, the Panel did not err by upholding the ALJ’s determination that any injuries claimant sustained as a result of the secondary motor vehicle accident were not compensable.

Background

Claimant worked for a tree service from June 2019 to January 2020, trimming, cutting, and removing trees. On Monday, January 13, 2020, claimant texted the tree service owner, indicating that he had awakened with a “very sore lower back.” He texted that following his work the previous Friday, his pain level “was at a 7, and this morning about an 8.” He also texted that he needed to see a doctor and that “[p]icking up logs on Friday was the cause” [Opinion, ¶ 2].

The tree service owner provided Claimant with a list of treaters, as required by the Colorado Act, and Claimant selected one. On January 16, 2020, Claimant’s wife drove him to the medical appointment. En route, they were involved in a motor vehicle accident. Despite that involvement, Claimant and his wife proceeded to the medical appointment. Claimant testified that after the motor vehicle accident he experienced headaches, arm tingling, shoulder pain, and neck and low back strain.

Earlier Back Injury

In 2002, Claimant had injured his back in an accident on an oil rig. Veterans Administration (VA) medical records established and claimant admitted that he received treatment for his continuing back pain in 2016, 2017, 2018, and 2019. Notably, in November 2019—weeks prior to the injury he allegedly suffered while working for the tree service—claimant reported to his VA physician that he was experiencing such severe chronic back pain that he requested a back brace to help with his work. An MRI performed on December 16, 2019, at the request of the VA physician found moderate right and mild left-sided foraminal stenosis at L4-5, right disc extrusion, and a left paracentral disc extrusion at L5-S1 abutting the descending S1 nerve root, causing moderate left-sided foraminal stenosis.

Given that medical history, the employer and its workers’ compensation carrier contested the claim. The carrier arranged an IME. After examining claimant, taking his medical history, and reviewing his extensive prior medical records, the IME physician concluded that Claimant did not suffer an injury on January 10, 2020. As the doctor explained, simply suffering pain while working was not conclusive evidence that an injury occurred. Instead, the doctor attributed Claimant’s back pain to his pre-existing back condition. The doctor conceded, however, that Claimant’s condition may have worsened as a result of the January 16, 2020, motor vehicle accident, and that claimant may have suffered additional symptomology associated with the accident.

ALJ’s Findings

Following a hearing, the ALJ found the IME physician’s opinion persuasive and credible, concluding that claimant did not suffer a compensable injury on January 10, 2020. In contrast, the ALJ discredited Claimant’s testimony, finding him to be neither credible nor persuasive.

Having determined that Claimant did not sustain a work-related injury, the ALJ also denied and dismissed Claimant’s request for benefits arising out of the motor vehicle accident. Relying on the quasi-course of employment doctrine, claimant maintained that because the accident occurred while he was on his way to his medical appointment, any resulting injuries should be covered, even if the work-related event did not cause a compensable injury. The ALJ disagreed. She concluded that the quasi-course of employment doctrine only applied if there was first a compensable injury. She therefore denied and dismissed Claimant’s claim for medical and TTD benefits.

Appellate Court’s Decision

Acknowledging that an employer is responsible for the direct and natural consequences that flow from a compensable injury, the appellate court stressed that the employee nevertheless bore the burden of establishing that the injury was causally connected to the employee’s work. Here, the ALJ found that Claimant did not suffer an injury on January 10, 2020. In fact, the ALJ determined that Claimant did not suffer any work-related injury the the course of his employment with the tree service. The Court stressed that Claimant had not challenged that finding on the part of the ALJ.

Instead, Claimant had argued that even though his underlying injury was not compensable, the quasi-course of employment doctrine mandated that he nevertheless be compensated for the injuries he sustained in the accident while driving to his appointment with doctor. He argued that his secondary injuries should be covered because he would not have been traveling to the doctor’s office but for his contractual relationship with his employer, which allowed his employer to designate his medical provider.

Quoting Larson’s Workers’ Compensation Law, § 10.05, the court said “Larson’s expressly contemplates that coverage will only exist for secondary injuries if the initial injury is compensable” [Opinion, ¶ 26]. The court noted that Claimant had urged the court to disregard the summation of existing law in Larson, noting that although treatises may distill the rule to require an initial compensable injury before injuries sustained in a second accident can be compensated, “[n]o Colorado court [had] entered a finding consistent with the treatises” [Opinion, ¶ 27].

The court continued, stressing that Colorado appellate courts had often looked to Larson “as a reliable source synthesizing existing workers’ compensation law. Citing Travelers Ins. Co. v. Savio, 706 P.2d 1258 (Colo. 1985), the court said:

Indeed, in Savio, the supreme court cited Larson’s as its authority for the proposition that “a subsequent injury is compensable under the quasi-course of employment doctrine only if it is the ‘direct and natural’ consequence of an original injury which itself was compensable.” Savio, 706 P.2d at 1265. Given the supreme court’s apparent adoption of the rule articulated in Larson’s, we cannot stray from it [Opinion, ¶ 27].

Nor was the court persuaded that the principle of liberal construction of the Act mandated a different outcome. The provision that the Act should be liberally construed could not, said the court, be extended to clothe the court with power to read into it a provision that did not exist. Accordingly, the court concluded that the Panel did not err in upholding the ALJ’s determination that any injuries claimant sustained as a result of the January 16, 2020 motor vehicle accident were not compensable.