This summary was computer-generated without any editorial revision. It is not official, has not been checked for accuracy, and is NOT citable.
Facts
An injured worker, employed by the City of Albuquerque, sought to change his designated health care provider from the employer's initial selection to a physician of his choice after the statutory 60-day period. The employer objected to this change, arguing procedural deficiencies in the worker's notice and challenging the validity of the applicable workers' compensation regulations (paras 5-7).
Procedural History
- Workers' Compensation Administration, June 28, 1991: The workers' compensation judge designated the worker's chosen physician as the health care provider, rejecting the employer's objections (paras 7-8).
Parties' Submissions
- Employer (Appellant): Argued that the workers' compensation regulation (Rule WCA 91-1(VI)) was inconsistent with the governing statute (Section 52-1-49), that the worker's notice of change was procedurally deficient, and that the judge lacked jurisdiction to designate the worker's chosen physician. The employer also claimed a denial of procedural due process and argued that the burden of proof should have been on the worker to show the unreasonableness of the initial care (paras 2, 6, 10, 16, 22-23, 27).
- Worker (Respondent): Contended that his notice substantially complied with statutory requirements, that the regulation was valid and consistent with the statute, and that the employer bore the burden of proving the unreasonableness of the care provided by the worker's chosen physician (paras 7, 10, 23-24).
Legal Issues
- Was the workers' compensation judge's order designating the worker's chosen health care provider a final, appealable order?
- Is Rule WCA 91-1(VI) consistent with Section 52-1-49 of the Workers' Compensation Act?
- Did the worker's notice of change of health care provider comply with statutory requirements?
- Did the workers' compensation judge have jurisdiction to designate the worker's chosen health care provider?
- Was the employer denied procedural due process?
Disposition
- The Court of Appeals affirmed the workers' compensation judge's decision, upholding the designation of the worker's chosen health care provider (para 28).
Reasons
Per Apodaca J. (Minzner and Chavez JJ. concurring):
- Appealability of the Order: The court held that the judge's order was final and appealable because it fully resolved the issue of the health care provider designation, which was the only matter before the Workers' Compensation Administration at the time (paras 8-9).
- Validity of Rule WCA 91-1(VI): The court found that the regulation was consistent with Section 52-1-49, as it properly treated an objection to a notice of change of health care provider as a request for a change and placed the burden of proof on the objecting party to show unreasonableness of care (paras 13-18).
- Worker's Notice: The court determined that the worker's notice substantially complied with the statutory requirements, even though it was sent eight days before the first appointment instead of the required ten days. The employer failed to demonstrate prejudice from this minor deviation (paras 23-26).
- Jurisdiction of the Judge: The court concluded that the workers' compensation judge had statutory authority to designate the worker's chosen health care provider under Section 52-1-49(F) (para 27).
- Due Process Claim: The court rejected the employer's due process argument, noting that the employer did not attempt to present evidence at the hearing and that the regulations allowed for the presentation of evidence (para 22).
The court emphasized that the statutory amendments to Section 52-1-49 reflected a legislative intent to provide workers with greater input in selecting their health care providers, balancing the need for trust in medical care with the requirement for reasonable treatment (paras 19-20).