This summary was computer-generated without any editorial revision. It is not official, has not been checked for accuracy, and is NOT citable.
Facts
The Worker sustained a back injury in 1988 while moving a patient at her workplace. Following a mediation conference in 1990, a recommended resolution was issued, granting her a lump sum settlement, vocational rehabilitation benefits, open medical benefits for 18 months, and attorney fees. The resolution became binding in January 1991. After undergoing spinal fusion surgery in March 1991, which was unsuccessful, the Worker required corrective surgery in October 1992. The Employer refused to cover the costs of the second surgery as the 18-month medical benefits period had expired (paras 2-4).
Procedural History
- Workers' Compensation Administration, January 1991: The recommended resolution became a binding compensation order after the Worker did not reject it within the statutory period (para 2).
- Workers' Compensation Administration, post-1992: The Workers' Compensation Judge dismissed the Worker’s petition to modify the compensation order, holding that it could not be reopened due to the Worker’s failure to reject the recommended resolution or request its modification within 30 days (para 4).
Parties' Submissions
- Appellant (Worker): Argued that the two-year limitation period under Section 52-5-9(B) for modifying a compensation order based on a change in condition should apply, rather than the 30-day period under Section 52-5-5(C). She also requested the court to directly apply Section 52-5-9 and grant her requested modifications (paras 1, 5).
- Respondents (Employer and Insurer): Contended that the compensation order could not be modified as the Worker failed to reject the recommended resolution or seek its modification within the 30-day statutory period. They also argued that prior case law precluded modification of the order under Section 52-5-9 (paras 4, 7).
Legal Issues
- Does the two-year limitation period under Section 52-5-9(B) apply to the modification of a compensation order based on a change in condition, rather than the 30-day period under Section 52-5-5(C)?
- Can a compensation order resulting from a recommended resolution be modified under Section 52-5-9(B)(1) on the grounds of a change in condition?
Disposition
- The Court of Appeals reversed the Workers' Compensation Judge’s dismissal of the Worker’s petition and remanded the case for further consideration of whether the Worker could demonstrate a change in condition under Section 52-5-9(B)(1) (paras 1, 11-12).
Reasons
Per Bosson J. (Apodaca CJ and Black J. concurring):
The Court held that the two-year limitation period under Section 52-5-9(B) applies to modifications of compensation orders based on a change in condition, as opposed to the 30-day period under Section 52-5-5(C). The Court relied on its prior decision in Norman v. Lockheed Engineering & Science Co., which distinguished between modifications based on mistake or excusable neglect (governed by Section 52-5-5) and those based on other grounds, such as a change in condition, which fall under Section 52-5-9 (paras 5-6).
The Court rejected the Employer’s reliance on Armijo v. Save 'N Gain and Quintana v. Motel 6, Inc., noting that neither case addressed modifications under Section 52-5-9. It emphasized that compensation orders, even those resulting from recommended resolutions, are modifiable under Section 52-5-9(B)(1) to accommodate changes in a worker’s medical or physical condition (paras 7-9).
The Court declined to determine whether the Worker’s condition constituted a "change in condition" under Section 52-5-9(B)(1), leaving that issue for the Workers' Compensation Judge to decide on remand (para 10).