(1) A claimant whose impairment rating is nineteen percent or less may not receive more than one hundred eighty-five thousand dollars from combined temporary disability payments and permanent partial disability payments. A claimant whose impairment rating is greater than nineteen percent may not receive more than three hundred thousand dollars from combined temporary disability payments and permanent partial disability payments.
(2) For the purposes of this section, any mental impairment rating shall be combined with the physical impairment rating to establish a claimant's impairment rating for determining the applicable cap. For injuries sustained on and after January 1, 2025, the director shall adjust these limits on the amount of compensation for combined temporary disability payments and permanent partial disability payments on July 1, 2025, and each July 1 thereafter, by the percentage of the adjustment made by the director to the state average weekly wage pursuant to section 8-47-106.
Source: L. 91: Entire section added, p. 1311, § 16, effective July 1. L. 2005: Entire section amended, p. 1505, § 1, effective January 1, 2006. L. 2009: Entire section amended, (SB 09-243), ch. 269, p. 1223, § 4, effective July 1. L. 2010: Entire section amended, (SB 10-187), ch. 310, p. 1459, § 7, effective January 1, 2011. L. 2021: Entire section amended, (HB 21-1050), ch. 384, p. 2571, § 5, effective September 7. L. 2024: Entire section amended, (HB 24-1220), ch. 389, p. 2693, § 3, effective January 1, 2025.
ANNOTATION
Given that the general purpose of temporary and permanent benefits is to compensate for a present or future possible wage loss, there is no improper discrimination that results from the placing of a limit upon the total benefits, both temporary and permanent, to be received. Colo. AFL-CIO v. Donlon, 914 P.2d 396 (Colo. App. 1995).
Applicability of this section can only be determined if two conditions are met: (1) The claimant reaches maximum medical improvement, and (2) the claimant's medical impairment rating is established. Donald B. Murphy Contractors v. Indus. Claim Appeals Office, 916 P.2d 611 (Colo. App. 1995).
The cap on the receipt of benefits imposed by this section does not apply so long as a claimant is entitled to receive temporary total disability benefits under § 8-42-105 (3). The receipt of such benefits is not an overpayment, and there is no duty to repay them. UAL v. Indus. Claim Appeals Office of Colo., 2013 COA 48, 312 P.3d 235.
Neither this section nor § 8-43-303 addresses the situation of further temporary total disability benefits being awarded after the limit on combined temporary total and permanent partial benefits has been paid. But in view of underlying policies, in this situation the employer should be entitled to offset any permanent partial disability benefits paid against temporary total disability benefits. Donald B. Murphy Contractors v. Indus. Claim Appeals Office, 916 P.2d 611 (Colo. App. 1995).
General assembly clearly intended to require employers to continue paying benefits without application of the cap until such time as a claimant reaches MMI. Leprino Foods Co. v. Indus. Claim Appeals Office, 134 P.3d 475 (Colo. App. 2005).
Claimant is not entitled to additional temporary total disability benefits for the period between the date of the first determination of maximum medical improvement and the date the claimant returned to work even though a second independent medical examination physician opined the claimant did not reach maximum medical improvement until a date following the claimant's return to work when both maximum medical improvement ratings were less than 25 percent. The possibility that events may have unfolded differently does not establish a right to an exemption from the $60,000 cap resulting in an overpayment when the final rating was less than 25 percent. Rogan v. Indus. Claim Appeals Office, 91 P.3d 414 (Colo. App. 2003).
In construing that § 8-41-301 (2)(b) meant that award for medical impairment benefits is limited but that award for temporary disability benefits is not, the court noted that combined amount of temporary disability benefits and permanent partial disability benefits was limited by this section. City of Thornton v. Replogle, 873 P.2d 30 (Colo. App. 1993).
The plain language of this section shows there is no exception, for purposes of calculating the cap, for temporary disability benefits paid on account of vocational rehabilitation. Grogan v. Lutheran Medical Center, Inc., 950 P.2d 690 (Colo. App. 1997).
The mental impairment rating cannot be combined with the physical impairment rating for purposes of exceeding the benefit cap applicable to an impairment rating of 25 percent or less. Dillard v. Indus. Claim Appeals Office, 121 P.3d 301 (Colo. App. 2005), aff'd, 134 P.3d 407 (Colo. 2006).
In determining the relationship between this section and § 8-42-104 (5)(a), the statutory disability cap should be determined not by combining but by separately calculating the "impairment ratings" for each injury. Browne v. Indus. Claim Appeals Office, 2021 COA 83, 495 P.3d 974.