Spirit v. ICAO ( 2024 )

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<div>23CA2200 Spirit v ICAO 10-03-2024 </div>
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<div>COLORADO COURT OF APPEALS </div>
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<div> </div>
<div>Court of Appeals No. 23CA2200 </div>
<div>Industrial Claim Appeals Office of the State of Colorado </div>
<div>WC No. <span>5-131-365 </span>
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<div>Spirit Hospitality II LLC, d/b/a Candlewood LLC and Truck Insurance </div>
<div>Exchange<span>, </span>
</div>
<div> </div>
<div>Petitioners, </div>
<div> </div>
<div>v. </div>
<div> </div>
<div>Industrial Claim Appeals Office of the State of Colorado and <span>Juliana Luis</span>, </div>
<div> </div>
<div>Respondents.<span> </span>
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<div> </div>
<div> </div>
<div>ORDER AFFIRMED </div>
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<div>Division V </div>
<div>Opinion by JUDGE <span>LUM</span> </div>
<div>Brown and Berger*, JJ., concur </div>
<div> </div>
<div>NOT PUBLISHED PURSUANT TO C.A.R. 35(e)<span> </span>
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<div>Announced October 3, 2024 </div>
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<div>Law Offices <span>of Collin T. Welch, </span>Joe M. Espinosa, <span>Oklahoma City, Oklahoma, for </span>
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<div>Petitioners </div>
<div> </div>
<div>No Appearance for Respondent Industrial Claim Appeals Office </div>
<div> </div>
<div>Cerda Legal, Adan Cerda, Gregory Cairns, Denver, Colorado, for <span>Respondent</span> </div>
<div>Juliana Luis<span> </span>
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<div>*Sitting by assignment of the Chief Justice under provisions of Colo. Const. art. </div>
<div>VI, § 5(3), and § 24-51-1105, C.R.S. 2024. </div>
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<div>1 </div>
<div>¶ 1<span> </span><span>Spirit Hospitality II LLC, d/b/a Candlewood LLC and Truck </span>
</div>
<div>Insurance Exchange (petitioners) appeal an order of the Industrial </div>
<div>Claim Appeals Office (the Panel) affirming the finding of an </div>
<div>administrative law judge (ALJ) that claimant Juliana Luis had not </div>
<div>reached maximum medical improvement (MMI) for a compensabl<span></span>e </div>
<div>injury<span>. <span>We affirm. </span></span>
</div>
<div>I.<span> <span>Background </span></span>
</div>
<div>¶ 2<span> </span><span>Luis sustained an admitted work injury in 2019 related to her </span>
</div>
<div>right upper arm. She was placed on modified duty in her job as a </div>
<div>housekeeper for Candlewood Suites.<span> </span>Luis is relatively short in </div>
<div>stature, noted in medical records to stand at four feet,<span></span> eight inches </div>
<div>tall.<span> <span>On February 15, 2020, Luis was at work, cleaning a hotel </span></span>
</div>
<div>room, when she stood on a chair in order to reach the t<span></span>op of a </div>
<div>microwave oven<span>. </span>While stepping onto the chair with her left foot, </div>
<div>the chair moved from under her, causing her to fall to the ground.<span> </span>
</div>
<div>She fell onto her left side, landing on her left hip and knee.<span> </span>The </div>
<div>medical records indicate that she twisted her back during the fall, </div>
<div>and the chair fell on top of her. </div>
<div>¶ 3<span> </span><span>Luis was seen the same day by Sheree Montoya, a nurse </span>
</div>
<div>practitioner at Concentra Fort Collins.<span> </span>Luis reported burning pain </div>
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<div>2 </div>
<div>radiating to the left buttocks, causing decreased mobility in <span></span>rotating </div>
<div>and bending the spine. Two days later<span>, </span>Luis visited Dr. Jeffrey </div>
<div>Baker at Concentra<span>, </span>reporting pain in the left hip, leg, and lowe<span></span>r </div>
<div>back as well as <span>“</span>some radiation of pain to her knee.<span>”</span><span> </span>Dr. Baker </div>
<div>diagnosed sacroiliac strain and referred Luis to <span>a </span>physical therapi<span></span>st </div>
<div>at Concentra, Nicholas <span>Wr</span>ight, who saw her the same day.<span> </span>She </div>
<div>visited Dr. Baker again on February 25, reporting both back and </div>
<div>left knee pain. Dr. Baker diagnosed her with a continued sacroi<span>li<span>a</span></span><span>c </span>
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<div>strain as well as a contusion to her left knee. </div>
<div>¶ 4<span> </span><span>Luis continued <span>to</span> work in a modified position through the end </span>
</div>
<div>of March 2020, but then she was laid off due to the COVID-<span>19 </span>
</div>
<div>pandemic.<span> <span>On April 22, 2020, Luis visited Steven Toth, P.A., who </span></span>
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<div>noted that she complained of right leg pain when walking. <span></span> She </div>
<div>stated that the pain was there originally on the date of <span></span>injury but </div>
<div>she did not report it. </div>
<div>¶ 5<span> </span><span>She continued treatment for her work injury with Dr. Baker<span>, </span></span>
</div>
<div>DPT Wright<span>, </span>and a chiropractor, Dr. Parker.<span> </span>She had an MRI of her </div>
<div>lumbar spine and pelvis in August 2020. </div>
<div>¶ 6<span> </span><span>Luis was referred to Dr. Gregory Reichhardt on October 5, </span>
</div>
<div>2020, <span>as </span>an authorized treating physician (ATP) for evaluation of </div>
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<div>3 </div>
<div>her injury.<span> </span>Dr. Reichhardt noted that Luis reported pain in the low </div>
<div>back, radiating pain down to the foot, weakness in the left<span></span> leg, and </div>
<div>left knee pain. Dr. Reichhardt also documented in his rec<span></span>ords that </div>
<div>Luis complained of bilateral lower extremity pain and weaknes<span></span>s. </div>
<div>¶ 7<span> </span><span>Dr. Reichhardt<span>’</span>s examination confirmed right arm pain and </span>
</div>
<div>left leg pain. He documented that her August MRI reflected <span></span>disc </div>
<div>bulges and degeneration as well as foraminal stenosis. He </div>
<div>specifically attributed her back and knee pain to the Februa<span></span>ry 15, </div>
<div>2020, work injury, and her right arm pain to the August 25, <span></span>2019, </div>
<div>work injury. He reported that Luis complained of right <span></span>ankle pain </div>
<div>related to the injury that wasn<span>’</span>t included <span>in</span> her workers<span>’</span> </div>
<div>compensation claim. Luis informed him that her employer <span></span>didn<span>’</span><span>t </span>
</div>
<div>list the ankle pain initially and providers indicated they couldn<span>’</span><span>t </span>
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<div>treat the pain because it wasn<span>’</span>t listed.<span> </span>He recommended an MRI of </div>
<div>her left knee and an electrodiagnostic evaluation (EMG) for her lef<span></span>t </div>
<div>lower extremity. </div>
<div>¶ 8<span> </span><span>Luis followed up with Dr. Baker, who documented that she </span>
</div>
<div>had continued back pain and left knee tenderness and pain. He </div>
<div>ordered an MRI on her left knee, which was done in December </div>
<div>2020. </div>
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<div>4 </div>
<div>¶ 9<span> </span><span>On December 11, 2020, Luis returned to see Dr. Reichhardt,<span></span> </span>
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<div>who noted that she was having weakness in the right leg, wh<span></span>ich she </div>
<div>thought was related to dry needling.<span> </span>Luis had complained that a </div>
<div>nerve was hit, and one day after her second dry needling treatm<span></span>ent, </div>
<div>she had difficulty coordinating her right leg, which then got worse </div>
<div>after her last chiropractic treatment. </div>
<div>¶ 10<span> </span><span>Dr. Reichhardt saw Luis again in January and February of </span>
</div>
<div>2021. Luis reported pain and weakness in both legs and inability <span></span>to </div>
<div>walk without a cane<span>. </span>At some point, Dr. Reichhardt was </div>
<div>erroneously informed by P.A. Toth that Luis had not reported her </div>
<div>knee injury until ten days after the injury<span>. </span>Dr. Reichhardt<span>’</span>s notes </div>
<div>from the February 2021 visit state that, after talking with P.A. Toth, </div>
<div>“<span>it appeared that her knee pain was probably not related to he<span></span>r </span>
</div>
<div>injury.<span>”</span><span> <span>His notes indicated he discussed this with Luis, who said </span></span>
</div>
<div>she did not have any problems with her knee prior to her inj<span></span>ury, </div>
<div>and she felt it was related to her injury. </div>
<div>¶ 11<span> </span><span>At petitioners<span>’</span> request, <span>Dr</span>. Douglas Scott performed an </span>
</div>
<div>Independent Medical Exam (IME) on February 23, 2021.<span> </span>Dr. Scott </div>
<div>opined that the mechanism of injury occurred without signi<span></span>ficant </div>
<div>force due to Luis<span>’</span><span>s </span>short height, and that Luis reached MMI <span></span>on June </div>
</div></div>
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<div>5 </div>
<div>3, 2020.<span> </span>Luis continued treatment with Dr. Reichhardt, who </div>
<div>performed an EMG and recommended injections and massage </div>
<div>therapy. At a visit on July 20, 2021, Dr. Reichhardt put Luis <span>at</span> </div>
<div>MMI. His impressions indicated that Luis had pain and weakne<span></span>ss </div>
<div>in the low back and left lower extremity, both of which he related to </div>
<div>the February 15, 2020, injury. Dr. Reichhardt assigned impairment </div>
<div>ratings both for the back and left knee. </div>
<div>¶ 12<span> </span><span>Petitioners then requested <span>a </span>division independent medical </span>
</div>
<div>examination (DIME).<span> </span>On August 10, 2022<span>, t</span>he DIME physician, Dr. </div>
<div>Sander Orent, concluded that Luis was not at MMI. After </div>
<div>examining Luis, he documented that she had constant low <span></span>back </div>
<div>pain that radiated down both legs. She also had trouble raising her </div>
<div>left leg<span>, </span>had pain with swelling in both knees, and had swelling and </div>
<div>restricted range of motion in the right ankle. He diagnosed her wit<span></span>h </div>
<div>lumbar strain and bilateral knee contusions, with the left <span></span>knee </div>
<div>injury occurring at the time of her work injury. He also diagnose<span></span>d </div>
<div>her with a right ankle sprain, noting that the <span>“</span>mechanism of injury </div>
<div>is certainly consistent<span>, </span>there have been no intervening events[,] and </div>
<div>I do believe this patient<span>’</span>s history.<span>”</span><span> </span>Dr. Orent also opined that an </div>
<div>injury to Luis<span>’</span>s right knee was caused by chiropractic manipulati<span></span>on </div>
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<div>6 </div>
<div>she underwent as a result of her other injuries.<span> </span>He found Luis was </div>
<div>not at MMI because she required a repeat MRI of the low back, </div>
<div>medical findings relating to the left knee, and further care. </div>
<div>¶ 13<span> </span><span>At petitioners<span>’</span> request<span>, </span>Dr. John Aschberger performed an IME </span>
</div>
<div>in November 2022. He agreed with Dr. Reichhardt<span>’</span>s assessment </div>
<div>that Luis had attained MMI on July 20, 2021.<span> </span>Dr. Reichhardt </div>
<div>examined Luis again in November 2022, after talking to Dr. </div>
<div>Aschberger.<span> <span>Dr. Reichhardt recommended Luis be treated for </span></span>
</div>
<div>cervical spine impingement and <span>a </span><span>clonus.</span>
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<div><div>1</div></div>
<div>
<div> </div>
<div>¶ 14<span> </span><span>In December 2022, Dr. Scott issued a supplemental repo<span></span>rt at </span>
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<div>petitioners<span>’</span><span> request. He reviewed further records an<span></span>d noted that his </span>
</div>
<div>opinions had not changed; that Luis had reached MMI on J<span></span>une 3, </div>
<div>2020; and that Dr. Orent<span>’</span><span>s </span>impairment opinions were questi<span></span>onable. </div>
<div>¶ 15<span> </span><span>Petitioners filed an application for hearing (AFH) in September </span>
</div>
<div>2022, checking the boxes for <span>“</span>medical benefits,<span>”</span> <span>“</span>reasonably </div>
<div>necessary,<span>”</span><span> and <span>“</span>permanent partial disability benefits.<span>”</span><span> </span>Under </span>
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<div>“<span>other issues,</span>”<span> petitioners listed </span><span>“<span>Overcoming DIME, MMI, credits, </span></span>
</div>
<div>offsets, intervening event<span>, </span><span>waiver.<span>”</span></span><span> </span>Luis filed a response to the AFH </div>
<div> </div>
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<div><div>1</div></div>
<div><div> Dr. Aschberger described clonus as <span>“</span>repetitive contraction.<span>”</span> </div></div>
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<div>7 </div>
<div>on issues including medical benefits, average weekly wage, </div>
<div>temporary disability benefits, and, if Luis was found to <span></span>be at MMI, </div>
<div>permanent partial disability benefits and <span>Grover</span> medical benefit<span></span>s. </div>
<div>¶ 16<span> </span><span>A hearing was held in January 2023.<span> </span>Luis, Dr. Orent, Dr. </span>
</div>
<div>Aschberger, and Dr. Scott all testified. The ALJ issued findings of </div>
<div>fact and conclusions of law, concluding that petitioners faile<span></span>d to </div>
<div>prove by clear and convincing evidence that the DIME physi<span></span>cian </div>
<div>was incorrect, and therefore, Luis was not at MMI. Petitioners file<span></span>d </div>
<div>a petition for review under section 8-<span>43</span>-301(5), C.R.S.<span></span> 2024<span>. </span>After </div>
<div>briefing, the ALJ issued supplemental findings of f<span>act</span> and </div>
<div>conclusions of l<span>aw</span> but didn<span>’</span>t change h<span>er</span> conclusion. The ALJ </div>
<div>ordered petitioners to pay for reasonably necessary medical care </div>
<div>“<span>related to the February 15, 2020[,] work injury</span>”<span> to </span><span>“<span>cure and reli<span></span>eve </span></span>
</div>
<div>[Luis] of the compensable injury.<span>”</span><span> </span>The ALJ also ordered petitioners </div>
<div>to pay temporary total disability benefits as of July 20, 20<span></span>21, and </div>
<div>continuing until terminated by law. </div>
<div>¶ 17<span> </span><span>Petitioners then appealed to the Panel, which affirmed. This </span>
</div>
<div>appeal followed. </div>
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<div>8 </div>
<div>II.<span> <span>Standard of Review and Legal Principles </span></span>
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<div>¶ 18<span> </span><span>Our review of the Panel<span>’</span>s order is narrow. <span>See Metro Moving &amp; </span></span>
</div>
<div>Storage Co. v. Gussert<span>, 914 P.2d 411, 415 (Colo. App. 19<span></span>95). We </span>
</div>
<div>may set aside an order only upon the following grounds: </div>
<div>[t]hat the findings of fact are not sufficient to </div>
<div>permit appellate review; that conflicts in the </div>
<div>evidence are not resolved in the record; that </div>
<div>the findings of fact are not supported by the </div>
<div>evidence; that the findings of fact do not </div>
<div>support the order; or that the award or denial </div>
<div>of benefits is not supported by applicable law. </div>
<div>§ 8-<span>43</span>-308, C.R.S. 2024. </div>
<div>¶ 19<span> </span><span>We must accept the ALJ<span>’</span>s findings of fact if they are supported </span>
</div>
<div>by substantial evidence. <span>Id.</span><span> </span>Substantial evidence is <span>“</span>that quantum </div>
<div>of probative evidence which a rational fact-finder would accept <span></span>as </div>
<div>adequate to support a conclusion, without regard to <span></span>the existence of </div>
<div>conflicting evidence.<span>”</span><span> </span><span>Metro Moving &amp; Storage</span>, 914 P.2d at 414. In </div>
<div>applying this test, <span>“</span>we must view the evidence as a whole and in t<span></span>he </div>
<div>light most favorable to the prevailing party.<span>”</span><span> </span><span>Id.</span><span> </span>We defer to the </div>
<div>ALJ<span>’</span><span>s credibility determinations and resolution of conflicts i<span></span>n the </span>
</div>
<div>evidence, including conflicts in the medical evidence. <span>Id.</span><span> <span></span><span>Causation </span></span>
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<div>is generally a question of fact for the ALJ. <span>Faulkner v. I<span></span>ndus. Claim </span>
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<div>Appeals Off.<span>, 12 P.3d 844, 846 (Colo. App. 2000). </span>
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<div> </div>
<div>9 </div>
<div>¶ 20<span> </span><span>The exclusive remedy available to employees for workplace </span>
</div>
<div>injuries in Colorado is the Workers<span>’</span> Compensation Act of Colorado </div>
<div>(the Act), §§ 8-<span>40</span>-101 to -<span>47</span>-209, C.R.S. <span></span>2024.<span> </span>To provide care to </div>
<div>an injured employee under the Act, the employer or t<span></span>he employer<span>’</span><span>s </span>
</div>
<div>insurer identifies a list of providers from which the employee selects </div>
<div>an<span> ATP.<span> </span>§ 8-<span>43</span><span>-404</span><span> </span>(5)(a)(I)(A), C.R.S. 2024. Following this <span></span>care, </span>
</div>
<div>the ATP determines when the employee has reached MMI and the </div>
<div>degree of any permanent impairment.<span> </span>§ 8-<span>42</span>-107(8)(b)(I), C.R.S.<span></span> </div>
<div>2024.<span> <span>If a<span>ny</span> party disputes the ATP<span>’</span>s finding</span>, </span>t<span>he</span><span> party may initiate </span>
</div>
<div>the selection of an independent medical examiner to conduct a </div>
<div>DIME.<span> </span><span>See</span><span> § 8-<span>42</span>-107.2(2)(a)(I), (b)-(c), C.R.S. 2024. The DIME </span>
</div>
<div>physician examines the claimant and makes an independent </div>
<div>finding of the claimant<span>’</span>s condition.<span> </span>This finding may only be </div>
<div>overcome by clear and convincing evidence.<span> </span>§ 8-<span>42</span>-107(8)(b)(III). </div>
<div>III.<span> <span>Analysis </span></span>
</div>
<div>¶ 21<span> </span><span>In their opening brief, petitioners raise the following issues: </span>
</div>
<div>•<span> <span>Whether the Panel correctly held that Workers<span>’</span> </span></span>
</div>
<div>Compensation Rule of Procedure <span>11</span>-5, Div. of Workers<span>’</span> </div>
<div>Comp. Rule 11-<span>5,</span> 7 Code Colo. Regs. 1101-3, (WCRP 11-<span>5)</span> </div>
</div>
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<div> </div>
<div>10 </div>
<div>do<span>es not prevent the DIME physician from evaluating <span></span>any </span>
</div>
<div>and all body parts in determining MMI. </div>
<div>•<span> <span>Whether the ALJ correctly held that the DIME physician<span>’</span><span>s </span></span></span>
</div>
<div>opinion on MMI was not overcome by clear and convincing </div>
<div>evidence. </div>
<div>•<span> <span>Whether the ALJ erred by not finding that Luis had an </span></span>
</div>
<div>intervening event. </div>
<div>•<span> <span>Whether the ALJ erred <span>by</span> allowing undisclosed testimony </span></span>
</div>
<div>by a non-retained expert. </div>
<div>We examine each contention in turn. </div>
<div>A.<span> <span>WCRP <span>11</span>-5 Did Not Limit the Scope of the DIME </span></span>
</div>
<div>¶ 22<span> </span><span>Petitioners contend that Dr. Orent was not authorized t<span></span>o </span>
</div>
<div>examine Luis<span>’</span><span>s </span>lower extremities because they only listed her ba<span></span>ck </div>
<div>and psychological issues on their DIME application.</div>
</div>
<div><div>2</div></div>
<div>
<div> </div>
<div> </div>
</div>
<div><div>2</div></div>
<div>
<div> <span>It<span>’</span></span>s unclear whether petitioners take issue with the exa<span></span>mination </div>
<div>and inclusion of all lower extremities or just the right <span></span>knee and </div>
<div>right ankle. Their briefing generally refers to <span>“</span>lower extremities,<span>”</span> </div>
<div>but when asked about the left knee at oral argument,<span></span> petitioners<span>’</span> </div>
<div>counsel said that the left knee was omitted but <span>“</span>my client did not </div>
<div>take issue with that.<span>”</span><span> </span>Because this distinction doesn<span>’</span>t affect our </div>
<div>analysis, we will refer generally to petitioners<span>’</span> objection to Dr. </div>
<div>Orent<span>’</span><span>s examination of Luis<span>’</span><span>s <span>“</span></span>lower extremities.<span>”</span> </span>
</div>
</div>
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<div><div>
<div> </div>
<div>11 </div>
<div>¶ 23<span> </span><span>Section 8-<span>42</span>-107.2(5)(a)(I) states that <span>“</span>[The Director of </span>
</div>
<div>Workers<span>’</span><span> Compensation] shall promulgate rules consistent <span></span>with this </span>
</div>
<div>section (5) to determine the amount and allocation of costs <span></span>to be </div>
<div>paid by the parties for the independent medical examination.<span>”</span><span> </span>
</div>
<div>WCRP 11-5(A) provides a schedule for the fees a DIME physi<span></span>cian </div>
<div>may charge based on body parts and date of injury.<span> </span>Div. of </div>
<div>Workers<span>’</span><span> Comp. Rule 11.5(A), 7 Code Colo. Regs. 1101-3. </span>
</div>
<div>Petitioners rely on that rule to argue that the Director of Worke<span></span>rs<span>’</span> </div>
<div>Compensation must have meant to substantively limit DIME </div>
<div>physicians by enacting a structured pay schedule based on the </div>
<div>number of body parts and quantity of medical record<span></span>s. But the </div>
<div>statute makes no mention of any substantive limitation on the </div>
<div>examining physician<span>’</span>s assessment of MMI based on the <span></span>number of </div>
<div>body parts selected on the DIME application, <span>see</span> § 8-<span>42</span>-107.2, and </div>
<div>WCRP 11-<span>5 </span> is also silent on the matter. We cannot read lang<span></span>uage </div>
<div>into the rule or statute, and we must give the plain language of <span></span>the </div>
<div>statute and rules their full effect. <span>See Smith v. Exec. Cust<span></span>om Homes, </span>
</div>
<div>Inc.<span>, 230 P.3d 1186, 1191 (Colo. 2010) (court canno<span></span>t give a statute </span>
</div>
<div>a meaning that the plain language does not support). </div>
</div></div>
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<div> </div>
<div>12 </div>
<div>¶ 24<span> </span><span>In this case, petitioners argue that since they endorsed only </span>
</div>
<div>the low back and psychological impairment on their DIME </div>
<div>application, Dr. Orent erred when he went beyond those body <span></span>parts </div>
<div>to examine Luis<span>’</span><span>s </span>lower extremities. In other words, they argue that </div>
<div>Dr. Orent, as the DIME physician, should have reviewed only what </div>
<div>the petitioners wanted him to. The Panel rejected that argum<span></span>ent, </div>
<div>concluding that WCRP <span>11</span>-5 uses the list of body regions t<span></span>o compute </div>
<div>the DIME fee, and not to limit the scope of the DIME evaluation. </div>
<div>¶ 25<span> </span><span>We agree with the Panel. Nothing in the applicable st<span></span>atute or </span>
</div>
<div>WCRP 11-5 limits a DIME physician from addressing any <span></span>and all </div>
<div>relevant body parts. <span>See Peitz v. Indus. Claim Appeals O<span></span>ff.<span>, <span>2024 </span></span></span>
</div>
<div>COA 102, ¶¶ <span>28</span><span>-<span>30</span>;</span><span> see also Paint Connection Plus v. I<span></span>ndus. Claim </span>
</div>
<div>Appeals Off.<span>, 240 P.3d 429, 433 (Colo. App. 2010) (MMI should be </span>
</div>
<div>determined by considering the date on which all of the claimant<span>’</span><span>s </span>
</div>
<div>injuries from the accident have reached maximum recovery). </div>
<div>¶ 26<span> </span><span>Relatedly, petitioners contend that, by not exercising her </span>
</div>
<div>“<span>right</span>”<span> to add body parts to the DIME, Luis waived the right <span></span>to have </span>
</div>
<div>those body parts addressed by Dr. Orent or the ALJ. We disagree.<span></span> </div>
</div></div>
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<div> </div>
<div>13 </div>
<div>¶ 27<span> </span><span>Waiver is the intentional relinquishment of a known right.<span> </span></span>
</div>
<div>Burlington N. R. Co. v. Stone Container Corp.<span>, 934 P.2d 902<span>, </span>905 </span>
</div>
<div>(Colo. App. 1997). </div>
<div>¶ 28<span> </span><span>Under section 8-<span>42</span>-107.2(2)(b), <span>“</span>if any party disputes a finding </span>
</div>
<div>or determination of the [ATP], such party shall request the selection </div>
<div>of an IME.<span>”</span><span> </span>Here, Luis<span>’</span>s ATP, Dr. Reichhardt, had determined he<span></span>r </div>
<div>to be at MMI. Petitioners disputed the ATP<span>’</span>s findings and requeste<span></span>d </div>
<div>a DIME.<span> </span>Therefore, they controlled the initial request for which </div>
<div>body parts they wanted examined.</div>
</div>
<div><div>3</div></div>
<div>
<div> <span> </span>
</div>
<div>¶ 29<span> </span><span>While petitioners argue that Luis could have added the lower </span>
</div>
<div>extremities to the DIME application if she wanted Dr. Orent <span></span>to </div>
<div>examine them, they <span>don<span>’</span></span><span>t </span>cite any statutory or regulatory <span></span>procedure </div>
<div>expressly providing a mechanism for her to do so.<span> </span>At oral </div>
<div>argument, petitioners suggested that Luis could have used WCRP </div>
<div>11<span>-<span>11<span>. But that rule merely explains how the parties can <span></span>address </span></span></span>
</div>
<div> </div>
</div>
<div><div>3</div></div>
<div>
<div> <span>It<span>’</span></span>s not clear whether Luis could have requested her<span></span> own DIME at </div>
<div>this point because petitioners hadn<span>’</span>t entered a final admission of </div>
<div>liability for the February 2020 injury<span>. </span><span>See</span> § 8-<span>42</span><span>-107.2(2)(a)(I)(A)</span><span>, </span>
</div>
<div>C.R.S. 2024 (<span>“</span>For the claimant, the time for selection <span></span>of an IME </div>
<div>commences with the date of mailing of a final admission of lia<span></span>bility </div>
<div>by the insurer or self-insured employer that includes an </div>
<div>impairment rating issued in accordance with section <span></span>8-<span>42</span><span>-107.<span>”</span><span>).</span></span> </div>
</div>
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<div> </div>
<div>14 </div>
<div>non-compliance with the rule. It doesn<span>’</span>t provide any mechanism </div>
<div>for the non-requesting party to add body parts to the <span></span>DIME. </div>
<div>¶ 30<span> </span><span>Even if there was some ad hoc procedure Luis could have used </span>
</div>
<div>to request amendment of the application<span>, </span>petitioners cite no </div>
<div>language suggesting that the court was required to grant the </div>
<div>request. Likewise, petitioners cite no language suggesting that <span>a </span>
</div>
<div>claimant<span>’</span><span>s failure to make such a request (1) precludes a DIME </span>
</div>
<div>physician from examining or opining about non-selected body <span></span>parts </div>
<div>or (2) waives a claimant<span>’</span>s ability to defend the DIME physician<span>’</span><span>s </span>
</div>
<div>findings before the ALJ. In sum, Luis had no clear right <span>—</span> and </div>
<div>certainly no duty <span>—</span> to add body parts to the application at the time </div>
<div>that petitioners requested the DIME. </div>
<div>¶ 31<span> </span><span>For these reasons, we reject petitioners<span>’</span> arguments that <span>WC</span>RP </span>
</div>
<div>11 <span>(or Luis<span>’</span>s purported failure to attempt to amend the applicati<span></span>on<span>) </span></span>
</div>
<div>prevented Dr. Orent from opining about Luis<span>’</span>s lower extremities <span></span><span>or </span>
</div>
<div>prevented the ALJ from considering those opinions. </div>
<div>B.<span> <span>The DIME Physician<span>’</span>s Determination </span></span>
</div>
<div>¶ 32<span> </span><span>A <span>DIME physician<span>’</span>s MMI determination must be overcome <span></span>by </span></span>
</div>
<div>clear and convincing evidence<span>. </span> § 8-<span>42</span>-107(8)(b)(III). Clear and </div>
<div>convincing evidence is evidence demonstrating that it is <span>“</span>highly </div>
</div></div>
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<div id="pf10" data-page-no="10">
<div><div>
<div> </div>
<div>15 </div>
<div>probable<span>”</span><span> that the DIME physician<span>’</span>s rating is incorrect.<span> </span><span>Met<span></span>ro </span></span>
</div>
<div>Moving &amp; Storage,<span> 914 P.2d at 414.<span> </span>Therefore, to overcome the </span>
</div>
<div>DIME physician<span>’</span>s opinion, the evidence must establish t<span></span>hat it is </div>
<div>incorrect.<span> <span>Leming v. Indus. Claim Appeals Off.<span>, 62 P.3d 1015, 101<span></span>9 </span></span></span>
</div>
<div>(Colo. App. 2002). Such evidence must be unmistakable and <span></span>free </div>
<div>from serious or substantial doubt. <span>Id.</span> </div>
<div>¶ 33<span> </span><span>We do not separately review each individual basis for an ALJ<span>’</span><span>s </span></span>
</div>
<div>credibility determination and resolution of conflicting eviden<span></span>ce in </div>
<div>isolation. Nor do we hold the ALJ to <span>“</span>a crystalline standard in </div>
<div>articulating . . . findings of fact.<span>”</span><span> </span><span>Magnetic Eng<span>’</span>g, Inc. v. I<span></span>ndus. </span>
</div>
<div>Claim Appeals Off.<span>, 5 P.3d 385, 388 (Colo. App. 2000). </span>
</div>
<div>¶ 34<span> </span><span>As the ALJ observed, Dr. Orent testified in detail, consistent </span>
</div>
<div>with his report, about the reasons he concluded Luis wasn<span>’</span>t at </div>
<div>MMI. The ALJ<span>’</span>s thorough findings of fact and conclusions of <span></span>law </div>
<div>reveal that the ALJ carefully considered the testimony of each </div>
<div>witness and concluded that Dr. Orent was more credible than <span></span>the </div>
<div>other testifying physicians. </div>
<div>¶ 35<span> </span><span>Specifically, the ALJ found that Dr. Scott<span>’</span>s testimony in </span>
</div>
<div>finding that Luis reached MMI on June 3, 2020 <span>—</span> when Dr. Parke<span></span>r </div>
<div>said that Luis could perform a squat despite continuing </div>
</div></div>
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<div id="pf11" data-page-no="11">
<div><div>
<div> </div>
<div>16 </div>
<div>symptoms <span>—</span> was <span>“</span>simply not credible.<span>”</span> The ALJ explained that<span></span> Dr. </div>
<div>Scott had relied heavily on Dr. Parker<span>’</span><span>s <span>“</span></span><span>suspect<span>”</span></span> notations </div>
<div>indicating Luis <span>“</span>transitioned from a seated to a standing p<span></span>osition </div>
<div>without difficulty, pain complaints, or pain behaviors<span>”</span> despite her </div>
<div>reports of continued pain and symptoms. </div>
<div>¶ 36<span> </span><span>As to Dr. Aschberger, the ALJ noted that he didn<span>’</span>t disagree </span>
</div>
<div>that Luis needed further evaluations but had simply <span></span>concluded that </div>
<div>“<span>since the treatment provided did not resolve her complaints . . .<span></span> </span>
</div>
<div>they were probably unrelated to the work injury.<span>”</span><span> </span>Additionally, the </div>
<div>ALJ credited Dr. Orent<span>’</span>s testimony that Dr. <span>Aschberger’s</span> and Dr. </div>
<div>Scott<span>’</span><span>s opinions were simply differences of opinion. </span>
</div>
<div>¶ 37<span> </span><span>Finally, the ALJ concluded that Dr. Reichhardt<span>’</span>s opinion was </span>
</div>
<div>more persuasive than Dr. Scott or Dr. Aschberger, but it <span></span>still didn<span>’</span><span>t </span>
</div>
<div>rise to the level of clear and convincing evidence because, <span></span>among </div>
<div>other things, Dr. Reichhardt relied on the erroneous </div>
<div>communications from another provider that Luis hadn<span>’</span>t complaine<span></span>d </div>
<div>of leg pain during the visits immediately after the injury. </div>
<div>¶ 38<span> </span><span>We will not second-guess these credibility determinations, the </span>
</div>
<div>ALJ<span>’</span><span>s assessment of the persuasive value of the evidence, or t<span></span>he </span>
</div>
</div></div>
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<div>
<img alt="" src="https://icbg.s3.amazonaws.com/media/MMX/n%2Be/MMXn%2BekQ817y/lXyeovZwcgeMWibwHo7dUSO3Lu0a7r74%3D?AWSAccessKeyId=ASIA5PHC3MTPU2UP5BQD&amp;Expires=1728529360&amp;Signature=00MOpEJkNnskn%2BxBvHRnKZuECl4%3D&amp;x-amz-security-token=IQoJb3JpZ2luX2VjEBIaCXVzLWVhc3QtMSJHMEUCIQDQ0%2BjLXPPJeutfbRlNXUFprUGFcL8tkjsaKZ9764ZUcgIgG1drJVCIjGsXt1xVKie%2BWwkzRyGiCq6FgjSG79sVdzgqsgUIaxAAGgw5MjYwNDEyMDM5MzUiDOKC2fhl83Z0g8RChyqPBTDxki91cB86kebDlVu9zXtTBEKo9R2TeXS87x2f7AUbu6pIXgcoBmH270kFQ%2F0USnQm82O7op90jz66mlEtbD%2FT5TLPuirGclk%2B2GVv2y8A1Ez7WFS%2Fr%2FDZOxT1visvaCBwUt2VBlKcBIGpTmZ7TPNrIYEAJMfwo2%2FjiWPTpNoFGSnR7qDIK46e9wQDLoT1mYZvGQS%2FEuCiUztGM9Pm%2BYwU6ThB7C1vRL2%2F7dqx3qxXPKH0TJWuLSylVhE828K1g80yH%2FbH9VrhlYbKGnPzmWe6OZPjC4dtMEvXv9wWLg774QcfM25Sgf8MNmx6EKS27r80aW1Fa9jb%2FOXhz4n4LHZcVcbHcfo8j7E7liX%2FcJDt%2BZxhmzXD2%2BFnXu8EhqKYQyOxUJHgCcY8mAmWYHeF2AGocsc8Yo8%2F0h9%2FSaR4fPn3s4MaSEdF5ZxHfCtVRxjA36tdkx1J%2BD8dmVwvFfUNQOwjnCVUG2%2BW1i4YOWxCl5G9Z2zFPBL6EbXNV%2BiBAHYZgPIl4phBZs2XDCCWjLUnNA7GrAJv4B1imgbh40NqacbCzbAx%2BX3C%2B%2FzkoQg5LI%2B%2BDhTLFAXajFsnVd3imnaGof5OWRGl8mqQUWaxo4wHxWAKgDyt%2BteZkaF1kp%2BDg7uWByO38NzmnjUdtHlK7%2FbbHQhVn2hjfwVKGWEiZApUqwhzu5UPTAtWbtk36Hn0CIwss29QJFsJBZbTNWpsnd5BGx4Rt5NDZ9owtw%2F2qTd%2FnQrhJ9mHm7imcNkM5XLad5TpPaC2nx%2BcOzG6yLLoGxyMGcMh8C3o16NpEW3XulBQ1nanpZ5Mi%2F2ThIfmDdkTf91MzuXnAct9LTQCJmM2mmi%2BhJF9IrpHQgBEgiRUnozlmV0wutycuAY6sQEFyJms0aBrKmmPxoTSo7EAt15UKVt2nuEMukCI4JDc6%2BjM7trcUtvLva5d5pLRzU%2F%2BB6Y%2B37YLEeqQW1FoJPdoXMhaw71fV95j0sdTBLS6qbR36hEUxr3wTF%2FkttQLnl6xz8SWEbwPTlsCElFC6E4UmZ7W%2ByDQGBuGdHZRG3hVY%2BIQDoDoMwrXbtdrMBEJotzzdf9rwDlB19Wql1sLjq%2B9bCEN70iDjHDHUdV2vjFqsgE%3D"><div>
<div> </div>
<div>17 </div>
<div>resolution of conflicting evidence.</div>
</div>
<div><div>4</div></div>
<div>
<div> <span>See Metro Moving &amp; Storage<span>, 914 </span></span>
</div>
<div>P.2d at 414-<span>15</span><span>.</span><span> </span>We see no reason to disturb the ALJ<span>’</span><span>s </span>
</div>
<div>conclusion <span>—</span> or the Panel<span>’</span>s decision upholding it <span>—</span> that Dr. </div>
<div>Orent<span>’</span><span>s report had not been overcome by clear and convincing </span>
</div>
<div>evidence. </div>
<div>¶ 39<span> </span><span>We next address and reject petitioners<span>’</span> arguments to the </span>
</div>
<div>contrary. </div>
<div>¶ 40<span> </span><span>As best we can discern, petitioners first argue that Dr. Orent </span>
</div>
<div>made an error in applying the American Medical Association (A<span></span>MA) </div>
<div>Guides and Division<span>’</span>s Impairment Rating Tips.<span> </span>The Panel </div>
<div>concluded, and we agree, that the AMA guides apply <span></span>solely to the </div>
<div>calculation of permanent impairment. <span>See</span> § 8-<span>42</span>-101(3.7), <span></span>C.R.S. </div>
<div>2024.<span> <span>Similarly, the Panel concluded that because the Division </span></span>
</div>
<div>Impairment Ratings Tips are interpretations of the AMA guides, </div>
<div>they also have no bearing on whether a patient has reached MMI. </div>
<div>Petitioners don<span>’</span>t cite <span>—</span> and we haven<span>’</span>t found <span>—</span> any authority <span></span>to </div>
<div> </div>
</div>
<div><div>4</div></div>
<div>
<div> To the extent petitioners argue that the ALJ erred because Dr. </div>
<div>Orent<span>’</span><span>s findings about Luis<span>’</span>s range of motion were <span>“</span></span>non-</div>
<div>physiologic<span>”</span><span> or <span>“</span>not substantiated,<span>”</span> we disagree. It is the <span></span>ALJ<span>’</span>s sole </span>
</div>
<div>prerogative to resolve conflicts in the medical evidence. <span>See Met<span></span>ro </span>
</div>
<div>Moving &amp; Storage Co. v. Gussert<span>, 914 P.2d 411, 415 (Colo. <span></span>App. </span>
</div>
<div>1995). </div>
</div>
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<div><div>
<div> </div>
<div>18 </div>
<div>the contrary. Because the patient must be at MMI before a </div>
<div>permanent impairment rating is assigned, <span>see Rosten v. I<span></span>ndus. </span>
</div>
<div>Claim Appeals Off.<span>, 2023 COA 62, ¶ 23, we don<span>’</span>t see how Dr. </span>
</div>
<div>Orent<span>’</span><span>s purported failure to apply the AMA guides or <span></span>the Division </span>
</div>
<div>Impairment Ratings Tips undermines the ALJ<span>’</span>s finding that his </div>
<div>opinion wasn<span>’</span>t overcome by clear and convincing evidence. </div>
<div>¶ 41<span> </span><span>Next, petitioners appear to argue that Dr. Orent<span>’</span>s opinion was </span>
</div>
<div>unpersuasive because <span>he</span> based his inclusion of the right ankle and </div>
<div>right knee <span>on</span> Luis<span>’</span><span>s </span>reporting even though the medical recor<span></span>ds do </div>
<div>not mention a right ankle injury occurring on the date of inj<span></span>ury.<span> </span>
</div>
<div>But the ALJ found, with record support, that the medical records </div>
<div>showed a pattern of Luis<span>’</span><span>s </span>complaints regarding her right <span></span>lower </div>
<div>extremity, with PA Toth noting her complaints of right leg <span></span>pain as </div>
<div>early as April 2020.<span> </span>Dr. Reichhardt also documented in his October </div>
<div>2020 report that Luis had bilateral lower extremity pain and </div>
<div>weakness.<span> <span>Notably, both PA Toth and Dr. Reichhardt noted that<span></span> </span></span>
</div>
<div>Luis informed them that the right leg or ankle pain had <span></span>been </div>
<div>present on the date of the injury. </div>
<div>¶ 42<span> </span><span>Finally, to the extent petitioners argue that Dr. Orent<span>’</span><span>s </span></span>
</div>
<div>testimony was overcome because (1) he didn<span>’</span>t consider the </div>
</div></div>
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<div><div>
<div> </div>
<div>19 </div>
<div>independent medical exams performed by two other <span></span>professionals; </div>
<div>(2) he didn<span>’</span>t consider the DIME from Luis<span>’</span>s 2019 workplace injury;<span></span> </div>
<div>and (3<span>) <span>he</span></span> testified inconsistently with his report, we decline to </div>
<div>address these arguments because they are undeveloped.<span> </span><span>See </span>
</div>
<div>Woodbridge Condo. Ass<span>’</span>n., Inc. v. Lo Viento Blanco, LLC<span>, 2020 COA </span>
</div>
<div>34,<span> ¶ 41 n.12 (noting that this court doesn<span>’</span><span>t <span>“</span></span>consider unde<span></span>veloped </span>
</div>
<div>and unsupported arguments<span>”</span>). </div>
<div>¶ 43<span> </span><span>Accordingly, we see no reason to set aside the Panel<span>’</span>s decision. </span>
</div>
<div>C.<span> <span>Intervening Event </span></span>
</div>
<div>¶ 44<span> </span><span>Petitioners next contend that the ALJ erred by failing to f<span></span>ind </span>
</div>
<div>that Luis suffered an intervening injury. We disagree. </div>
<div>¶ 45<span> </span><span>An intervening injury may sever the causal connection </span>
</div>
<div>between the industrial injury and the claimant<span>’</span>s condition. <span>See </span>
</div>
<div>Standard Metals Corp. v. Ball<span>, 172 Colo. 510, 512, 474 P.2<span></span>d 622<span>, </span></span>
</div>
<div>623 (1970). <span>It</span> is petitioners<span>’</span> burden to prove that Luis<span>’</span><span>s </span>disability is </div>
<div>attributable to the intervening injury or condition and not <span></span>the </div>
<div>industrial injury.<span> </span><span>See Atlantic &amp; Pacific Co. v. Barnes</span>, 666 P.2d 163, </div>
<div>16<span>5 (Colo. App. 1983) (<span>“</span>[A]s a general rule, the burden of pr<span></span>oof rests </span>
</div>
<div>upon the party who asserts the affirmative of an issue.<span>”</span><span>).</span><span> </span>Whether </div>
<div>petitioners have sustained their burden to prove Luis<span>’</span><span>s </span>disability </div>
</div></div>
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<div id="pf15" data-page-no="15">
<div><div>
<div> </div>
<div>20 </div>
<div>was triggered by an intervening event is a question of f<span></span>act for </div>
<div>resolution by the ALJ.<span> </span><span>See City of Aurora v. Dortch</span>, 799 P.2d 462<span>, </span>
</div>
<div>464 (Colo. App. 1990). </div>
<div>¶ 46<span> </span><span>Petitioners contend Luis must have injured herself during an </span>
</div>
<div>emergency trip to Mexico, thus severing the causal connection </div>
<div>between the injury and her condition. As best we can discern, this </div>
<div>is based on evidence that (1) Luis reported in November 2022 t<span></span>hat </div>
<div>she had fallen <span>“</span><span>15</span><span>-<span>20<span>”</span></span></span> times over the preceding year and (2) Luis </div>
<div>began walking with a cane sometime after her Mexico trip. </div>
<div>¶ 47<span> </span><span>During the hearing, Luis testified that in November 2021 sh<span></span>e </span>
</div>
<div>traveled to Mexico for approximately one month for an eme<span></span>rgency, </div>
<div>but she didn<span>’</span>t testify about any injury that happened t<span></span>here. The </div>
<div>ALJ noted that <span>“</span>there was no confirmation or credible evidence t<span></span>hat </div>
<div>[Luis] suffered any accident or incident while she was in Mexico,<span>”</span> </div>
<div>and petitioners don<span>’</span>t cite to any in the record. </div>
<div>¶ 48<span> </span><span>For these reasons<span>, </span>we are not persuaded that the ALJ erred </span>
</div>
<div>when she found <span>“</span>insufficient evidence to determine that it<span></span> is more </div>
<div>probable than not that [Luis]suffered an intervening event.<span>”</span> </div>
</div></div>
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<div><div>
<div> </div>
<div>21 </div>
<div>D.<span> <span>Undisclosed Testimony </span></span>
</div>
<div>¶ 49<span> </span><span>Finally, petitioners contend that the ALJ erroneously allowed </span>
</div>
<div>Dr. Orent to answer a hypothetical question about Luis<span>’</span>s clonus </div>
<div>condition because the opinion expressed in his answer wasn<span>’</span><span>t </span>
</div>
<div>disclosed before trial. </div>
<div>¶ 50<span> </span><span>During his testimony, Dr. Aschberger opined that Luis may </span>
</div>
<div>have suffered from a clonus condition that contributed to s<span></span>ome of </div>
<div>her complaints and symptoms related to her lower extremities.<span> </span>He </div>
<div>also opined that the clonus was not caused by the work<span></span>place injury. </div>
<div>¶ 51<span> </span><span>Dr. Orent testified after Dr. Aschberger. On direct </span>
</div>
<div>examination, he opined<span>, <span>“</span></span>I don<span>’</span><span>t </span>know why she has this clonus. I </div>
<div>am as disturbed . . . as Dr. Aschberger is, but I am not so q<span></span>uick to </div>
<div>say that it is not related to her occupational injury.<span>”</span><span> </span>Counsel then </div>
<div>asked, <span>“</span>Doctor, hypothetically, if you were to find out t<span></span>hat the </div>
<div>claimant fell prior to an evaluation and, in [falling], had hit <span></span>her </div>
<div>head, might that explain a clonus finding from Dr. Aschb<span></span>erger?<span>”</span> </div>
<div>Petitioners objected on the grounds that any opinion about <span></span>the </div>
<div>hypothetical was undisclosed.<span> </span>The court overruled the objection </div>
<div>because <span>“</span>the door was opened by how Dr. Aschberger testif<span></span>ied.<span>”</span><span> </span>Dr. </div>
<div>Orent then opined that <span>“</span>a clonus is an upper neuron disease,<span>”</span> an<span></span>d </div>
</div></div>
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<div><div>
<div> </div>
<div>22 </div>
<div>“<span>a fall that injured the neck and/or head is certainly <span></span>possible as a </span>
</div>
<div>cause for these upper motor neuron findings.<span>”</span> </div>
<div>¶ 52<span> </span><span>Assuming, without deciding, that the ALJ erred by admitting<span></span> </span>
</div>
<div>the testimony, petitioners don<span>’</span>t explain <span>—</span> and we can<span>’</span>t discern <span>—</span> </div>
<div>how the error prejudiced them. As best we can tell, Dr. Orent <span></span>didn<span>’</span><span>t </span>
</div>
<div>rely on the clonus when opining that Luis wasn<span>’</span>t at MMI. And we </div>
<div>don<span>’</span><span>t see that the ALJ relied on the disputed testimo<span></span>ny when it </span>
</div>
<div>concluded that (1) the DIME wasn<span>’</span><span>t </span>overcome by clear and </div>
<div>convincing evidence and (2) petitioners didn<span>’</span>t prove that Luis </div>
<div>suffered an intervening fall that was unrelated to the workplace </div>
<div>in<span>jury. Accordingly, we perceive no reversible error<span>. </span><span>See</span> C.A.R. </span>
</div>
<div>35(c) (appellate court may disregard any error or def<span></span>ect not affecting </div>
<div>the substantial rights of the parties); <span>Cherry Creek Sch. Dist. No. <span></span>5 v. </span>
</div>
<div>Voelker<span>, 859 P.2d 805, 812 (Colo. 1993) (noting that <span></span>a party<span>’</span><span>s </span></span>
</div>
<div>substantial rights are affected <span>“</span>where it can be said with f<span></span>air </div>
<div>assurance that the error influenced the outcome of the case <span></span>or </div>
<div>impaired the basic fairness of the trial itself.<span>”</span>). </div>
<div>IV.<span> </span><span>Disposition </span>
</div>
<div>¶ 53<span> </span><span>The Panel<span>’</span><span>s </span>order is affirmed. </span>
</div>
<div>JUDGE BROWN and JUDGE BERGER concur. </div>
</div></div>
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