Rogan v. ICAO, 02CA1770 (October 9, 2003): Claimant sustained a compensable injury in 1995. Employer paid temporary total disability (TTD) benefits until the treating physician placed claimant at maximum medical improvement (MMI) on October 18, 1999. Based on the treating physician's permanent impairment rating of 23%  for claimant's lower extremity, employer filed a final admission of liability (FAL) for previously paid TTD benefits and permanent partial disability (PPD) benefits for a total award of $60,000, the benefit cap for a 25% or less impairment

rating under C.R.S. § 8-42-107.5. Claimant contested the FAL and obtained a division-sponsored independent medical examination (DIME). The DIME physician concluded that claimant did not reach MMI until October 23, 2001. Claimant then requested additional TTD benefits from October 18, 1999 (the first MMI date) to October 23, 2000 (when claimant returned to work). An administrative law judge (ALJ) held that because claimant received a rating of less than 25% and was paid $60,000 in combined TTD and PPD benefits, he was not entitled to any more TTD benefits.

A workers' compensation insurer may be ordered to pay medical benefits after a claimant reaches maximum medical improvement (MMI). These post-MMI medical benefits are known as "Grover medicals," "Grover benefits," or sometimes simply "Grovers." The name comes from the 1988 Colorado Supreme Court case called Grover v. Industrial Commission, 759 P.2d 705 (Colo. 1988).  In that case, the supreme court held that an administrative law judge may order payment for future, post-MMI medical treatment if there is substantial evidence in the record that such treatment is reasonably necessary to relieve the claimant from the effects of the industrial injury, or to prevent deterioration of the claimant's present condition.
  The claimant need not be receiving treatment at the time of MMI to obtain Grover benefits. Claimant is entitled to a general award of future medical benefits if the need for post-MMI treatment is established. However, respondents remain free

to  challenge the reasonableness and necessity of any particular course of treatment.
  When filing a final admission, W.C.R.P. IV(N)(1) requires the insurer to specify and describe the insurance carrier's position on the provision of medical benefits after MMI, as may be reasonable and necessary within the meaning of the Worker's Compensation Act. You may want to admit only to specific post-MMI treatment recommendations, such as "claimant will require 6 weeks of physical therapy and medication management." Sometimes an open-ended admission ("reasonable, necessary and related post-MMI treatment by the authorized treating physician") is unavoidable, but may lead to ongoing disputes over the reasonableness and necessity of a proposed course of treatment. If you choose to admit only to specific treatment, however, do not assume that the claim is closed after such treatment is complete. A successful petition to close may be the only way to obtain full closure of a