A Colorado appeals court has settled a question that workers' compensation claims professionals may not have realized was up for debate - whether citing a doctor's report in a final admission of liability amounts to an illegal restriction on an injured worker's maintenance medical benefits.
The answer, the court said on March 12, 2026, is no.
The Colorado Court of Appeals ruled that nothing in the state's Workers' Compensation Act prevents an insurer from referencing a physician's report when admitting liability for post-MMI maintenance care. The court also held that such a reference does not, by itself, impose an impermissible limitation on the benefits a worker is entitled to receive.
The case arose from a 2013 back injury sustained by Fredy Barba during his employment with Cardinal Health 200, Inc. After surgery and physical therapy, Barba's authorized treating physician placed him at maximum medical improvement in December 2015, assigned a 25% whole person impairment rating, and recommended a specific course of maintenance treatment.
Cardinal Health's insurance carrier, XL Specialty Insurance Company, through its third-party administrator Sedgwick Claims Management Services, filed a final admission of liability consistent with the physician's findings. Barba objected and requested a Division Independent Medical Examination, which confirmed the MMI date and adjusted the impairment rating to 24%. An amended admission was filed in January 2017, and the case was closed.
Barba's condition worsened in October 2018, and an administrative law judge granted his request to reopen the claim. A second DIME followed in 2024, this time conducted by Dr. Bryan Alvarez, who confirmed the original MMI date, assigned a 17% whole person impairment rating, and recommended three months of physical therapy.
It was what happened next that triggered the dispute. When Sedgwick claims adjuster Blayre Spring filed a new final admission of liability on behalf of Cardinal Health and the insurer, she checked the box admitting maintenance care after MMI and added a handwritten note referencing Dr. Alvarez's medical report dated March 28, 2024.
Barba argued that this reference effectively tied his future maintenance benefits to the specific treatment Dr. Alvarez had recommended, in violation of section 8-42-107(8)(f) of the Workers'
Compensation Act. That provision requires employers filing a final admission to admit liability for related reasonable and necessary medical benefits by an authorized treating physician, and specifies that such benefits are not limited to any specific medical treatment. Barba sought penalties under the Act.
At a penalty hearing, Spring testified that she had no intention of limiting Barba's maintenance benefits. She explained that she included the reference simply to identify which physician's report supported the maintenance admission – a practical concern, she said, because the same doctor does not always address both permanent disability and maintenance care. She also noted that she had already removed the reference from an amended admission filed on June 28, 2024, at Barba's request.
The ALJ denied penalties, finding that the reference neither intended to limit nor actually limited Barba's benefits. The Industrial Claim Appeals Office agreed, and the Court of Appeals affirmed.
Writing for Division V, Judge Lipinsky explained that the statute is clear - an employer cannot limit maintenance medical benefits to any specific treatment in a final admission, and any attempt to do so is a nullity. But the statute does not go further. It contains no express prohibition against referencing a physician's report, and the court declined to read one in.
If the legislature had intended to dictate exactly what insurers must and must not include when admitting maintenance care, the court noted, it knew how to do so – pointing to other sections of the Act that spell out specific requirements for final admissions.
The court added a reassurance that may be of particular interest to claims professionals – because a reference to a physician's report cannot, as a matter of law, limit an injured worker's maintenance benefits, injured workers have no reason to fear that such a reference in a final admission of liability will restrict the future medical treatments they receive under the Act.
Judges Welling and Tow concurred.
