Amended Healthcare Lien Ruled Inadmissible in Personal Injury Suit

Background

On September 26, 2019, Cory Wolven and Jeanmadi del Rosario Velez were involved in a car accident in Wheat Ridge, Colorado after Velez's failure to stop at a stop sign resulted in a collision with Wolven's vehicle. Wolven sustained significant spinal and neck injuries from the accident, prompting her to initiate a personal injury lawsuit against Velez on April 8, 2021. The jury delivered a verdict in favor of Wolven on October 13, 2022, awarding her a total of $1,953,443.00 in combined damages. 

Velez appealed the verdict and judgment, citing issues with the trial case. The case was heard before the Court of Appeals of Colorado, Second Division, and was decided on January 18, 2024.

Arguments Raised on Appeal

On appeal, Velez raised three issues for review:

1. Velez believes the trial court erred by letting Wolven's expert talk about her 8% "whole person permanent impairment rating" based on the wrong edition of the AMA Guides. According to Velez, only the third edition of the AMA Guides should be used in Colorado workers' compensation cases, making the use of the AMA Guides irrelevant and inadmissible in other types of cases.
2. Velez argues that the jury needed more information about how impairment ratings are calculated for workers' compensation cases to accurately determine Wolven's damages.
3. The third issue concerns the trial court's decision to retroactively apply a statute to exclude evidence of Wolven's health-care provider lien from the trial, despite amendments made to comply with the statute before the trial.

Analysis

The appeals court addressed each of Velez's arguments in turn.

Admission of AMA Impairment Rating Evidence

The court admitted evidence of Wolven's impairment rating based on the AMA Guides over Velez's objection. Dr. Moorer testified as an expert that his examinations led him to conclude Wolven had suffered various permanent injuries. He then testified, over objection, that under the AMA Guides Wolven had an 8% whole person permanent impairment. On cross-examination, Velez established that the AMA Guides are typically used in workers' compensation cases and argued that impairment ratings should be excluded because they are only relevant in that context. 

The court found the reasoning in Herrera v. Lerma persuasive in holding that the impairment rating evidence based on the AMA Guides was relevant and not unfairly prejudicial. The AMA Guides can provide a standardized rating for an injured individual's impairment, as determined by a medical professional, which can aid the jury's factfinding. Any disagreement about the AMA Guides' value can be contested through examination and additional experts. A jury can decide the weight to give expert testimony.

The jury heard testimony about the exams and imaging informing the diagnosis and rating, the AMA Guides' use in workers' compensation and which version was used, and how the AMA intended the Guides to be used. The defense could have further cross-examined the relevance outside workers' compensation but largely did not. The court found the probative value of the evidence outweighed any risk of unfair prejudice.

The trial court did not abuse its discretion by relying on binding precedent to admit the evidence. Section 8-42-107(8)(b.5) does not prohibit AMA Guides evidence outside workers' compensation, and no other statute does. The court was bound by precedent finding this evidence relevant and not unfairly prejudicial.

Limiting Instruction

Velez's counsel requested that the trial court provide a jury instruction explaining that workers' compensation cases do not have a category for noneconomic damages, in order to avoid any confusion. Additionally, they requested the inclusion of a definition for "physical impairment." However, during the trial, Velez's counsel chose to drop the request for a definition of "physical impairment." The trial court denied both requests. 

The jury instructions that were ultimately accepted did not include a definition for "physical impairment." Instead, they were based on Colorado Pattern Civil Jury Instruction 6:1. Therefore, it can be argued that the trial court did not inaccurately inform the jury about the law by declining to include an instruction defining "physical impairment." 

The trial court was not required to provide a limiting instruction to the jury regarding how the AMA Guides calculate impairment ratings. By refusing Velez's requested limiting instruction, the trial court likely avoided confusing the jury. The trial court properly admitted the impairment rating evidence based on the AMA Guides and did not abuse its discretion in declining this instruction. 

Exclusion of Healthcare Lien

Wolven had financed a portion of her medical care through a health-care provider lien with Quantum Specialist Network (QSN). Five days before trial, Wolven's lien with QSN was amended to comply with the disclosure requirements under C.R.S. 38-27.5-103(2). The statute excludes compliant healthcare liens from trial. As such, the trial court excluded the amended QSN lien agreement from trial because it satisfied the statutory criteria for admissibility. 

In 2021, the Colorado legislature enacted new regulations governing health-care provider liens. The "collateral source rule" prevents a wrongdoer from reducing an injured party's damages by utilizing benefits from independent sources. The "pre-verdict evidentiary" element of the collateral source rule necessitates trial courts to exclude evidence of collateral source benefits. The court ruled that the amended lien agreement had met the requirements and, therefore, was not admissible at trial. 

Velez argued that the trial court made an error by granting statutory protection to the amended lien agreement when the original agreement had not conformed to the disclosure requirements. However, the statute does not prohibit amendments before trial; it only requires disclosures before lien creation. Even though the lien was amended just before trial, it met the disclosure requirements under 38-27.5-104(1) and liability rules under 38-27.5-105(4). The amended lien superseded the original agreement, so only the amended lien was relevant. 

The court acknowledged concerns about plaintiffs amending liens right before trial to exclude evidence. However, the statute plainly states compliant liens are excluded, regardless of timing, and courts cannot rewrite statutes. Only the legislature can impose timing restrictions. Since the amended QSN lien agreement satisfied the requirements of the new rules, the trial court was correct to exclude it from trial.

Final Ruling

The court of appeals rejected Velez's contentions and affirmed the jury verdict and the judgment of the trial court.