A serious workplace injury can have serious effects on your health and your ability to financially support your family. While you recover from your injury, you may not have a way to earn an income. A workers’ compensation claim may help you get financial relief by providing income while you get medical care. Unfortunately, work comp does not pay 100% of your wages, so an important question you may have is: how long does it take to settle a workers’ compensation case?
What is workers’ compensation?
Workers’ compensation, often known as work comp, workers’ comp, or workman’s comp, is a Colorado state run program that provides financial support to workers injured on the job. Workers’ compensation in Colorado primarily pays for medical treatment for your workplace injury and pay benefits to replace some of the income lost due to your injury.
Workers’ comp is the primary legal tool to get you money for a workplace injury. Most workplace accident injuries fall within work comp under Colorado law. Some workplace injuries fall outside of the Colorado work comp system. If somebody unrelated to your employer caused your injuries, you may be able to collect work comp benefits and separate claims against the third party.
Workers’ comp in Colorado is a no-fault system. Under most cases it does not matter how you received an injury at work. If you suffered an injury at work or due to your work, your employer’s work comp coverage generally must pay benefits. Workers’ compensation applies even if you cause your own injury. For example, if you slip off a ladder and hurt yourself, you can still collect work comp benefits.
Any Colorado employer that employees at least one non-owner must carry workers’ comp coverage to protect its workers. If your employer does not carry work comp coverage, it may face consequences including:
- Paying work comp benefits out of pocket;
- Fines assessed by the State of Colorado;
- Jail time;
- Losing the right to continue conducting business in the state.
As a worker you do not have to file a workers’ comp claim for a work injury; however, if you don’t file for work comp benefits you may not be able to recover for your injuries and lost wages any other way. If you suffer a work injury and discover your employer does not have work comp coverage, talk to a Colorado workers’ compensation attorney right away.
How does workers’ compensation in Colorado work?
Workers’ compensation has a few requirements for who and when you can file a successful workers’ compensation claim in Colorado. As discussed above, workers’ comp in Colorado is a no-fault system, so you do not have to prove your employer or a co-workers caused your injuries due to intentional or negligent acts. Generally, to qualify for work comp benefits in Colorado you must meet five eligibility requirements.
- You must be an employee of the business;
- The employer must have workers’ comp coverage;
- The injury is work-related;
- The employee met the reporting and filing deadlines;
- The worker attends all medical care appointments and follows through on recommended treatment.
An important issue that may arise with a workers’ comp claim is whether you are an employee or independent contractor. Independent contractors are not covered by workers’ compensation. If your employer’s work comp insurance company denies your claim because you are allegedly an independent contractor, talk to a workers’ compensation attorney in Colorado. Often employers misclassify employees as independent contractors. Just because your employer says you are an independent contractor does not make it true.
What is the timeline to settle a workers’ compensation claim in Colorado?
Workers’ compensation will begin paying for medical care and lost wages shortly after filing your claim (in most cases). A claim settlement may occur down the road and different lengths of time, depending upon your treatment and injuries. This is a typical timeline for a workers’ compensation case to settle in Colorado.
The injured worker files a workers’ comp claim with the employer
Your first step after obtaining any necessary emergency medical care is reporting the workplace injury to your employer. Your employer may challenge the claim, but if they do not challenge the claim you can expect to begin to receive pay benefits within a few weeks. These pay benefits make up a portion of your average weekly pay. These payments are not a settlement. These are ongoing payments while you cannot return to work in your regular position.
You continue to obtain medical treatment until you reach maximum medical improvement
You cannot get work comp payments without attempting to heal from your injury. You will need to establish care with a physician who will recommend a treatment plan to try to get you back to work. Eventually you will reach maximum medical improvement (MMI). Maximum medical improvement means you either returned to your pre-injury health condition or your physician determined you improved as far as treatment can get you. If you do not fully heal, your doctor will give you an impairment rating.
Receive a lump sum settlement
If you receive an impairment rating, your physician determined you are partially or totally permanently disabled. You then may receive a lump sum settlement of future work comp benefits. The amount you can receive depends upon the type and severity of disability. Often it takes several months before the work comp carrier will process the request for a lump sum payment.
If you receive a lump sum settlement that fully compensates you, then your work comp case is finished.
Request a pre-hearing conference and settlement discussions
Sometimes your workers’ comp claim does not flow so smoothly.
If you disagree with the work comp insurance company about coverage, benefits, or the lump sum payment, you can request a hearing. The hearing takes place with the Colorado Division of Workers’ Compensation. Before the hearing, you (or your attorney if you hired one) and the insurance company’s adjuster or attorney can engage in settlement negotiations. If settlement negotiations reach a fair result, you may settle the claim and cancel the hearing.
During negotiations, you (or your attorney) and the insurance company’s representatives will hold a pre-hearing conference. The conference is an opportunity to talk about disputed issues and exchange documents that may help settle your case. Your case may settle at or after the conference.
Typically it takes a few months to request a hearing and receive a pre-hearing conference date. If your work comp case settles at or shortly after the pre-hearing conference, it may take six months to settle your case.
Workers’ compensation hearing with a judge
If you still cannot reach a settlement after the pre-hearing conference, it is time for a hearing with a workers’ chttps://cdle.colorado.gov/icaowcomp judge. In Colorado, workers’ comp hearings occur before special administrative judges who decide workers’ comp cases.
After the pre-hearing conference, you can request a hearing date. You can request an expedited hearing. An expedited hearing will occur within 45 days of your request. A non-expedited request may result in a hearing up to 100 days after your request. After your hearing, the judge will consider the evidence and make a decision. Often, you (or your attorney) will not receive the judge’s decision for several weeks.
By the time you have a hearing and receive the decision, it may be as much as four additional months. In total, you may be a year after reaching maximum medical improvement.
Petition for review with the Industrial Claims Appeals Panel
If you disagree with the judge’s decision, you can appeal.
An appeal of a work comp judge’s decision is made to the Industrial Claims Appeals Office. The office assigns the appeal to the Industrial Claims Appeals Panel, which is made up of five administrative judges. Your appeal will be decided by at least two members of the panel. If you wish to file an appeal, you must file within 20 days of the judge’s decision.
Your appeal, called a petition for review, is a written appeal only. There is no additional hearing. You must order a transcript of the hearing and include it as part of your petition for review. You will provide the panel a legal brief explaining why you believe the judge decided your case incorrectly. Your employer or its insurance company will submit its own legal brief. The appeals panel will then consider your appeal and decide whether it agrees with the judge. Whatever the appeals panel decides is the final word from the Colorado Department of Labor and Employment.
This process often adds several months to your work comp claim.
Appealing to Colorado state courts
If you also disagree with the appeals panel, you may continue to appeal.
You can appeal the appeals panel’s decision to the Colorado Court of Appeals. Like the appeals panel, you will not get a new trial with the Court of Appeals. The Court of Appeals will only review the transcript, previous decisions in your case and both sides’ briefs.
You may receive a hearing with the Court of Appeals to argue your appeal in person, but the Court of Appeals may decide your appeal without hearing. Appealing to the Court of Appeals to this court often take a year or more to receive a decision.
If you disagree with the decision from the Colorado Court of Appeals, you can appeal one more time to the Colorado Supreme Court. Unlike previous appeals, the Colorado Supreme Court does not have to agree to hear your case. The Supreme Court rarely hears a third appeal of a workers’ compensation hearing.
How long does the average workers’ compensation case take to settle in Colorado?
Thankfully, most workers’ compensation cases in Colorado do not require multiple appeals to reach a resolution. There is no clear agreement on the average time to settle a workers’ compensation case in Colorado. Some workers’ comp law firms suggest an average of sixteen months from injury to settlement.
Be careful about assuming any average time period applies to your claim. Your case is specific to your incident, injuries and treatment progression. The insurance company and your employer may drag out the process or dispute your claim because they think it is in their interests. The same claim with a different employer and insurance company might settle within months while yours may take years.
Additionally, keep in mind your case may take longer to settle because you receive longer treatment than the “average” case. The longer you obtain treatment, the more likely you are healing and will end up with less impairment. It is better to heal fully and take longer than stop treating quickly because your injuries are permanent.
What if I am permanently disabled due to a workplace injury?
As a result of your workplace injury, you may experience permanent disability. You may have partial disability or total disability. Partial disability means you can perform some of your job duties but with limitations. If you are totally disabled, you simply cannot perform your job. In these situations, you may qualify for permanent disability benefits.
Your treating physician will determine if you have a permanent disability and assign an impairment rating. The impairment rating will become part of determining the value of any lump sum settlement of your workers’ comp claim. Your employer and its insurance company may decide to ask you to submit to an independent medical examination (IME) to get a second opinion. They will select their medical expert to conduct the IME.
When should I hire a Colorado workers’ comp attorney?
In Colorado you do not have to hire a workers’ comp attorney to represent you. You can elect to manage your own claim. Your employer’s workers’ comp insurance company will hire an attorney to defend against your claim. Hiring an attorney gives you an experienced voice to guide you through each step of the process. This can help you get good medical treatment, move your case more efficiently and give you a fair fight to get a fair result on your case. You should talk to Colorado workers’ comp attorneys early in your case so they can give you help at every step.