Workers Compensation – Denver Employment Lawyer

How long does workers’ compensation take to settle my case?

by Denver Employment Lawyer24 Aug 20224 Feb 20234 Comments

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.

What is workers’ compensation and how does it work?

by Denver Employment Lawyer22 Aug 20222 Dec 20222 Comments

Were you injured at work? You may worry about how you will pay your bills and take care of your family. The Colorado workers’ compensation system may help pay your lost wages and medical bills to help you get back on your feet. If you suffered a workplace injury, talk to Colorado attorneys for workers’ compensation benefits about your claim.

What is workers’ compensation?

Workers’ compensation is an insurance program that pays employees for workplace injuries. Workers’ compensation pays for most workplace injuries, even if you injured yourself at work. Unlike personal injury claims, like a car accident, you do not have to prove somebody else is at fault for your injuries. Workers’ compensation is a no-fault remedy for your workplace injury and lost wages. From workers’ compensation you can receive medical care without paying for the bills out of pocket, lost pay benefits and permanent disability compensation if you cannot return to the same type of work.

How does workers’ compensation work in Colorado?

We’ve talked about what workers’ compensation is, but you may have questions about how does workers’ compensation work in Colorado. Workers’ compensation in Colorado follows a specific process. The Colorado work comp helps work accident victims through the following process.

The employer obtains workers’ compensation insurance to cover its employees.
The employee suffers a workplace injury.
The employee seeks emergency medical care and reports the injury to the employer within four days of the accident.
Within ten days of receiving the report, the employer reports the injury to the Colorado Division of Workers’ Compensation.
The employee continues to obtain medical care. The employer may elect to send the employee to a specific provider of its choice.
If the employee cannot work, the insurance company pays a portion of the employee’s lost wages. The employer may elect to put the employee on light duty if appropriate and available.
Pay benefits continue until the employee can return to work. If the employee cannot return to work due to the injury, the employee receives pay benefits indefinitely as a permanent disability.
If the injured employee disagrees with the determination of benefits, the employee can file a workers’ compensation appeal. The appeal will be heard by an administrative law judge. Further appeals will go to the Industrial Claim Appeals Office and then the Colorado Court of Appeals.

Basically, after reporting you were hurt at work, you will seek medical treatment until you are healed or the treating physician determines you reached maximum medical improvement short of your pre-injury condition and you are some degree permanently impaired. After that, your workers’ compensation attorney and the employer’s insurance carrier will engage in a process to resolve the value of your work comp claim.

Is workers’ compensation a no-fault system in Colorado?

Yes–workers’ compensation is a no-fault system in Colorado. You can file a claim for benefits without proving your employer, a co-worker, or other person is at-fault for your injury. You can also claim benefits for an accident you caused, such as slipping off a ladder. Generally, all workplace injuries or injuries on the job are covered by workers’ compensation. There are a few exceptions, but your work comp attorney can talk to you about other options to pursue a claim.

The benefit of a workers’ compensation claim in Colorado under a no-fault system is that you do not have to settle your claim or file a lawsuit before you can get paid anything. In most personal injury cases, you have to reach a settlement or win a trial before you get paid anything.

If you have medical bills, lost wages and other out of pocket expenses in a personal injury case, you have to pay as you go and hope you get compensation in the end. In a workers’ compensation case, the work comp insurance company pays as you go, so they pay for treatment along the way and they pay you benefits for lost wages along the way.

How do I file a workers’ compensation case in Colorado?

Your first step after you receive emergency medical care is to notify your employer you were hurt at work. You need to notify your employer immediately.

If your workplace injury is an illness, you need to tell your employer as soon as you realize you are ill from a work condition. Your employer should submit a Form WC1 to the Colorado Division of Workers’ Compensation. The Form WC1 puts the Division of Workers’ Compensation on notice of the claim, income information and basic facts about the accident. The employer will also submit it to its insurance company for a determination of benefits and initiation of payments.

What if my employer won’t take a report of my workers’ compensation claim?

Sometimes employers refuse to accept your report of a workers’ compensation claim or try to discourage you from seeking workers’ compensation benefits. Although the employer doesn’t pay out of pocket for benefits when insured, the more claims an employer has the more likely it will pay an increased premium for workers’ compensation insurance. If your employer does not have insurance, it may have to pay out of pocket for your benefits. If your employer does not have work comp insurance, you should talk to a Colorado workers’ compensation attorney right away.

If your employer will not take your injury report, or fails to file a Form WC1, you can file the report yourself. You can complete a WC15–Worker’s Claim for Compensation and file it with the Division of Workers’ Compensation. Your employer has twenty days to evaluate your claim and advise if it accepts or rejects the claim.

Although you can wait up to two years to file your own work comp report, you should file as early as possible to begin receiving benefits. You should file a WC15 even if your employer does not have insurance because you may be able to receive payments from the Colorado Uninsured Employer Fund.

Workers getting help from Colorado workers' compensation attorneys

What medical care can I receive while on workers’ compensation in Colorado?

Workers’ compensation will pay for a wide range of relevant treatment and follow up care to get you back on your feet. This includes:

Emergency care, such as an emergency room or urgent care visit;
Doctor’s visits and evaluations;
Diagnostic imaging, such as MRIs;
Physical therapy, massage therapy and other forms of conservative treatment;
Medication;
Therapeutic injections
Surgery
Follow up rehabilitation to surgery and other procedures;
Medical devices and supplies;
Travel costs and mileage.

The standard for what treatment workers’ compensation will pay in Colorado is what is determined “reasonable and necessary” for your injuries. This decision may be challenged when the work comp insurance company refuses to pay for appropriate treatment.

How much lost wage will work comp pay in Colorado?

While you are out of work due to your workplace accident injury, you receive two-thirds of your average weekly wage in benefits. That amount tops out at 91% of the Colorado average weekly wage. Pay benefits continue until you can return to work. If you suffered a permanent total or partial disability, you may also receive a lump sum payment subject to statutory maximum amounts.

What does Colorado workers’ compensation pay if a workplace accident results in death?

If you lost a loved one due to a workplace accident injury, surviving dependents may receive benefits. These include pay benefits and compensation for funeral expenses. Colorado workers’ compensation sets a minimum benefit for cases involving a fatality. Pay benefits depend upon the deceased worker’s average weekly wage.

Dependent spouses may receive pay benefits for life or remarriage.

If a third party caused the accident, such as a car accident while your family member was driving in a work vehicle, you may also have a wrongful death case against the responsible party. That is not a work comp claim, but may greatly affect the amount of compensation family members can receive.

How can I win a workers’ compensation appeal in Colorado?

If your employer disputes your Colorado workers’ compensation claim, you may need to file an appeal with the Division of Workers’ Compensation to force your employer to pay on your claim. There are several key pieces of information in a work comp claim and appeal that you must prove:

Your injury occurred at work, was the result of the work you perform, or occurred during the course and scope of your job;
The type and severity of injuries;
How the injuries were caused by a workplace accident or condition;
Your average weekly wages;
Whether you can return to work at any point after the injury;
If your return to work is on a full time or part time basis;
If your return to work is subject to any restrictions on job duties or work hours;
That you made a timely report of injuries.

Although this may seem simple, you must have evidence of any disputed issue to clear up confusion and fight back against your employer’s accusations and defenses. For example, your employer may question whether a back injury was pre-existing or that only some of your back pain was caused by a workplace accident. You will need medical records and likely a medical expert to testify about the cause of your injuries. An experienced workers’ compensation attorney can assist you with obtaining medical care and presenting a strong case for your workers’ compensation claim.

Workers' compensation attorneys in Colorado winning an appeal

Do I need to hire a Colorado workers’ compensation attorney?

There is no requirement to hire a Colorado workers’ compensation attorney for your claim. You can file a claim and obtain benefits without an attorney.

Should I hire workers’ compensation attorneys in Colorado?

Although you are not required to hire workers’ compensation attorneys in Colorado for your claim, it may be to your benefit to hire an experienced attorney.

Employers and their insurance companies do not want to pay you a penny more than they have to and they will take every opportunity to lower the value of your claim, deny treatment and try to convince you to get as little treatment as possible. They will send you to medical providers who are on their side. Those providers may recommend less treatment or less expensive treatment. If you are disabled, they may give you an unreasonably low impairment rating, which will affect the value of your case.

You need good treatment and a fair evaluation of your case. Your workers’ compensation attorneys can make sure you see a physician who cares about your treatment and you receive a fair opportunity to heal and get back to work. Your workers’ compensation attorneys can fight against appeals, advise you on your legal rights and fight to get you fair compensation at the end of your claim.