There’s no such thing as a stupid question.
You might be confused or have questions regarding your work comp claim. You are not alone. There are many rules that you and your employer or the insurance company must comply with when dealing with your case. There are many legal technicalities that insurance companies often use to deny your claim or limit your access to benefits. People often find it difficult to know what benefits they are due and what might signal that there is a problem with their claim.
CoLawCo focuses on helping injured workers and their families get the benefits they need to get their lives back on track again. Colorado workers’ comp laws often change yearly (sometimes even faster). CoLawCo stays up on all of these changes so you can be provided with knowledgeable legal guidance.
Frequently Asked Questions
Some common questions and answers are provided below. The information provided here is very general and may not apply to your individual situation. If you have a question or you think you may not be getting the benefits you deserve, contact CoLawCo today for a free, individualized initial consultation.
How do I know if my injury is covered under work comp?
If your injury occurred during the course and scope of your employment then it is covered under the work comp. Whether an injury happened during the course and scope of your employment is often litigated, with a judge providing the answer. The facts and circumstances of cases vary greatly, and decisions are made on a case-by-case basis. If you have any concerns regarding whether your injury should be covered, contact CoLawCo today.
The type of injury you suffer from must relate to your employment. Commonly covered injuries include injuries to your back, arms, legs, head, and eyes. Commonly covered conditions include any back strain, whether it's cervical, thoracic, or lumbar; ruptured discs; bulging discs; broken bones; carpal tunnel syndrome; cubital tunnel syndrome; torn meniscus; torn tendons or muscles; or any condition as long as it is related to the work injury.
How do I claim work comp benefits?
You need to report your injury to your employer as soon as possible. Ideally, you will notify your employer in writing within 4 days of the work injury. If you miss more than 3 work shifts due to the work injury, your employer has a duty to notify the Division of Workers' Compensation of the injury, and the employer's duty to pay temporary disability benefits also arises.
If a general admission is not filed by the employer or insurer, you must file a worker's claim for compensation with the Division of Workers' Compensation. Failure to timely file a workers' compensation claim , if no admission has been filed in your claim, will result in your claim being denied and dismissed for failure to comply with the statute of limitations. If you have any questions regarding filing a workers' comp claim, contact CoLawCo today.
I don't think they're paying me enough. How do I figure that out?The amount of benefits you receive is driven by your average weekly wage (AWW). The average weekly wage is determined by reviewing how much you were being paid at the time of the injury. The amount can include amounts for fringe benefits or even compensation from a second employer, if the injury has affected your work for the second employer. Lost wages are often a concern for an injured worker and, if you are concerned regarding what you are owed, you should contact an attorney.
Keep in mind that pain and suffering are not covered under work comp. Most of the benefits in workers' compensation are paid by using certain formulas for the benefits. An attorney can help you understand what formula applies to your situation.
I think my impairment rating should be worth more. Is there anything I can do?
Yes. If you have an impairment rating, that probably means a final admission of liability (FAL) has been filed or is about to be filed. You have 30 days from the date a final admission of liability is mailed to you to object to the rating and request a hearing or a Division IME. You can challenge an impairment rating, but you must file a timely objection and file either an application for a hearing or a notice and proposal to select a Division IME physician.
For instance, if you injured your shoulder, it is possible that the insurance company only admitted liability for a scheduled rating. Depending on the circumstances, it is possible that you can proceed to hearing and convert the rating to a "whole-person rating," which is possibly worth more. If you have any questions regarding your impairment rating, contact CoLawCo today.
A second opinion from a Division IME physician is necessary to challenge a "whole-person rating." The Division IME process can be difficult to understand. You may wish to consult with an attorney before going through the Division IME process.
The doctor has released me, but I think I need more treatment. What do I do?
If the doctor has released you, it most likely means that he or she believes you are at "maximum medical improvement" (MMI). It may mean that a final admission of liability has been, or is about to be, filed. You can contest whether you are at maximum medical improvement by going through the Division IME process. If your claim has not been admitted, then it may mean you simply won't get any further treatment unless you file a timely claim and proceed to the hearing. If you believe you are being denied treatment for your injury, you should discuss the issue with a lawyer today.
I received some papers in the mail along with a check. Can I cash the check?
You should contact an attorney regarding the specifics of your situation. Most often in this situation, the insurer has filed a final admission of liability and paid some or all of the permanent partial disability. In other words, most often, you can cash the check and continue to fight for more benefits if you file a timely objection to the admission and either request a hearing or file a notice and proposal to select a Division IME physician.
But again, it is always wise to consult an attorney in this situation. A workers' compensation case can only be settled if settlement documents are signed by the parties and the Division of Workers' Compensation approves the settlement.
I'm told my claim is closed. What do I do?
If the adjuster or a doctor's office tells you your claim is closed, you should immediately contact CoLawCo. Often times, your claim is not truly closed with the Division of Workers' Compensation, but is simply administratively closed in the insurance company. There is a big difference.
If you've been told your claim is closed, you should immediately investigate what "closed" means in your circumstance. It could mean that a final admission of liability (FAL) has been filed and that you have a certain amount of time to object and proceed to a Division IME or hearing. If you hear the word "closed," it is a red flag and you need to take immediate action.
Even if your claim is closed, you have at least up to 6 years from the date of injury to petition to reopen your claim based on a worsening of your condition. You should contact an attorney today to discuss whether a petition to reopen is possible in your circumstances.
Contact CoLawCo to schedule an appointment for a free consultation to learn more.