What is Workers’ Compensation?
Workers’ compensation covers injuries and illnesses sustained in the workplace that are related to your occupation. If the Division of Workers’ Compensation determines that an injury or illness is work-related, workers’ compensation covers medical bills, lost wages up to two-thirds of an employee’s pay, and in the event of the worker’s death, benefits to the worker’s family.
What happens when I file a workers’ comp claim?
First, notify your employer after you’ve been injured or become ill as a result of your job. You have four days to do so, and your employer will file an insurance claim within ten days after notification.
When reporting an illness, the date of your diagnosis by a medical professional counts as the date of injury. You provide a written statement to your employer, who then completes an Employers’ First Report of Injury to file an insurance claim.
You may still get benefits even if you notify your employer after the four days, but this puts you at risk of losing some of your workers’ compensation benefits.
Why do I have to go to an Authorized Treating Physician?
If you don’t go to a doctor your employer approves, you risk losing your workers’ comp benefits. Your employer will most likely give you a list of approved physicians and allow you to select one from that list. As long as you choose one of these physicians, your benefits are safe.
Sometimes your employer won’t give you an approved list of physicians. If this is the case, you can go to any doctor of your choice without jeopardizing your benefits. However, you must be evaluated by a medical professional to receive workers’ compensation.
Can I go to a chiropractor, naturopath, or another medical specialist?
No. Chiropractors, naturopaths, and many other kinds of medical specialists are not covered by workers’ compensation benefits and are not usually on the approved list of doctors provided by your employer.
With sufficient reason, you may be allowed to switch to a specialist. However, you must discuss this with the insurance company first to find out if the change in medical care is appropriate and necessary for your injury or illness.
How will I be compensated for my time away from work while I’m injured or ill?
As a Colorado employee, you have up to 90 days of injury leave once you’ve missed three days of work. The first three days use sick leave. After that, you receive 100% of your wages during the 90 day period.
Each day is measured in occurrences as opposed to hours. This measurement means that any time, no matter how brief, that you take off from work related to your injury counts as one complete occurrence. You do not need to use a full day for it to count as one occurrence.
What types of benefits can I receive?
Permanent Partial Disability and Permanent Total Disability apply if your work-related injury prevents you from returning to your job in the same capacity as before you were injured.
Permanent Partial Disability means you receive compensation for a limited amount of time based on your injury. You may be able to work in a different role with Permanent Partial Disability.
Permanent Total Disability entitles you to two-thirds of your average weekly wages until you reach age 65.
In the event of a worker’s death, their family receives benefits. The worker’s spouse receives these benefits for life or until they remarry. Children receive benefits until they reach age 18 (or if they are a full-time student, age 21).
Can I refuse workers’ compensation benefits?
No. If you are awarded workers’ compensation benefits, you cannot voluntarily decline them.
Can I lose my workers’ compensation benefits?
Yes. If you are under the influence of drugs or alcohol at the time of your injury, you may lose or decrease your benefits. If your injury is a result of you intentionally not following proper safety regulations in the workplace, this also puts your workers’ comp benefits at risk.
What is Maximum Medical Improvement?
Maximum Medical Improvement (MMI) is the point where an employee no longer needs treatment for their injury. MMI does not necessarily mean you can return to work in the same capacity as before your injury or illness.
Sometimes a person reaches MMI without returning to the same level of health or ability. MMI simply means there is no further treatment recommended for your injury.
What is a modified duty position? Should I take it if my employer offers it to me?
Yes. Consult your physician to ensure the terms comply with any medical restrictions. Think carefully if you consider refusing a modified duty position. If you refuse, your employer will terminate your workers’ compensation benefits.
What if I need medical treatment after my claim is closed?
You may be able to receive compensation for medical treatment despite your closed claim. Claims automatically close after 60 days, so contact your claims adjuster for help with your next steps.
Can I sue someone else if I believe they are responsible for my injury?
Because workers’ compensation benefits protect your employer as much as they protect you, you cannot sue them if you believe your injury was their fault. You also cannot sue another employee at your company, even if you think their negligence caused your injury.
If someone outside of your workplace caused your injury, you might be able to file a subrogation lawsuit to receive damages.
Who can I call if I need help with my claim?
For more information or help filing your claim, you can contact:
- Your supervisor
- Your workers’ compensation liaison
- Your insurance claims adjuster
- The Colorado Department of Labor and Employment, Division of Workers’ Compensation
- State Office of Risk Management
If you need help understanding what you are legally entitled to as an employee, call Bell & Pollock, your Denver workers’ compensation attorney. We have experience negotiating on your behalf in workers’ compensation claims, and we’ll make sure you get the benefits you deserve.
If you did not find the answer to your question here, contact us at (720) 613-6736. We are happy to give you any additional information you need.