How Trump May Affect Workers’ Compensation In Colorado

How Trump May Affect Workers’ Compensation In Colorado

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The new Trump administration has ushered in some changes that many Americans weren’t quite prepared for, and much of the impact is not yet fully known. After all, he’s only been in office for a little over four months, and many changes are yet to come. With respect to workers’ compensation (work comp) benefits, the potential effect has not been fully realized. However, it appears that the greatest potential impact will come from the repeal of the Affordable Care Act (ACA) and budget cuts.

Healthcare Reform

In Colorado and many other states, the ACA, more popularly called Obamacare, has generated a favorable trend in work comp claims. Claim rates and costs have been dropping, and this movement is very likely due to increased worker access to healthcare. In its 2016 report, the Upjohn Institute for Employment Research identified a strong correlation between the decreased work comp claims and costs and the uptick in health insurance coverage.

Joe Paduda of Health Strategy Associates delves even deeper into the link between Obamacare and work comp claims. He alleges that workers who are hurt on the job have less reason to pursue care through their employer’s work comp insurance if they have their own health insurance.

Further, other health issues that may impact their work injury can be covered by the worker’s insurance, rather than work comp. For example, an employee with high blood pressure would need additional treatment for his hypertension before he could undergo a necessary work-related surgical procedure. However, when the worker has health insurance, his coverage would bear the additional cost, rather than work comp.

The proposed repeal and replacement efforts of Trump and the Republican-led House has thrown millions into uncertainty with respect to healthcare coverage. The most recent version of the new TrumpCare coverage, the AHCA, has the potential to take away health insurance from 14 million Americans by next year, according to the Congressional Budget Office (CBO) estimates. And the number of insured is expected to continue increasing over the next 9 years.

These dire projections could spell big trouble for work comp. Uninsured workers would likely once again turn to work comp for as much medical coverage as possible. These changes would also disproportionally affect older employees, workers in higher risk jobs and many who currently receive coverage through Medicaid. These issues will equate to increased claims and higher costs.

Budget Cuts and Safety Issues

Trump has also proposed budget cuts and safety reform rollbacks that will have adverse effects on the work comp system. While the Obama administration was moving towards establishing minimum workers’ compensation benefit standards on the state level, the Trump administration has expressed no interest in pursuing these reforms.

Repeal of an Obama-era OSHA safety regulation could have a detrimental impact on injured workers, as well. The “Volks” rule requires dangerous industry employers to keep health and safety incident records for five-and-a-half years. But Congress changed that to just six months, and Trump signed off. This minimum record-keeping requirement may prevent identification of frequent and repeated safety issues with many companies, and make it much more difficult for their employees to obtain work comp benefits when injured.

If a disabled worker is receiving both Social Security Disability Insurance (SSDI) and work comp benefits, the total may not exceed 80 percent of the average earnings that the worker was receiving before he became disabled. It they do, the SSDI benefits are reduced to offset the overage. In 15 states, this works in the reverse. Instead, it is the work comp benefits that are offset. On May 23, Trump released information on his most recent budget plan with proposed cuts. The Workers’ Compensation Reverse Offset faces elimination in 15 states, of which Colorado is one. With this change, work comp will need to make up the shortfall that the government has been covering via SSDI, hence, raising costs.

Overall, it appears that the Trump administration will be bad news for work comp in Colorado, and throughout the nation. And that’s only addressing what we know so far. If you have questions about these pending changes, or other workers’ compensation issues, please contact us for answers.

 

 

Sources

Kalin: Obamacare has had an impact on workers’ compensation claims in Colorado

AHCA, CBO, and Workers’ Comp

Four Ways the New Administration Will Influence Workers’ Comp

http://www.safetyandhealthmagazine.com/articles/15517-trump-signs-resolution-to-strike-down-volks-recordkeeping-rule

https://www.bostonglobe.com/news/politics/2017/05/23/here-list-agencies-and-programs-trump-budget-would-defund-entirely/DMRzbdY4lwB0XEGA13Y6PP/story.html

Social Security Recipients Second Amendment Rights preserved Having a Representative Payee No Longer Prevents You From Owning a Firearm

Social Security Recipients Second Amendment Rights preserved Having a Representative Payee No Longer Prevents You From Owning a Firearm

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In February 2017, the House of Representatives voted to “overturn an Obama administration rule” that required the Social Security Administration to “forward the names of all Social Security Disability Insurance . . . benefit recipients who use a representative payee . . . to the National Instant Criminal Background Check System . . ..

Reaction sadly was over-the-top and exaggerated as some gun safety advocates characterized the vote as the House permitting “severely mentally ill” people from getting guns and will make Americans less safe.

WHAT ACTUALLY HAPPENED

The Obama Administration required the Social Security Administration to send the records of Social Security Disability (SSDI) recipients who need a representative payee to the FBI for the National Instant Criminal Background Check System.  This meant these particular SSDI or SSI recipients were deprived of their right to purchase a firearm.

What’s a Representative Payee?

Individuals are required to have a representative payee for mental impairments when a beneficiary is “legally incompetent or mentally incapable of managing benefit payments.”  An injured and disabled worker who has difficulties remembering deadlines, properly doing math, or any other significant inability to spend their SSDI benefit properly may be required to have a representative payee even if his or her disability has nothing to do with a mental impairment.

Having a Representative Payee does not mean that your inability to mange finances is because a disabled worker is violent, or poses a risk to themselves or to others.

Because of the myriad of impairments that could require a representative payee, even the American Civil Liberties Union (“ACLU”) spoke out against the rule, saying “A disability should not constitute grounds for the automatic per se denial of any right or privilege, including gun ownership.”  Republican House Judiciary Chairman, Bob Goodlatte opposed the rule because “it paints all those who suffer from mental disorders with the same broad brush.”

Congress has now revoked that rule.

WHAT HAPPENS NOW?

Because of this vote, if you are awarded Social Security Disability benefits, SSDI or SSI, and have the need for a Representative Payee – the Social Security Administration will no longer automatically report you to the NICS.

Have Questions?

Navigating the Social Security Disability process is not always easy.  Circumstances are always changing, and we are happy to answer questions and help navigate the process.  Email – Tre Eyden, EDPNA, or call 970-356-9898.

What a Difference An “AND” Makes In Colorado Work Injuries

What a Difference An “AND” Makes In Colorado Work Injuries

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THE Industrial Claims Appeals Office (ICAO) HIGHLIGHTS A MAJOR LIMITATION ON MAINTENANCE MEDICAL CARE

Intersection between a law with a later statute creates a major distinction for injured workers’ medical care rights.

Lola Chism injured her left shoulder in July 2009 in an admitted work injury.  Following what was described as “considerable” physical therapy, and two surgical procedures her treating physician placed her at Maximum Medical Improvement(MMI) in January 2011.  The treating physician recommended, and the insurance carrier admitted for, future maintenance medical benefits.

Injured Colorado workers are entitled to medical benefits following an on-the-job injury “to cure and relieve effects of the injury.”  CRS §8-42-101(1)(a).  In 1988 the Colorado Supreme Court interpreted that law as requiring Colorado Workers Compensation Insurance carriers to pay for all medical care “to relieve the worker from the effects of the industrial injury” based upon the rationale that it “is an obvious fact of industrial life, however, that an injured worker can reach maximum medical improvement from an injury and yet require periodic medical care to prevent further deterioration in his or her physical condition.”  Grover v. Industrial Commission, 759 P.2d 705, 710 (Colo. 1988).

However the Colorado Legislature added a formal, statuotry definition of MMI as the “point when any physical impairment is stable and “no further treatment is reasonably expected to improve the condition.” That definition excluded from ‘further treatment’ any “future medical maintenance.”  CRS § 8-40-201 (11.5).

Ms. Chism continued to have ongoing physical therapy for her shoulder after MMI as maintenance care.  In December of 2015 the treating physician referred her to a surgeon who recommended a reverse total arthroplasty   The employer challenged the proposed treatment, however an ALJ ruled that the surgery should be approved, finding it reasonable and necessary to “cure and relieve” the effects of the injury. The employer appealed.

The ICAO determined the obligation to “cure” the effects of the injury ends at MMI because of the later 1991 statutory definition of MMI that declares “no further treatment is reasonably expected to improve” the injured worker’s condition.  Thus, ICAO reasons, only treatment that will relieve but not cure the work injury can qualify as maintenance care.

The ICAO remanded the case back to the Administrative Law Judge for further consideration if the proposed treatment would just “relieve” the injury, noting that there was no “bright line” test to distinguish between those treatments.  Because six years had passed after the injury, Ms. Chism cannot reopen her work injury claim, she is limited to maintenance care.  If this surgery is curative – it has to be denied under the ICAO’s parsing of the statute.

 

CITE:  Chism v. Walmart, WC No. 4-809-103-03, (January 9, 2017).

Appeals Office Shifts the Burden to Injured Workers in Responsible for Termination Claims

Appeals Office Shifts the Burden to Injured Workers in Responsible for Termination Claims

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Injured Workers must now be ready to provide evidence explaining that work absences weren’t their fault.

Injured workers who lose their job while treating for a work injury are entitled to lost wage benefits, called Temporary Total Disability.  However the Colorado Legislature changed the law allowing employers to avoid paying lost wages to injured workers when they are “responsible” for their termination.

Until now, the burden to prove this allegation has rested squarely upon the employer.  The employer must not only prove that the injured worker did – or failed to do – something that led to his or her termination – but that that it is was volitional on the part of the injured worker.  For example if a worker is fired for being late to work three times in one week, the employee could show that the absences were caused by circumstances outside his or her control.

Nicholas Coleman worked as a housekeeper and suffered a low back injury in late 2014.  However in February 2015 he was incarcerated for violating his parole and as a result stopped coming to work and was terminated.  After his release in August 2015 he sought lost wage benefits.  The employer denied claiming that Mr. Coleman was responsible for his termination.

At hearing, although the employer did introduce evidence that Mr. Coleman stopped coming to work, and that Mr. Coleman had been incarcerated for violating his parole – there apparently was no evidence why or how Mr. Coleman violated his parole.  Reasoning that the employer had failed to show proof as to whether the parole violation was volitional, the Administrative Law Judge was unwilling to assume that it was and awarded benefits.

The Industrial Claims Appeals Office (ICAO) remanded the case back for a further hearing and testimony.  The ICAO imposed the burden not on the employer, but the injured worker.  “Typically, when an employer introduces evidence that a claimant has failed to show up for work when scheduled, this amounts to a prima facie case satisfying the employer’s burden of demonstrating the claimant was at fault for the job separation. See Lucero v. Industrial Claim Appeals Office, 812 P.2d 1191 (Colo. App. 1991)(employer’s initial burden to show claimant was discharged for disqualifying reasons). The claimant must then introduce exculpatory evidence or evidence showing that his failure to show up for work when scheduled was non-volitional. See Gonzales v. Industrial Commission, supra (disqualification for failure to meet defined standards, unless the claimant is not at fault in the circumstances).”

This burden-shifting is a major departure from traditional litigation when a a party must prove each and every statutory requirement.  Now, employers may simply be able show that a worker was fired in accordance to policy without showing that the worker acted volitionally.  Then if the employee doesn’t provide an explanation, the employer will win.  This case highlights another reason why injured workers need experienced and dedicated attorneys.  Workers Compensation Law Changes weekly and you or your loved one needs an attorney who keeps up with these changes.

 

Source Citation:  Coleman v. Starmark Holdings, WC No. 4-969-560-02, (January 9, 2017)

 

Case Update: If The Insurance Carrier Shuts Off My Lost Wage Benefits – Can I Get Penalties?

Case Update: If The Insurance Carrier Shuts Off My Lost Wage Benefits – Can I Get Penalties?

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MacDougal v. ICAO, Bridgestone Retail Tire Operations

The Court of Appeals put out an (unpublished) opinion affirming the denial of penalties against an adjuster for failing to reinstate lost wage benefits (TTD). On February 6, 2015, a Physician’s Assistant (PA) – not the actual Authorized Treating Physician – placed the injured worker at maximum medical improvement (MMI) and removed all restrictions – effectively clearing the worker for regular duty. However the section for permanent impairment was left blank..

The Insurance Carrier filed a Final Admission admitting to zero impairment that day. However eleven days later, on advice of counsel, the adjuster filed a General Admission of Liability (GAL). The GAL did not reinstate TTD benefits – relying on the PA’s release to regular duty.

On February 23, 2015 the Authorized Treating Physician (ATP) wrote a letter raising concerns about the PA’s medical note and noted that the injured worker would need permanent restrictions and an impairment rating. Because the ATP did not rescind the PA’s release to regular duty – the carrier did not reinstate TTD Benefits. When the ATP saw the injured worker in April, he placed the injured worker at MMI and impairment. (It’s unclear if the ATP provided permanent restrictions.)

The injured worker sought penalties against the carrier’s refusal to reinstate TTD benefits. The Administrative Law Judge determined that while the Final Admission was invalid because there was ambiguity of what, if any, impairment the injured worker had – the release to regular duty was not vague. Further, the ATP’s letter of concern did not expressly impose restrictions or retract the release to regular duty.

Given that confusion, the Court of Appeals agreed that claimant had failed to show that the adjuster acted unreasonably.

Work injury claims in Colorado are complex and fast paced. Don’t make the mistake of thinking you don’t need an experienced fighter in your corner. With everything there is to worry about when you suffer an on-the-job injury – let us make sure you are getting the benefits the law provides you. Get a free consultation on your workers compensation case here.

Case: MacDougal v. ICAO, Bridgestone Retail Tire Operations, 16CA0705 (Colo. App. 2016)

Employees Get a Bad Rap for Workers’ Compensation Fraud

Employees Get a Bad Rap for Workers’ Compensation Fraud

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Workers’ Compensation fraud. Quick! What immediately comes to mind? Is it some guy playing golf, shooting baskets or mowing the lawn while a PI looks on covertly with a video camera, or some other similar scenario?  It’s no surprise if that’s the case. Injured employees get a pretty bad rap when it comes to public perception of workers’ comp claims.

“Gotcha” videos and concerted efforts by workers’ compensation insurance companies through the 1990’s and early 2000’s firmly planted a seed in the public’s mind about injured workers. In a bid for reform to lower the costs in workers’ compensation state systems, legislators and insurance companies furthered the myth of the injured worker who’s faking his illness or injury in order to get benefits without working.

For those people who have never suffered a devastating work injury or know someone personally who has, it’s often easy for them to believe that the whole situation can be easily faked. Of course, to workers and family members who have gone through this experience, and are still dealing with the aftermath, the idea of perpetuating a long-term fraud seems ridiculous, if not impossible.  Moreover, what the facts actually bear out is that a large amount of workers’ compensation fraud is perpetrated by employers or insurers, and that this type of fraud is far more costly.

Workers’ Compensation Fraud Facts

Overall, only 1 to 2 percent of workers’ compensation claims are found to be fraudulent. The Colorado Workers’ Compensation Act defines fraud as willfully making false statements or misrepresentations that are material to a claim in order to collect payments, compensation, awards or benefits. It breaks down this fraud by the following types:

  • Claimant/Applicant – Includes false claims, fake and exaggerated injuries, unreported income, and claiming injuries that happened outside of work.
  • Provider/Biller – Over-billing or inflated bills and non-rendered services.
  • Lawyer – Helping to file a false claim or sending claims to clinics who conspire in the fraud.
  • Insurance Adjuster – Changing a claim to substantiate a denial and accepting bribes and kickbacks for patient referrals.
  • Premium – Submitting false information to get a lower workers’ comp rate.
  • Employer – Misrepresenting facts to avoid claim acceptance and payment, lying to prevent or discourage their workers from pursuing claims, and misclassifying workers and under-reporting their injured workers’ wages.

By the Numbers

Note that Colorado identifies one form of fraud that involves wrongdoing by the worker versus five types that are perpetrated by some party other than the employee. Claimant fraud is typically the least costly, since it’s perpetrated by individuals. Each case usually averages around $2,000 or $3,000 obtained fraudulently. A common type of claimant fraud is when the employee double-dips by receiving workers’ comp benefits while earning work income on the side that he doesn’t report.

By contrast, Employer and Insurer workers’ comp fraud runs much higher in cost. In Texas, 2012 saw a loss of approximately $523,451 to claimant fraud versus $2.7 million due to premium fraud. In North Carolina, the state’s 2014-2015 Industrial Commission’s annual report revealed that the form of workers’ comp fraud most heavily investigated was employer fraud, accounting for 90.64 percent of the suspected fraud cases. Alleged employee fraud cases only represented 8.75 percent.

Employer fraud involves misclassifying workers as independent contractors instead of employees, and identifying workers in high-risk jobs as holding low-risk jobs. In June 2015, the Economic Policy Institute revealed that between 10 and 20 percent of employers misclassify at least one employee as an independent contractor. Clearly, the picture of the employee as the “face of workers’ compensation fraud” is wrong and costly.

If you have suffered a work injury in Colorado, it’s important that you substantiate your claim. A Denver workers’ compensation lawyer can help you with this. He understands what is required to prove your claim and to overcome the negative perception that many employees are faking their injury or illness. Contact a Denver or Greeley workers’ comp lawyer for legal guidance and counsel for your Colorado Workers’ Compensation claim.

NPR: Working ‘The Chain,’ Slaughterhouse Workers Face Lifelong Injuries

NPR: Working ‘The Chain,’ Slaughterhouse Workers Face Lifelong Injuries

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Our very own Britton Morrell weighs in with NPR on slaughterhouse work injuries:

“Teresa stuffed 7- to 10-pound hams in bags, at times up to 50 hams a minute. Starting with a wage of $11.50 an hour, she worked 12-hour shifts, sometimes seven days a week. She was awarded employee of the month four times.

Then, she started experiencing problems in her right shoulder. After reporting the pain to her supervisors, they told her that if she was injured, she should go home.

“The supervisors were very nasty,” she says. “They wanted everything fast, they wanted to produce a lot of quantity. They didn’t care about the people.”

She says she went to the company doctor, who told her the shoulder problem was a bone spur. Finally, her shoulder got so bad, she was diagnosed with injuries from repetitive motions and had to have surgery.

Occupational Safety and Health Administration (OSHA) 2014 data that showed repetitive motion injuries among beef and pork processing workers were nearly seven times that of other private industries. And 76 percent of workers in a Maryland plant had abnormal nerve conditions in at least one hand, according to a 2015 report by the National Institute for Occupational Safety and Health.

Britton Morrell, an attorney in Greeley, Colorado., represents workers who file and are denied a workers’ compensation claim for “cumulative trauma.”

Credit to: NPR.org

Credits to: NPR.org

The claims are hard to prove, he says, because a worker must apply a checklist of risk factors. How many repetitive motions are required on the job? Does the worker hold his extremities at an awkward posture? Is there a vibratory mechanism attached to the job?

“It’s a Byzantine checklist,” Morrell says.

Experts have to be hired, which is expensive, he says. Calculations for claims are complicated and involve a worker’s age, body part and pay rates. And these calculations vary between states because of workers’ compensation laws.

“At some point for serious injuries there’s an acknowledgement: We’re never going to get these things back to the way they were before,” Morrell says.”

Read the entire article on NPR’s Website

 

 

Five Ways You Get Screwed In Your Work Injury – And Don’t Even Know It

Five Ways You Get Screwed In Your Work Injury – And Don’t Even Know It

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Because we offer free consultations, we meet with injured workers every week. After twenty-one years of doing this, I am struck by how often these hard-working men and women mistakenly think they are dealing with people who are trying to be fair and honest. The reality is that almost everyone involved with a work related injury has one goal: get the injury done and over with as quickly and cheaply as possible.

So the injured worker waits until they think they “need” an attorney. The problem is workers don’t see how they are being short-changed now. When injured workers tell me they want to wait because they think everything is going okay – I ask them these five questions to show them that they are already being taken advantage of without even knowing it.

1. When you were injured did your employer give a paper that allowed you to choose one of four suggested doctors?

Except in a few rare cases, when you are injured on the job – the employer has to give you the names of four unrelated medical clinics and you get to choose. If your employer does not do this immediately – you have the right to select your own doctor. In workers compensation the doctors are given tremendous power over what kind and amount of benefits you receive. If your employer told you to go to one particular clinic – you got short-changed without even knowing it.

2. Did the adjuster let you know to keep track of your mileage and submit it for reimbursement?

Under Colorado Workers’ Compensation law you are not only entitled to have 100% of your medical care covered – but you are entitled to be reimbursed (currently 53 cents a mile) for mileage to and from medical appointments. This quickly adds up to hundreds – if not thousands – of dollars.

3. Are you told you have to clock out for medical appointments – or worse – told you can’t schedule medical appointments during work hours?

There are so many medical appointments you can have – doctors, specialists, physical therapy, diagnostic, and chiropractic that you will just have appointments during your work. If you have to clock out for your medical appointments – you are entitled to two-thirds of your lost wages. Most employers don’t tell you this and some employers insist that you can’t schedule appointments during the work week. This may be illegal and Administrative Law Judges take a very dim view of employers interfering with medical care.

4. How was your average weekly wage collected?

The adjuster will average your earnings prior to the injury and admit to an Average Weekly Wage (AWW) and pay lost wage and permanent impairment benefits are based on that AWW. At least 70% of the time we calculate a higher AWW than the adjuster. That’s because we dig beyond the numbers. We look at seasonal changes in the wages, bonuses, raises, lost benefits, and in some cases we can get the AWW increased for increased wages after the injury.

5. Have you been told to change doctor or wait longer than ten days for medical care to be approved?

You are treating with Dr. X – but now the insurance carrier tells you that you have to change – or that Dr. X is no longer “authorized” to treat workers’ compensation injuries. You are waiting for an MRI, or therapy, or a surgical consult – but everyone is waiting for it to get authorized … and the weeks drag on. In workers’ compensation the carrier must advise you in writing whenever treatment is denied within seven business days of the request for authorization. The carrier does not have the right to change your doctor.

We help injured workers like you focus on what’s important – healing up and taking care of your body so that you can pursue your dreams and support your family. Don’t trust people whose job it is to pay as little as possible on your claim to do what’s right by you. You need someone in your corner. Get in touch with Denver Workers Compensation attorney for a free consultation on your case.

Life Care Planning: An essential component in your Workers’ Compensation Settlement

Life Care Planning: An essential component in your Workers’ Compensation Settlement

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Workers’ Compensation legal representation involves a great many moving parts, and if you are injured on the job in Colorado, a Greeley or Denver workers’ compensation lawyer is invaluable. Your attorney can ensure that important issues are thoroughly addressed during settlement negotiations. In the event of long-term disability from a work injury, it’s essential that your settlement includes a comprehensive life care plan. This vital component is necessary to cover and address issues that you will face in the future. Many injured workers are extremely concerned with the here and now. How will you pay bills, support your family, receive medical care and replace lost income? This is completely understandable. Your life is in upheaval and you are dealing with urgent issues that need to be addressed quickly. But once the dust settles, what then? Your long-term care is an important factor. How you will pay for rehabilitation, continue to provide for yourself and your family, and take advantage of medical advancements is key. These are the things that a life care plan deals with.

Key Differences Between Workers’ Compensation Benefits and Personal Injury Awards

If at Maximum Medical Improvement (MMI), you are determined to be permanently and totally disabled due to a work-related injury, you are no longer able to earn a living through gainful employment. Your workers’ compensation Permanent Total Disability (PTD) benefits provide income to replace this wage loss. Experts assess your life expectancy, how long you would have been able to work and the amount of income you would have earned over this time span. This amount should be reflected in your settlement. But, that’s not the end of the story. Your injury has likely left you with a number of medical, physical, emotional and rehabilitative needs. A comprehensive settlement should allow for these needs as well. This is where a well-designed life care plan comes into play.

Establishing and Proving Your Long-Term Needs

The input and testimony of qualified life care planning experts is essential to your workers’ compensation settlement. They are skilled in reviewing the evidence to determine your future personal and medical needs, and any remaining earning capacity. These forensic consultants delve into your medical reports and your prognosis. They examine how similar injuries have affected other workers, the associated costs they have accrued, the previous settlement amounts that have been awarded in these cases and a number of other contributing factors to determine what you need to provide for you over the long-term. Important factors for consideration include:

Coverage for medical advancements that can help your recovery

  • Financial compensation for your income loss
  • Funds availability for technological and medical apparatuses that help you live a fuller life
  • Home care and assistance to replace the duties you are no longer able to perform
  • Travel expenses related to your medical and psychological care
  • Various other costs related to your care and disability

Retaining Qualified Experts for Life Care Planning

Naturally, you cannot rely upon your employer and their workers’ compensation insurance carrier to provide extensive research for your life care plan. They don’t work for you. Their goal is to take care of your claim as expediently as possible at the minimum of expense. Your Denver or Greeley workers’ compensation attorney is the professional that you can count on to ensure that all of your long-term care needs are accounted for in your settlement. An accomplished legal professional in this field understands what is at stake and has the necessary resources to establish the necessity of each and every requirement in a comprehensive life care plan. He retains a skilled life care planner and collaborates with this professional to negotiate a settlement that covers all of your long-term needs.

Key Differences Between Workers’ Compensation Benefits and Personal Injury Awards

Key Differences Between Workers’ Compensation Benefits and Personal Injury Awards

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People are often confused about workers’ compensation benefits in Colorado. Many believe that recipients are paid in a manner similar to personal injury lawsuits. Others may understand that there is a statutory standard, but are unaware of the parameters. Let’s try to clear up some of this confusion with an overview on what workers’ compensation pays employees who have been injured in work-related accidents or have fallen ill due to their job duties.

Many of you are aware that personal injury awards can range into the hundreds of thousands of dollars based on the type of injury sustained and the fault of the negligent party. These awards and settlements are often boosted by the careless or negligent behavior of the company that led to the injury. In many cases, the amount of money received is increased due to punitive damages. Workers’ compensation benefits operate quite differently.

Negligence or fault is not a factor in workers’ compensation cases. Instead, these benefits are set up as insurance for instances when your work duties lead to injury or illness. The benefits are meant to replace the work income that you would have normally earned had your injury not prohibited you from working and gaining employment income. Rather than assigning blame and seeking to compensate you for what you have lost and suffered, workers comp pays you a percentage of the wages you have lost due to your injury. This can range from a temporary timeframe to a permanent arrangement based on the unique circumstances of your injury and outcome.

You Won’t Believe These Unusual Workers’ Compensation Cases

In some cases, you may be eligible to receive education or vocational benefits to help you learn a new skill or trade when you are no longer able to perform the job you were doing prior to your injury. And if your injuries are so severe that you can neither return to your previous work nor perform the duties of some other job, then you may be eligible for long term disability payments. These benefits seek to compensate you for the income you will lose out on for the duration of your remaining working days. Experts apply extensive and complicated formulas to determine what this lifelong work income would be. Benefits are then paid out as either a lump sum or periodic payments over time.

These benefits also cover medical bills related to your injury, to include treatment, surgeries, therapy, rehabilitation and some associated costs, such as mileage to and from your medical appointments.

Workers’ Compensation Fee Schedule and Benefit Payments

The Colorado Workers’ Compensation fee schedule is reviewed annually. For the July 1, 2016 through June 30, 2017 time period, the maximum amount you can receive for lost wages is $939.82 per week. This may apply to workers who’s weekly earnings were at least $1,409.73. If you are determined to be disabled and your impairment is 25 percent or less, the maximum lump sum you may receive is $86,697.04. If your impairment is rated at higher than 25 percent, the maximum amount is $173,391.90. This applies to workers who were injured after January 1, 2014. These are the maximums. To determine the specific amount you are eligible to receive, your employer’s workers’ comp carrier determines your average weekly wage and multiples it by 66 and 2/3 percent. There is no minimum weekly benefit.

These formulas are often complicated and confusing. You may also be eligible for scheduled or non-scheduled impairment and/or body disfigurement. Our experienced Denver workers’ compensation lawyers can help you understand these benefits and work to ensure you receive the maximum amount that you are entitled to under law.