Physician Assistants Can Declare MMI

Physician Assistants Can Declare MMI

Denver Workers Compensation Workers Compensation Blog

The Statute and case law permits a physician to delegate to a PA the determination of MMI.

Susan Griego injured her wrist at work on June 6, 2016, when a trash dumpster lid closed on her hand. After being provided a list of designated medical providers, the claimant elected to treat at the CCOM clinic. The claimant never saw a physician but was examined and treated by Physician’s Assistant (PA) Byrne. PA Byrne placed her at maximum medical improvement (MMI) on August 8, 2016 with no permanent impairment. The form was co-signed by Dr. Daniel Olson, M.D. The respondents filed a Final Admission of Liability on January 6, 2017 based upon the PA’s report.

Ms. Griego filed an application for a hearing disputing the legitimacy of the Final Admission.  The ALJ upheld the legitimacy of the Final Admission relying on W.C. Rules of Procedure 16-5(A)(6) and 16-7(F)(1), 7 CCR 1101-3, which allow authorized treating physicians to countersign WC 164 forms completed by a PA. The ALJ also referenced § 12-36-106(5) C.R.S. and the decision in Sims v. Industrial Claim Appeals Office, 797 P.2d 777 (Colo. App. 1990) as authority allowing a physician to delegate to a PA the determination of MMI.

Workers’ Compensation, MMI and other work injury issues can be difficult and confusing to understand. Our Workers’ Compensation Attorneys can help you navigate your Workers’ Compensation Claim. Get a free review of your Denver Workers Compensation case today.

 

Pinnacol Privatizing: Insurer of Last Resort for Multiple States?

Pinnacol Privatizing: Insurer of Last Resort for Multiple States?

Workers Compensation Blog

 

In the current political climate, it’s important to pay attention to more than just the presidential race. While that certainly calls the most attention to itself in terms of politicizing and polarizing people, other measures on the ballot and future legislation can affect Colorado voters significantly. Specifically, Denver workers compensation lawyers are looking at Pinnacol Assurance, which released proposed language for a law that would let it sell workers’ compensation policies outside the state of Colorado.

Greeley workers compensation lawyers will probably be the first to tell you that Pinnacol, as a state-chartered workers’ compensation insurer, is required to offer some level of workers’ compensation insurance to almost all companies. That means it’s probably the biggest insurance company and covers workers all over the spectrum of fields. Pinnacol could cover anything from construction companies to startups that just barely reach the minimum amount of employees after which a company is required to carry workers’ compensation insurance.

In December of 2015, Pinnacol announced that it planned to submit a proposal that would form a new company to sell workers’ compensation coverage in other states. Since state laws differ as they relate to workers’ compensation, this is a bold and almost unheard-of move for the Colorado workers’ compensation insurer of last resort. Pinnacol is, in fact, considered a state “political subdivision” so no matter what this change does, it cannot privatize Pinnacol.

Part of the reasoning behind Pinnacol’s move to provide workers’ compensation to states outside of Colorado is that other workers’ compensation insurers sell insurance in multiple states. Pinnacol policyholders, like companies that utilize Pinnacol but have multiple locations, had to have multiple insurance companies depending on the state. Pinnacol argues that this drove away business and kept the company from realizing its full potential.

The full language of the proposed legislation is on Pinnacol’s website. In 2012, the company tried and failed to privatize. Pinnacol says this new bill doesn’t call for privatization—simply the creation of a private subsidiary of Pinnacol. The distinction, it argues, is important.

Part of the worry about privatizing Pinnacol is that it will fundamentally change the way workers’ compensation insurance in Colorado is offered and available to the majority of people. Denver workers’ compensation attorneys often negotiate with Pinnacol to get injured workers the care they require. The insurance company pays for medical treatment, which is necessary because of work injuries. Pinnacol argues that the change would allow it to stay competitive and innovative. Many other private workers’ compensation companies sell insurance across state lines but Pinnacol is the best insurance at what it currently does.

Workers’ compensation is part of the worker safety net people don’t realize they need until it’s too late. When representing themselves at the polls, those who work and those who don’t should consider as many different aspects of themselves as possible. This means thinking ahead to the possibility of needing workers’ compensation insurance even if they don’t believe it’s likely that they’ll ever need the insurance.

If Pinnacol spreads itself too thin, there is a very real possibility that it will no longer be able to provide workers’ compensation insurance for so many companies at such a low cost. Business concerns aside, insurance companies exist to safeguard the people who buy insurance. In the case of workers’ compensation and Pinnacol, Pinnacol owes a responsibility to the businesses it insures and the workers who are injured and need medical care.

Workers’ Compensation can be difficult, confusing, and very complex. Kaplan Morrell has helped thousands of injured workers since 1997 get the benefits they deserve. Contact us here or call us at(866) 356-9898 for your free consultation.
Source: http://www.businessinsurance.com/article/20160217/NEWS08/160219837/comp-insurer-looks-to-sell-policies-outside-state-lines?tags=%7C70%7C92%7C304

How Trump May Affect Workers’ Compensation In Colorado

How Trump May Affect Workers’ Compensation In Colorado

Denver Disability Denver Workers Compensation Workers Compensation Blog

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

How Does House Bill 1119 Stack Up For Workers’ Compensation In Colorado?

How Does House Bill 1119 Stack Up For Workers’ Compensation In Colorado?

Denver Workers Compensation Greeley Workers Compensation Lawyer Workers Compensation Blog

The Colorado General Assembly has proposed new legislation that would address the issue of worker injuries when their employers have no workers’ compensation insurance. If passed, the proposed law packaged in House Bill 1119 will create the Colorado Uninsured Employer Act.

Colorado’s HB 1119 Overview

This legislation is a show of bipartisanship with support from Democrat Senator Cheri Jahn and Democrat Representative Tracy Kraft-Tharp and Republican Senator Jack Tate and Republican Representative Lang Sias. The Act would create a fund from which eligible injured workers can draw benefits. Employer penalties and fines imposed by the Division of Workers’ Compensation for no insurance coverage will help fund the account. Other financial sources may include grants, donations, and public and private gifts.

The bill also directs the establishment of a governing board to cover a range of duties for the uninsured employer fund. Some of these responsibilities include the setting of criteria for rates, claims adjustments, rules adoption and benefit payments. The Board must establish a plan of operation for fund administration duties and money collection procedures for the fund.

The Plight of the Injured Worker and No Workers’ Compensation Coverage

As a worker, when you are considering employment, you may look at several different factors. While stable work hours, healthcare benefits, paid leave, and retirement plans are frequently considered, whether your potential employer has workers’ compensation coverage rarely comes up.

Because it’s the law, most workers assume their employer has the necessary coverage. They only discover a lapse if they experience a work injury that leads to a Colorado workers’ comp claim. A seriously injured employee who is unable to receive benefits under workers’ comp due to their employer’s negligent insurance oversight is left in a precarious position.

Workers’ comp covers medical treatment for your injury or illness. It also pays a percentage of your wage loss if you are unable to work due to your injury. With no workers’ comp coverage, these and other benefits are no longer available.

Seriously injured workers find themselves struggling to receive desperately needed medical treatment and facing overwhelming unpaid bills due to their lost wages. In the event of a resulting disability, the injured worker is unable to receive the temporary or long-term disability benefits that would otherwise be available to him under the workers’ comp program.

Related: Passage of Amendment 69 Could be Bad News for Colorado Workers’ Compensation

One option in this situation is to sue your employer in civil court for the losses associated with your injury. A big problem with this method of reimbursement is the length of time it typically takes to recover damages in civil court. The process is lengthy, and your medical and financial needs are immediate. The biggest problem is that most employers don’t have the assets to pay the benefits due injured workers. Bankruptcy is declared – or the business stops functioning – and the injured worker is left with an order he or she cannot collect.

The proposed Colorado Uninsured Employer Act is a far more effective solution to the uninsured employer problem. Many other states already have these funds set up for these types of injured workers. Some have temporary disability insurance programs instead.

Uninsured Employers’ Workers’ Compensation Fund Examples

Several states, such as California, New Jersey, and New York, have some form of compensation funding for injured workers whose employers have no coverage. California has two funds, the Uninsured Employers Benefits Trust Fund (UEBTF) and the Subsequent Injuries Benefits Trust Fund (SIBTF).

New Jersey also operates two funds, the Uninsured Employer’s Fund and the Second Injury Fund. In New York, their Uninsured Employers Fund (UEF) assigns direct liability to the employer for compensation payments and medical costs.

HB 1119 was introduced on January 20, 2017 and is currently under consideration. Meanwhile, if you have suffered a work injury and subsequently learned that your employer has no workers’ compensation insurance, contact a seasoned Colorado Workers’ Compensation lawyer like Kaplan Morrell to explore your options.

Need help now? We’re here for you. Contact our Denver Workers’ Compensation Attorneys here, and if you’re out in the “burbs” you can reach our Greeley Workers’ Compensation Attorneys here.  We’re here to help- and we will fight to get you the benefits you are entitled to!

 

 

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

colorado gun laws Denver Disability Denver Workers Compensation gun laws Social Security Blog Workers Compensation Blog

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.

Two most common overlooked benefits injured workers in Colorado should get – but don’t.

Two most common overlooked benefits injured workers in Colorado should get – but don’t.

Denver Workers Compensation Greeley Workers Compensation Lawyer Workers Compensation Blog

There are some Denver workers’ compensation benefits that are well known such as medical care and payment of lost wages.  However, there are also some benefits that are not as well known and should not be overlooked.

Some injured workers who are owed disfigurement benefits.  Disfigurement benefits are paid for things like scars from surgery or suffering from a limp.  The workers’ compensation insurance company is not required to automatically pay such a benefit.

Another benefit is mileage reimbursement.  The workers’ compensation insurance company needs to reimburse you for all of your trips to doctors, physical therapy visits and even to pick up your medications at the pharmacy.  Even if someone else provides transportation for you, you can still get reimbursed for that mileage.  If you are unable to get to your medical appointments, the insurance company has to provide you some form of transportation to get you there.  We would welcome the opportunity to explore these little known benefits with you.

As always, how this or any other issue we discuss in this blog would apply to your case depends on many more factors.  We urge you to call us to see if you are entitled to workers’ compensation benefits.  Workers Compensation is difficult, confusing, and very complex.  Kaplan Morrell has helped thousands of injured workers since 1997 get the benefits they deserve.   Contact us here or call us at (866) 356-9898 for your FREE CONSULTATION.

Top Ten Most Costly Work Injuries Of 2016

Top Ten Most Costly Work Injuries Of 2016

Denver Workers Compensation Workers Compensation Blog

The Liberty Mutual Research Institute revealed 2016’s top ten causes of the most costly work injuries.

Here they are:

1. Overexertion involving outside sources. $13.79 Billion (Examples include lifting, pushing, pulling objects.)

2. Falls on the same level. $10.62 Billion (Slip and falls on slippery surfaces)

3. Falls to a lower level.  $5.50 Billion (Scaffold, ladder, stair falls)

4. Struck by Object or Equipment. $4.43 Billion

5. Other Exertions or Bodily Reactions. $6.5 Billion

6. Roadway incidents involving motorized vehicles.  $3.7 Billion

7.  Slip or trip without fall.  $3.8 Billion

8. Caught in/Compressed by Equipment or Objects. $1.95 Billion

9.  Struck against object or equipment.  $1.94 Billion

10. Repetitive Motions involving micro-tasks. $1.81 Billion.

Some work injuries cost more because of the nature of the injury.  Injuries requiring surgery will be more costly, not simply because of the medical care, but also because of the additional lost time during the recovery.  Injuries from lifting, in this study, may be more costly simply because those kinds of injuries are more common and numerous.  The injuries in this study included only those injuries where the employee missed six or more days of work.

When you’ve been injured on the job in Colorado, your primary concern is getting healed and back to your life. For the vast majority of injured workers that happens, but some workers sustain serious injuries that continue to interfere with their lives.  We’re here to help seriously injured works get the medical care and the Colorado Workers’ Comp benefits they deserve.  Don’t wonder, “What are my rights under Colorado Workers Compensation?”  Instead, call us and meet with an experienced Denver Workers’ Compensation attorney for a free consultation. Let us help with filing your Colorado Workers’ Comp claim- we can help get it approved.

 

 

 

Source:  http://imag e.email-libe rtymutual.com/lib/fe541570726d02757312/m/1 /2017+WSI.pdf

Employees Get a Bad Rap for Workers’ Compensation Fraud

Employees Get a Bad Rap for Workers’ Compensation Fraud

Denver Disability Denver Workers Compensation Greeley Workers Compensation Lawyer Workers Compensation Blog

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

Denver Disability Denver Workers Compensation Greeley Workers Compensation Lawyer Workers Compensation Blog

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

Denver Disability Denver Workers Compensation Workers Compensation Blog

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.