Am I Eligible? Requirements for Workers’ Compensation Claims In Colorado

Oct 5, 2015 | Compensability

In the current job climate, many people find themselves jumping at the first work opportunity that comes along without waiting to find out if their employer provides workers’ compensation insurance. Greeley and Denver workers’ compensation attorneys often have to do research to make sure a person’s injury is covered by his or her company’s workers’ compensation insurance. Fortunately, workers’ compensation insurance is required by state law for any company with employees. There are certainly some exceptions but more likely than not, the company where you work is required to carry workers’ compensation insurance. So how do you know if you qualify? How do you know if you have a claim?

Put simply, it depends. Many companies avoid paying for workers’ compensation insurance because they don’t have employees. This doesn’t mean no one works at the company, as Denver workers’ compensation lawyers will quickly tell you. This simply means the company codes those employees as something other than employees. For example, painting companies may decide to label all their employees as independent contractors, in spite of the fact that those employees go where their bosses tell them to go when their bosses tell them to go there. These so-called independent contractors have their checks signed by management at their companies and have all their tools of the trade provided to them by the larger company where they work.

Related: Make No Mistake, The Workers’ Compensation Insurance Carrier is not on your side

Basically, though, three factors have to be met for an injured employee to qualify for a workers’ compensation claim.

  1. The person or company where the individual works must have workers’ compensation insurance or be required to carry it even if they don’t-
  2. The injured worker must be an employee of that person or company, and-
  3. The injury or illness has to be related to the specific work that individual does at the company where he or she is employed.

The workers’ compensation insurance that covers companies is required by law. However, which companies need to be covered depend on a state-to-state basis. Some companies need over a specific number of employees to be required to carry insurance for workers’ compensation. Some states don’t set a minimum. Some charities can opt out of workers’ compensation insurance in certain states whereas other states don’t allow charities to opt out. Most employers, however, have to carry the insurance and if your employer says they don’t have to, check with an attorney. Workers’ compensation insurance is a benefit to employers because if a worker is injured on the job, they can sue against the insurance instead of his or her employer.

Being an employee of a company is a question of definition. As mentioned earlier, there are certain cases where people aren’t covered because they are considered independent contractors who contribute to the company while technically distinct from it. Volunteers are also not technically employees so they don’t receive benefits connected with workers’ compensation. There are of course exceptions. It would probably be unfair to not cover volunteer fire fighters, for example, and some states let organizations opt in to workers’ compensation insurance for their volunteers.

Work-related injury or illness is another gray area. After all, who can say if asthma, for example, was a pre-existing condition or something brought on by allergens a worker was exposed to? The chain of causation is sometimes difficult to draw. Many cases have come out recently where companies argue their employees’ poor health came from outside factors rather than specific exposures at work. In the case of a missing limb or a fall, the link of causation is fairly obvious but diseases or illnesses can be tougher. Some things to look at include whether other workers showed similar symptoms, whether the industry lends itself to a specific type of illness if good precautions are not taken, and/or if the employee displayed pre-existing conditions.

Even if all three factors are met, however, some workers still don’t qualify for workers’ compensation benefits based on the specifics of their cases. Domestic, undocumented, seasonal, and agricultural workers sometimes fall into this special category of excluded workers.

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 our Denver and Greeley workers’ compensation attorneys here or call us at303-780-7329 for your free consultation.