Workers’ Compensation Can Pay for the Prosthetic You Need
If you need a prosthetic because of a work injury, Colorado workers’ compensation can cover it, whether that’s an artificial arm, a hearing aid, or another covered device you need to help replace or improve the function affected by your injury. In general, workers’ compensation covers not only the medical care to get you back to 100 percent as much as possible, but also a prosthetic if you need one. But what counts as a prosthetic, and what happens if you need a replacement?
Watch the video: Are Prosthetics Covered Under Workers’ Compensation?
What Prosthetics Are Covered by Workers’ Compensation?
When you hear “prosthetic,” you probably think of an artificial arm or leg. But Colorado’s law covers more than that. Its list includes these devices when they’re reasonably needed to replace or improve the function affected by the injury:
- Artificial limbs
- Hearing aids
- Glasses
- Braces
- Dentures
- Canes
The insurance carrier must provide the device if you need it because of your work injury. For example, if you lose your hearing in a workplace accident, you are entitled to a hearing aid. If a work injury results in amputation and you need a prosthetic arm, workers’ compensation has to pay for it.
Who Pays for a Workers’ Compensation Prosthetic?
Your employer’s workers’ compensation insurance company provides the covered device, as we explain in the video. Colorado law puts that responsibility on the employer as part of your workers’ compensation medical benefits.
A prosthetic claim follows the same path as other medical benefits: your authorized treating physician documents that the device is reasonably required because of the work injury and prescribes it, and the carrier then authorizes and pays for it. Keep the prescription and all correspondence — if the carrier disputes whether the device is “reasonably required,” that documentation becomes the evidence that supports your claim.
Can I Get a Replacement Prosthetic?
What happens if your prosthetic wears out? Or if your body changes and it doesn’t fit the way it used to? Those are important questions, and you shouldn’t assume a replacement has to come out of your own pocket.
Colorado’s Division of Workers’ Compensation says reasonably necessary replacement prosthetic devices must be provided. If your device wears out or no longer fits, talk with your treating provider about what you need, and get help if you have questions about coverage.
If the device no longer fits or works because your body changed, for example, you gained or lost weight or muscle, you must show the change was caused by the work injury, not something unrelated. Otherwise, you may have to pay for the replacement.
Have questions about a prosthetic or a replacement?
Kaplan Morrell has been helping injured and disabled workers and their families since 1997, and we work on a contingency fee basis. If you or someone in your family was hurt on the job, you don’t have to sort through these questions alone. Our Colorado Workers’ Comp attorneys can help.
Call us at 970-356-9898 or use our online chat. Your consultation is free and confidential, and we can talk through your situation.
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Read Video Transcript: Your Rights to Prosthetics in Colorado Workers’ Compensation
Lightly edited for readability. Timestamps are based on the supplied captions and mark grouped passages, not word-for-word timing.
0:00 Some work injuries are serious enough that an injured worker needs a prosthetic. What is a prosthetic, and what are your rights in Colorado if you need one?
0:23 I’m Britton Morrell with Kaplan Morrell. We have been helping injured and disabled workers and their families get the benefits they deserve since 1997. If this video helps you, please like, subscribe, or comment below. We’d love to have you be part of our online community.
In this video, I discuss how workers’ compensation covers prosthetics, what they are, and what happens if you need a new one.
0:48 In general, workers’ compensation not only covers the medical care to get you back to 100 percent as much as possible, but also covers a prosthetic if you need one.
0:57 Prosthetics are artificial limbs, hearing aids, braces, canes, dentures, and glasses, and the insurance carrier has to furnish a prosthetic device if you need it. If you lose your hearing because of a work injury, you are entitled to a new hearing aid.
1:13 If you need glasses because of a work injury, you are entitled to glasses. If you lose an arm and need an artificial mechanical arm, workers’ compensation has to pay for it.
1:21 What happens if a prosthetic wears out? If it wears out, you can get a covered replacement.
1:29 But if the prosthetic no longer works because your body has changed and you are now bigger or smaller, you have to show that the physical change was due to the injury. Otherwise, you have to pay for the replacement.
1:44 Prosthetics are a really important part of medical care and maintenance care, but as always, it can be complicated, especially if you need a new one. A worn-out prosthetic is replaced, but if it doesn’t fit because your body has changed, you will have to show more.
2:00 If you or a member of your family has been injured on the job, please feel free to contact us. We have been helping injured workers on a contingency fee basis, which means we only get paid if we are successful.
2:14 Call us, send a text message, or visit our website. Our initial consultations are free and confidential, and they give you the peace of mind that comes with knowing your rights.
2:23 Thank you for spending part of your day with me.
