As Denver injury lawyers who help workers suffering from workplace accidents, our first concern is to make sure that the employer and insurance company have notice of the incident. Employers are required to provide medical care, and many injured workers are satisfied with this, thinking they have preserved their rights.
However we go one step further to make sure that the accident has been reported to the State of Colorado’s Division of Workers’ Compensation. This is a critical moment in preserving injured workers’ rights because it forces the insurance company to either formally admit – or deny – liability. Once a case is admitted – then the injured worker has access to many more rights.
Unfortunately for one injured worker, she treated for months after a chair collapsed on her at work without filing a claim and requiring the carrier to admit liability. Then her company selected doctor began to opine that her condition was not related to the incident at work. At that moment the insurance company was free to deny the claim, by filing a Notice of Contest, forcing the injured worker to go to hearing.
At hearing – the Judge ruled against her – and denied her claim. She appealed, complaining that the company Doctor, Dr. John Burris, was not an accident reconstruction expert. The Industrial Claims Appeals Panel (ICAP) affirmed, stating, “To the extent the claimant argues it defies logic and common sense for Dr. Burris to opine she suffered no injury at all when he is not an accident reconstruction expert or forensic engineer, and did not see her immediately after her fall, this assertion goes to the weight to be afforded Dr. Burris’ opinions. Because the weight and credibility to be assigned expert testimony is a matter within the ALJ’s discretion, we again are unable to conclude there is any reversible error in the ALJ’s decision to credit Dr. Burris’ opinions.”
The injured worker also claimed that she was entitled to a formal second opinion to challenge her treating Doctor’s opinion, called a Division Independent Medical Examination. However because there had not been a claim, and an Admission of Liability, the ICAP determined that she was not entitled one.
The claimant also requests that we remand the matter to allow her the opportunity to seek a Division sponsored independent medical examination (DIME) in order to determine whether she is at maximum medical improvement and whether she has any ratable permanent impairment. Because there is substantial evidence supporting the ALJ’s determination that the claimant did not sustain a compensable injury in the first instance, however, this obviates the need to remand the matter so the claimant can pursue a DIME. See City of Boulder v. Payne, 162 Colo. 345, 426 P.2d 194 (1967) (no benefits flow to victim of industrial accident unless accident results in compensable injury); §8- 43-301(8), C.R.S.
Workers’ Compensation claims can be complicated. Had this injured worker timely filed a claim, and forced the carrier to admit liability in the beginning, she would have been entitled to a DIME.
Watch as Britton Morrell and Michael Kaplan explain about DIME, and the process of selecting a doctor for your Workers’ Compensation Case.
We help injured workers in Denver, Greeley, Loveland, Fort Collins, Arvada, Colorado Springs and everywhere else in Colorado. Call 303-780-7329 or click HERE to contact us today for your FREE consultation.
Citation: Jorgensen v. Air Service, WC No 4-894-311 (April 2014)