Medical Benefits with Colorado Workers’ Compensation Insurance

Oct 27, 2023 | Medical Benefits, WC & Other Laws

Medical Benefits with Colorado Workers’ Compensation Insurance – When you’re injured on the job the major benefit you can get under Workers’ Compensation is medical benefits, and it’s better than any other benefit you can get under any other type of insurance because of 2 reasons.

Medical Benefits with Colorado Workers’ Compensation Insurance

Firstly, there are no co-pays and no deductibles, the insurance company will pay 100% of the medical care. Secondly, there’s no limit to it, no lifetime limit, no per accident or per condition limit, the insurance company is obligated to give you whatever medical care is reasonable and necessary.

Furthermore, Workers’ Compensation only pays you a portion of what you lost. For example, lost wages are only 2/3, and they don’t pay 100%, but the medical benefit is the only benefit that’s not only paid 100% but it’s also the only benefit that it’s designed to get you back to the way you were before the injury.

How do Medical Benefits work?

When you get injured on the job and you give your employer notice, your employer is supposed to give you a list of doctors. If it’s an emergency get to the emergency room, and after it the employer should give you the list of doctors, and you will have to choose between them.

Chances are those doctors have been selected by the insurance company, and the one you choose will be the authorized treating doctor. If the employer doesn’t tell you to go to a doctor or doesn’t give you a list, you have the right to select your own doctor, which you should do, also call an attorney because the insurance company will try to fight you on this; it’s important that you get a treating doctor that you feel comfortable with.

Lastly, the authorized doctor can send you to other doctors, and those doctors are also authorized. That’s important because the insurance company only has to pay the bills of doctors who are authorized. If you go out and choose your own doctor the insurance company won’t have to pay for it.

Can I change my treating doctor?

There are several ways for you to change your treating physician if you’re dissatisfied with the care.

– One, you can write a letter to the insurance company and ask for a change to a particular doctor, and if they don’t give you a written denial within 20 days you get to change that doctor by law.

– Two, you can select the other doctor on the list within 90 days.

– Three, if you are able to show a real problem with your medical care, you could go to court and ask a judge to change the doctor.

– And four, if you disagree with what the treating doctor says about the fact that there’s no more medical care that will help you or your impairment rating, you’re entitled to a formal medical second opinion.