Marijuana Use Can Impact Your Workers’ Compensation Benefits

Marijuana Use Can Impact Your Workers’ Compensation Benefits

Denver Workers Compensation

When it comes to marijuana use on-the-job, the best advice is “don’t do it!” Contrary to what you may believe, whether for medical or recreational uses, your right to toke is not protected by law in the work environment. Colorado has legalized both the medical and recreational consumption of marijuana, but our state laws still butt up against federal laws. And this makes for lots of confusion across the board.

Employers on Marijuana Use

Legal marijuana, whether for medical reasons or recreational use, is no mandate for use at work. Employers are well within their legal rights to prohibit consumption at work and to require drug testing to weed out users from their workforce.

Federal law prohibits the possession and consumption of marijuana for any reason. This supports the rights of employers in banning marijuana consumption in their employees. Now that the new Trump administration is in place, federal versus state law on marijuana may become even murkier. Currently, there is no clear-cut answer on whether the federal government will be cracking down on states that allow legal marijuana use.

Statewide Marijuana Use Laws

As of the November 2016 election, more than half of all the states in the union, plus D.C., now have medical and/or recreational marijuana use legislation on their books.

1. California passed legal recreational marijuana use last November.
2. Massachusetts joined the ranks of recreational marijuana use states this past election.
3. Maine will soon be allowing limited recreational marijuana use and on-site consumption in social clubs.
4. Though late to the party, Nevada is now a legal recreational marijuana state.
5. Washington, D.C. voted for nonmedical marijuana use in 2014.
6. Oregon came aboard on recreational use of marijuana in the summer of 2015.
7. Alaska passed recreational marijuana law in 2015.
8. Colorado passed legislation to allow recreational marijuana use in 2012. Recent ballot initiatives support public consumption programs in Denver.
9. Washington joined Colorado in groundbreaking recreational marijuana use in 2012.
10. Florida, Arkansas, North Dakota, Montana, Arizona, New Mexico, Minnesota, Michigan, Illinois, Louisiana, Ohio, Pennsylvania, New York, Vermont, New Hampshire, Connecticut, Rhode Island, New Jersey, Maryland, Delaware have all legalized medical marijuana.

Bottom Line: Colorado Statute on Marijuana and Workers’ Compensation

Regardless of what the future holds for legal marijuana consumption, for now, Colorado Statute, Article 42 of Title 8 limits your financial benefits under the workers’ compensation system if you test positive for a controlled substance. You can lose 50 percent of your income replacement benefits if marijuana use is detected. While you will still receive full medical treatment benefits, your finances will likely suffer greatly from this impact.

Note that the issue with federal vs. state laws on marijuana impact this area of the law as well. §8-42-112.5. C.R.S. excludes medically prescribed drugs from the identified controlled substances, but that’s the problem. Doctors in Colorado cannot prescribe marijuana. They can only advise their patients on its use.

If you have questions about marijuana and the workplace and workers’ compensation benefits, ask a lawyer. Your pot-smoking buddy probably has a lot of opinions and knows quite a bit about the legalities of smoking weed in Colorado. But workers’ compensation is a complicated system wherein state and federal laws often overlap. A Colorado workers’ compensation lawyer is your best source of information on this thorny subject. We’re always here to answer your questions- don’t wait- get a free consultation on your workers’ compensation case now.


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.

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

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

Denver Workers Compensation Workers Compensation Blog

Colorado has long been a sort of “proving ground” for new and tentative legislation. Some reasons for this is our status as a swing state and the ease of getting initiatives on our voting ballots in the first place. National groups frequently test proposals in our state, and often the proposed legislation is quite extraordinary. Take legalized recreational marijuana in 2012, for instance. This election year will be no different, and there will be several controversial initiatives on the ballot for voters to decide upon, such as “right to die” and raising the minimum wage to $12. One such ballot initiatives that is of particular interest for Colorado’s workers’ compensation system is universal health care.

Amendment 69 – ColoradoCare Ballot Initiative

This proposed amendment is an attempt to introduce a single payer system, also called universal health care, to Colorado. The proposed program, named ColoradoCare, would replace the Affordable Care Act. Estimates place the yearly price tag for ColoradoCare at around $25 billion dollars. A business and worker tax, along with an increased state tax rate, is meant to pay for the program. This tax option does away with deductibles and medical insurance premiums. However, this tax increase would practically double the current state budget, and saddles Coloradans with the highest income tax rate in the nation.

Accountability is questionable. This program is to be run by a board of 21 members who will be elected by plan members. Furthermore, there are no real specifics about what the new plan will cover, just what programs it will replace. The board will retain sole authority on coverage decisions. Hospital and doctor reimbursement levels are uncertain, calling into question continued quality care under the new system.

Potential Impact on our Workers’ Compensation (WC) Program

ColoradoCare will collect funding and administer the Colorado Workers’ Compensation program, as well as all other state and federal programs, with the exception of Medicare. This has the very real potential of destabilizing a well-functioning system. Our Workers’ Compensation program in Colorado is widely viewed as one of the best in the nation, as it efficiently balances affordable premiums for employers and the provision of fair benefits for injured employees. Denver Workers’ Compensation attorneys are a big part of this system.

– Overhaul of how the Colorado Workers’ Compensation program works

Currently, the system both replaces lost wages and provides medical care for injured workers. The proposed single-payer system will remove the healthcare portion of this system from the program and move it under ColoradoCare. It’s not known how the new set-up will work with only wage replacement under WC, but confusion and disarray are far too likely. There is also the question of cost. Employers currently pay for Workers’ Compensation insurance to cover all of the benefits for injured employees. They will now pay a higher tax rate for ColoradoCare and still be on the hook for the indemnity portion of Workers’ Compensation. It’s a quagmire.

– Unsettles a working system

Workers’ Compensation in Colorado does more than pay out benefits. It promotes worker-safety programs and encourages employers to prevent workplace injuries. Providers and established Workers’ Compensation health professionals are experienced in managing worker injuries. They collaborate with employers and workers to help them get to maximum medical improvement and get back to their jobs safely, whenever possible.

– Eliminates subrogation

Workers Compensation is a no-fault system. But sometimes, there is fault, due to a non-employer third-party. In these cases, Workers’ Compensation insurers can pursue monetary recovery from the negligent party through subrogation. With the passage of Amendment 69, first rights to subrogation cedes to ColoradoCares. This loss of funds impacts the insurers and injured workers ability to recover for injuries.

– More Unknowns

At this time, it is not even known whether ColoradoCare will cover the incidental expenses that Workers’ Compensation in Colorado addresses, such as transportation to medical appointments. And there is no guarantee that injured workers will continue to be able to see qualified professionals in occupational medicine and other specialties that are required to give injured employees the best possible specialized care in a timely manner. Overall, there are simply too many variables and unknowns to enthusiastically support Amendment 69 for implementation of ColoradoCare in our state this November. For individuals who are injured at work, the best thing they can do is seek a qualified attorney. Our top rated Denver workers’ compensation attorneys can help injured workers file their claim, get the medical care they need, and help them seek lost wages to help cover living expenses and medical bills.


Amendment 69

Oil Gauging Practice as a Health-damaging Working Condition

Oil Gauging Practice as a Health-damaging Working Condition

Denver Disability Denver Workers Compensation Social Security Blog Workers Compensation Blog

There was a controversial case here in Colorado just recently. A judge ruled in favor of a widow whose husband died because of unfavorable working conditions.

Jim Freemyer, an oil-field worker, died in 2014 after inhaling toxic chemicals in a low-oxygen atmosphere at the Gaddis oil tank site. What he did was most commonly known as ‘tank gauging,’ in which the worker, in this case Freemyer, was tasked to hold a measuring device to check the tank’s oil level. He was employed by Now or Never Trucking Inc. in Greeley. His widow was awarded funeral expenses and a monthly death benefit. Aside from that, she also expects to receive an amount of $19,600, as ordered by the Occupational Health and Safety Administration (OHSA). OSHA wrote to Mrs. Freemyer that Now or Never exhibited lapses in safety measures, which consequently caused his husband’s demise.

Freemyer had an existing ailment, a cardio vascular diseas, at the time of his death. Pinnacol Assurance used this reason in an attempt to deny him of his posthumous benefits. Nevertheless, the judge took into consideration the testimony of Freemyer’s doctor. The doctor testified that his continuous exposure to toxic gasses caused his pre-existing heart ailment. The oil firm was already at fault to begin with.

Deplorable working conditions

Opening the hatches of oil tanks is extremely dangerous. Hydrocarbon chemicals escape through the top and are immediately ingested by workers. These chemicals often come in the form unseen gasses which make it difficult to know if anything is wrong. A low-oxygen environment exasperated the problem.

It was also reported in the case proceedings that Freemyer was wearing a filter respirator. However, it was revealed that the said respirator was not intended for low-oxygen environments. In other words, the respirator was a failure. There were also no efforts on the part of the company to hold training sessions (so that employees would know how to recognize hazard). Lastly, the company did not impose strict measures to address low-oxygen atmospheres.

Related: Oil Gauging: Dangerous Work and One Man’s Posthumous Benefits

The importance of this case

This case highlights the reality of oil field workers who risk their health for their job. Freemyer’s widow said that she wished she could’ve known more about the pitfalls of working at an oil field. This case sends a strong message to oil companies that they should keep up with safety standards. Freemyer died due to the company’s neglectful practices and was awarded posthumous benefits. Similar cases can follow suit. This event has also garnered wide media coverage and consequently, has gained the public’s much needed attention.

Contact a Denver workers compensation lawyers for similar issues

A Denver and Greeley workers compensation attorney can enlighten employees about this matter. Before he died, Freemyer was already working under duress. An injustice has been done but went unnoticed—until his tragic death. Don’t let the same happen to you. At this point, you need to know your rights to a safe working environment. No one can explain it better to you than an experienced workers compensation lawyer from Kaplan Morrell. For decades, we have helped hundreds of Colorado workers. Contact us today for a FREE CONSULTATION.

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

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

Denver Disability Denver Workers Compensation Social Security Blog Workers Compensation Blog

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 at(866) 356-9898 for your free consultation.


Claiming Workers’ Compensation Even in Events Considered as “Acts of God”

Claiming Workers’ Compensation Even in Events Considered as “Acts of God”

Denver Disability Denver Workers Compensation Social Security Blog Workers Compensation Blog

Employers in Colorado are required by law to maintain an insurance policy for their workers in case of injuries sustained on the job. This is great news for employees, especially those who work in difficult and hazardous jobs.

However, just because your employer has an insurance policy does not mean that you are completely protected and will be properly compensated when you get caught in an accident. Without a Denver workers’ compensation attorney, there is one thing that insurance companies will tell you they will not cover, and those are incidents considered as “acts of god.”

What are acts of god?

Acts of god have become an umbrella term for unavoidable events of nature such as natural disasters or extreme weather events like flashfloods, earthquakes, tornados, and hurricanes. Another term for this is force majeure, which is French for “superior force.”

Insurance companies often claim that they do not have any mutual obligation when something out of control happens to an employee. In other words, they do not have to pay for injuries or damages caused by acts of god. After all, no one can be held responsible for volcanic eruptions or storm surges.

So when your insurance company tells you that the accident that happened to you at work is an act of god, does that mean that you have no say on the issue? Not if you have a Denver workers’ compensation lawyer who will have your back.

When is something NOT an act of god?

For example, you are working inside your office when a weak but palpable earthquake strikes and you get injured by falling debris. This should automatically mean that your insurance company should compensate you because you sustained an injury at work, right?

Wrong. Since an earthquake is an unforeseeable event, your insurance company can easily ease out of the situation and tell you that you do not qualify for any type of workers’ compensation even if you sustained an injury. End of story.

Related: Wrongfully Denied: How Insurance Companies Look Out for Themselves

Fortunately, having a competent Denver workers’ compensation attorney can help find a loophole even in this seemingly ironclad situation. No one might be responsible for the earthquake, but there might be someone who might be held accountable for the injury. This depends on the severity and foreseeability of the event, as well as the quality of your office building construction.

Hence, if the construction of the building is proven inadequate, then the injury cannot be considered as an act of god. Rather, it becomes an issue of a normal natural occurrence causing disproportional damage or injuries. In that case, the employer will be held responsible, and the insurance company cannot simply get off the hook and tell you that they cannot pay you for the physical damages you incurred.

As an employee, knowing your rights is important in claiming workers’ compensation. Having good counsel is also highly recommended, so that no insurance company can take advantage of you—with or without an act of god.

If you need more information or legal assistance, a Greeley workers compensation lawyer is readily available. Contact Kaplan Morrell today and talk to one of our Colorado workers compensation attorneys today.

Influential Pockets: The Story of Insurance Companies and County Prosecutors

Influential Pockets: The Story of Insurance Companies and County Prosecutors

Denver Disability Denver Workers Compensation Social Security Blog Workers Compensation Blog

A native of Odessa, Texas, Roy Kyees recently had a workers’ compensation case in that state. Unlike Denver workers compensation attorneys and Greeley workers compensation lawyers, in Travis County, Texas (Odessa is in this county), Texas Mutual Insurance Company has a deal with the Travis County District Attorney. At first blush, this is a decent deal intended to keep workers’ compensation fraud at a minimum and make workers’ compensation insurance affordable for the businesses in the area. If handled properly, of course the reduction of fraud and affordability of insurance are noble goals.

According to Tim Riley, the main investigator of fraud at Texas Mutual, the company simply pays back the prosecutor of Travis County when a fraud case comes up on the docket. Texas Mutual argues there is no conflict of interests because there isn’t enough interaction between the County prosecutor’s office and the fraud department at Texas Mutual. While two enterprising businesses could easily take advantage of such an exclusive relationship, in this case, the partnership is argued as shallow at best.

An investigation by the Texas Tribune, however, points out that the relationship may not be as simple as Texas Mutual would argue. Apparently, there are no written safeguards in terms of the procedure, not much awareness of the conditions of the contractual partnership, and questionable social media posts put on by the lead prosecutor of the insurance fraud unit. All things considered, a person couldn’t necessarily be accused of paranoia for finding this relationship between one of the biggest insurance providers in the state of Texas and a county prosecutor’s office a little too convenient.

Related: What are types of Colorado Workers’ Compensation Insurance?

Roy Kyees had a work injury in an Odessa, Texas, oil field. He’s worked in oil fields since he was 13 years old. Greeley workers compensation lawyers constantly have similar cases, as they are fairly common in areas with a good amount of oil production. The difference for Mr. Kyees was his resulting arrest, which was embarrassing to say the least, and the fight he had to put up to prove he wasn’t a criminal for reporting his work injury. He had to endure malicious prosecution and eventually settled, after winning the criminal case cooked up against him. As a result, Mr. Kyees is understandably untrusting of both the criminal justice system in his home county and the workers’ compensation program as a whole. He thinks the relationship is more of a partnership, with the prosecutors taking whatever the insurance company wants them to take.

In general, funding deals like these aren’t entirely unheard-of. Insurance companies often fund local prosecutors’ investigations of their fraud cases because with a touchy question like workers’ compensation, or any insurance claim, the insurance company’s first duty is to defend its insured. For workers’ compensation, this means the company purchasing the insurance. While an injured worker can be considered part of that company, generally, insurance companies look after their own interests and the interests of the employer. Technically, workers’ compensation can be considered a type of “no-fault” insurance so many of the traditional rules about insurance companies being vaguely antagonistic toward anyone trying to collect insurance money don’t apply. But the fact remains that generally, insurance companies don’t want to pay out on claims so it’s in their interest to find as many fraudulent claims from the claimant side as possible. When you file a workers’ compensation claim, you become the claimant.

Usually, insurance companies create a large pool from which prosecutors who specialize in workers’ compensation fraud can draw from. That way, no one insurance company is directly in control of the suits the prosecutor brings. This is the type of arrangement we have in Colorado, as well as Massachusetts and California. Even this kind of deal seems to create a tendency for courts to lean toward insurance companies’ interests against individual claimants.

A case like Roy Kyees’ may not have come up in Colorado because of the larger pool of insurers who contribute to the prosecutors’ fund. The obvious tendency toward insurer interests in courts seems clear, however, and serves to show how difficult it can be to enter the realm of workers’ compensation.

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.

What the Division of Workers’ Compensation Can Do Under APA

What the Division of Workers’ Compensation Can Do Under APA

Denver Disability Denver Workers Compensation Social Security Blog Workers Compensation Blog

Any workers compensation lawyer would tell you that you may have a great chance of claiming the benefits to which you are entitled to but not everyone would tell you how. You need to know how the game works because it is your name and life that are on the line.

What is the difference between the law and the rules? Some say that the law tells what a person can and cannot do while rules tell the manner of how to do it. The Administrative Procedures Act or APA delineates certain actions that agencies should follow in interpreting the laws which the Colorado legislature has written. The APA also describes in detail the powers of the Division of Workers’ Compensation. In relation to this, every Greeley disability attorney follows whatever is provided under the APA to ensure a speedy and organized hearing of cases. 

Powers of the Division of Workers’ Compensation

  1. Rule-making

The Division has the power to make rules. However, it cannot write whatever rule it pleases. It has to conduct its rule-making proceedings under the APA. The process begins with a public announcement as to the interest of writing a new rule. Thereafter, the agency should ask individuals to participate in a representative group of participants. The members of this group should be representatives of various organizations or groups with stakeholder interest on the topic of the intended rule. They should be the ones who will be affected, whether positive or negative, by the proposed rules.

Should the secretary of the state require, a draft of the proposed rule or amendment to an existing rule accompanied with a statement as to such proposal shall be filed with the secretary. This may oftentimes be requested to come with a cost-benefit analysis.

Once the representative group is complete, a public hearing will be conducted where these representatives may participate. The final proposal will be reviewed by the agency. Such will be published and will take effect 20 days after publication.

  1. Licensing

The Division can also issue, revoke, suspend, annul, limit or modify a license of an employer. However, there are two requirements that must be satisfied before agency proceedings may be instituted against the employer. First, there must be a notice in writing. The notice shall contain all the relevant and objective facts or conduct that may warrant any administrative sanction. Relevant documents shall be attached to such notice as well. Second, the licensee must have been afforded a reasonable opportunity to comply with all the legal requirements which its business failed to satisfy.

  1. Hearings and determinations

The Division may be tasked to hear a workers’ compensation claim once in a while. It shall send notices of hearing to concerned parties. Each notice of hearing shall contain the time, place, nature of hearing, and the legal authority which has jurisdiction over the hearing.

Any person who receives a notice shall file a written answer 30 days after such notice has been served or mailed. Failure to answer is a ground for default.

Read More: Denver Worker Denied Re-Opened Case

Every decision of the Division shall include a statement of findings and conclusions on the material facts and issues presented.

A good workers compensation lawyer can guide you in all your claims and dealings with the Division of Workers’ Compensation.

Workers’ Compensation can be arduous, confusing, and complicated. 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.

Paying Providers More May Help Workers Recover Faster

Paying Providers More May Help Workers Recover Faster

Denver Disability Denver Workers Compensation Social Security Blog Workers Compensation Blog

It’s old news that workers’ compensation systems differ between states. Everything from compensation amounts for missing limbs to the amount of choice workers have for their doctors can be different between Colorado and, for example, New Mexico. That’s why it’s so important for a disabled worker in Denver to seek out a Denver disability attorney or Denver disability lawyer for his or her disability claim.

Recently, some state workers’ compensation systems are increasing the incentive for doctors to see and provide treatment for injured workers in a timely manner. This incentive can manifest in a number of ways, from the dollar amount workers’ compensation systems are willing to pay out to providers to the amount of visits workers are allowed for physical therapy after the primary treatment has occurred. In North Carolina, provider reimbursements will increase in July in an attempt to reduce treatment delays and allow injured workers to recover sooner.

Related: Would’a, Should’a, Could’a Doesn’t Matter When it Comes to Health Insurance

Delaying treatment, as any Denver disability lawyer worth his or her degree will tell you, can often prolong a workers’ compensation claim and force workers to suffer through their injuries while increasing frustration with the entire system. Under the new rule in North Carolina, the largest amount a professional service can be billed for will be between 40 and 95 percent more than current base amounts for Medicare. Before this increase, the fee schedule was based on the reimbursement rates for Medicare outlined in 1995.

This step taking effect in North Carolina and potentially in Arizona is a grand leap forward for insuring workers receive treatment in as timely a manner as possible and helping injured workers get back to work sooner. Other states considering similar increases include Florida, Montana, Indiana, South Carolina, Utah, Virginia, and New Hampshire. Increases in reimbursement for providers is of course not the only factor that influences access to care for injured workers. Choice of provider, especially in rural areas, is an enormous factor, in addition to how familiar given providers are with the mass of paperwork workers’ compensation entails.

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.


Steps to Take When Workers Compensation Claim is Denied

Steps to Take When Workers Compensation Claim is Denied

Denver Disability Denver Workers Compensation Social Security Blog Workers Compensation Blog

Most often than not, legitimate workers’ compensation claims are denied. However, this is not the end of the line. A competitive and highly knowledgeable Denver workers compensation attorney can help bring your case to the next stage of the fight.

Reasons for Denial

Insurance companies are usually mandated to deny claims for a variety of reasons. When your claim gets denied, you need to know why and you need to know that there is always a thing that can be done after a denial. Some of the most common reasons employers and insurance companies use for denials are:

  • the employee is off-the-work when the injury-causing event occurred,
  • the injury is not sever enough or not disabling,
  • the injury is the result of a pre-existing condition and not aggravated by the work,
  • the employee failed to report the injury within four (4) days, or
  • the employee submitted incomplete medical records.

Next steps after a workers’ compensation claim is denied

As early as possible, acquire the services of a Denver workers’ compensation lawyer. In case your claim was denied prior to having a lawyer by your side, after denial is the best time to get one.

When denied, your next step involves filing an application for hearing and appearing before an administrative law judge. At this stage, both parties to the case will present medical evidence and circumstances in relation to the injury. Specifically, the following will take place:

1. Office of Administrative Courts Hearing

The administrative law judge in this stage will rule whether your claim needs to be appealed or you are entitled to a different kind of benefit. You must apply or request for this before a hearing can take place.

2. Prehearing conference

Before the actual appellate hearing, you will be required to sit with your employer or its insurer to amicably settle the claim. This dispute resolution will be facilitated by the Colorado Division of Workers’ Compensation. No trial will be held during amicable settlements.

3. Petition for Review

Should your claim be denied in the hearing with the administrative law judge, you are required to file an appeal through Petition for Review within 20 days from such decision. After filing, the same judge may modify the decision or may send the case to the Industrial Claim Appeals Panel.

4. Court Appeals

Whichever party will be denied by the Industrial Appeals Panel may further appeal with the Colorado Court of Appeals and the Colorado Supreme Court after that.

Related: Taxes and Your Disability Benefits Part II: Supplemental Security Income

Why you need a Denver workers compensation attorney

Claiming workers’ compensation involves a complicated process and is very stressful. A workers’ compensation lawyer can help walk you through the whole process. A Denver workers compensation attorney can assist you with:

  • extensively studying the circumstances surrounding your injury,
  • developing a strategy to pursue your claim,
  • filing a claim on your behalf, and
  • recommending to you the best course of the claim.

In case third parties are involved in your case, a Denver workers compensation attorney can help you recover from your employer and the other parties.

Kaplan Morell understands your concern and has helped thousands in claiming the compensation due to them. We are the Denver and Greeley workers compensation lawyer to contact. Call us at (866) 356-9898 for your FREE CONSULTATION.