How Workers’ Compensation Carriers in Colorado Prey On Injured Workers

Denver Workers Compensation

How do attorneys tend to pitch their services…they tell potential clients that insurance carriers will take advantage of their knowledge of the system and the injured workers’ lack of knowing the system. There is no truer example of this than the following:

In CO, when an injured worker is assigned a psychological impairment that results from a work-related injury, their compensation benefits, typically, are limited to 12 weeks of the injured worker’s weekly wage loss benefits. For example, an injured worker who receives $500 per week in wage loss benefits and receives a 5% psych. impairment that equates to $15,000 in compensation benefits; is typically limited to $6000 [$500 x 12 weeks]. HOWEVER, THERE ARE 2 EXCEPTIONS TO THE RULE LIMITING THE INJURED WORKER’S COMPENSATION BENEFITS in this context.  One, which I will discuss herein, is that IF the psych. impairment results from a “crime of violence”, the limitation DOES NOT apply.  In other words, if the injured worker was assaulted at work, their compensation is not limited to 12 weeks.

So why do I feel compelled to write all of this? It certainly in dry and boring, but here is my point.  I had a client of mine who was assaulted at work.  The worker’s compensation carrier KNOWING THAT MY CLIENT WAS ASSAULTED limited her benefits to 12 weeks.  Because we are experts in workers’ compensation, we “corrected” the carrier’s lack of understanding (a kind way of stating that we didn’t let the carrier screw our client) and forced them to admit for the correct amount of benefits which yielded an additional $11,000.  Without our assistance, our client would never have known that they were getting taken advantage of and being stripped of the benefits they were entitled. THIS TYPE OF STUFF HAPPENS ALL OF THE TIME.  WHETHER YOU CONSIDER THIS A PITCH OR CONSIDER THIS A SERVICE ANNOUNCEMENT TO THE COMMUNITY,  KNOWLEDGE IS POWER; USE IT!

What to Do if Your Workers’ Compensation Case in Colorado is Denied

Denver Workers Compensation

In some cases, getting compensated in the aftermath of an injury might not be as easy as you initially anticipated. In the vast majority of circumstances, workplace injuries are covered by employers with worker’s compensation insurance. This doesn’t mean your claim will be accepted. If your case is denied, there are still some options and you have the power to appeal to the denial and try to reverse the outcome of the situation. Appeals happen through the state’s board of workers compensation – but before trying that route, it is important to understand why your particular case has been denied. To cover every possible scenario and to gain a better perspective of the situation, as well as your own rights, it might be wise to hire an attorney to consult and assist you through the process.

Specific regulations will vary from state to state, but there are many reasons why your worker’s comp claim could have been denied.

Perhaps, you did not report your injury on time. If you wait too long before reporting an injury, you might not receive any compensation. Some workers try to hide their injury, or ignore it, trying to soldier through it to avoid losing working hours and income. On the other hand, failing to attend an injury and rest might actually worsen the situation, and it might come back and haunt you at a later date. Some people experience symptoms of an injury only days after an accident, and if the event has not been reported promptly, they might risk not receiving anything. Even if it doesn’t seem serious at first, always report your injury and file your claim in a timely manner.

Some injuries, on the other hand, are simply not eligible for compensation. This is often the case of stress-related injuries, since the exact root of the problem is often very difficult to prove with transparency.

In certain cases, your comp claim could have been denied because your employer disputed the claim. Perhaps, claiming that the injury did not indeed happen at the work place, or that it was caused by horseplay on the injured part.

This article barely scratches the surfaces: there are many reasons why a comp claim could be denied, and if you think the decision is unfair in your case, consult an attorney and appeal for a chance of reversal.

What is the IWP and What Does it Do?

Denver Workers Compensation

IWP is an organization that focuses on delivering medicinals at the homes of injuries individuals. This is not exactly like your average mail-order pharmacy, as IWP’s service is particularly geared towards people who have experienced recent injuries. Read on to learn more about some of IWP’s most distinctive marks and perks.

 Fast turnaround and prompt assistance for people of all walks of life.

 When affected by injuries, immediate care is absolutely essential. This is the reason why IWP pledges to deliver prescriptions with an extremely fast turnaround. Normally, the service is able to deliver prescription meds within the span of 7 to 14 days, which is absolutely remarkable. At a small additional overcharge, customers can even request convenient next-day delivery, when immediate delivery is essential.

With locations spread throughout Massachusetts, Arizona and the state of California, IWP has a growing and effective infrastructure to cater to people throughout the country. IWP is committed to serving customers efficiently, regardless of their background. For this reason, the actually offer flexible language services through a dedicated customer services that can answer to requests in English, Spanish, Italian, Polish and many other languages and dialects. This way, IWP can ensure clarity and user-friendliness when serving customers of different cultural heritages – boasting the same excellent high standards for everyone.

Ultimately, this service is particularly perfect for people looking for prompt assistance and for a truly understanding relationship with a pharmacy.

For additional information, resources and know-how, please visit IWP’s official website:

www.iwpharmacy.com

How Your Work Injury Can Affect Your Home Life

Denver Workers Compensation

Getting injured could become the gateway to a wide range of issues, and the aftermath of an accident should never be taken lightly.

Injuries are scary to deal with. In some cases, the effects of an accident could have lasting impacts on your daily routine. Some people are stuck with post-injury symptoms that they need to deal with for the rest of their lives, including chronic pain, arthritis and more. In some cases, pain can be managed with the help of physical therapy, painkillers or alternative solutions such as acupuncture. On the other hand, certain injuries could deeply affect the lifestyle of an individual’s home life. In some unfortunate scenarios, people affected by injuries might no longer continue with their works – this is particularly common in fields such as athletics, where people who get injured might sometime be unable to keep pursing their sport professionally.

The aftermath of an accident, particularly when it debilitates people and impairs their ability to work and provide for themselves, could cause a wide variety of collateral mental symptoms, such as stress, depression or anxiety. In a vicious circle of irony and damage, such mental issues, could in turn cause yet another layer of physical ailments, including high blood pressure and cardiac problems. An injury should not be taken likely, as it can be a gateway to a wide variety of problems that might affect you in ways you can’t even imagine. It’s a great idea to stay positive and promptly focus on recovering, but it is also important to fight for a compensation, when possible. Hiring an attorney could help your voice be heard and give you a better chance of a fair treatment.

Gerard Smith Q/A – Dealing with the Aftermaths of a Sporting Injury

Denver Workers Compensation

Many athletes throughout the world struggle to deal with the aftermath of a sporting injury. Not only is recovery daunting for an athlete, but it might pose an entire career at risk. In addition to that, getting compensated for an injury might be quite difficult in certain circumstances. In order to learn more about the process, please read on to learn about Gerard Smith, an athlete who agreed to talk to us provided we altered his name (yes, Gerard Smith is indeed an alias) and avoid to disclose the true nature of his sportsmanship and athletic affiliation.

Gerard took the time to answer a few of our questions and let us known about his stories, feelings and thought related to an injury he experienced some time ago. For legal reasons, Gerard is not really at liberty to discuss his case or divulge actual personal information, but his answers certainly shed some light on some issues that many athletes across the world can easily relate to. Please read on to find out more.

Q: You recently fell victim of a sporting injury. What was the most challenging aspect of the aftermath of that particular event?

 A: One of the most challenging aspects of the injury was the uncertainty that came after it. To this day, I still don’t know when, and whether I will recover fully. The situation is causing me financial loss, as well as other personal issues such as low morale. To make things worse, getting the right compensation for my injury, which was due to a third party’s negligence, was actually harder than I had anticipated.

Q: How did your injury affect your career?

A: As i mentioned earlier, the injury put a lot of uncertainty on my career. it is scary to think you might need to stop doing what you do for a long time, or worse of all, that you might never fully recover.

Q: What would you say to fellow athletes who might go through the same thing you had to endure, and what advice would you give them?

A: First and foremost, stay strong and set your priority straight. Seek legal help as soon as you can and have a clear view of your options. Your physical recovery is obviously going to be your first priority, but if you deserve compensation, don’t let it slide and even if you think the scales would tip in your favor, always hire an attorney, if only for peace of mind.

Thank you for your time and your thoughtful answers. We wish you all the best with your recovery and we’re sure you’ll be up and ready to hit the game soon!

Pinnacol Privatizing: Insurer of Last Resort for Multiple States?

Pinnacol Privatizing: Insurer of Last Resort for Multiple States?

Workers Compensation Blog

 

In the current political climate, it’s important to pay attention to more than just the presidential race. While that certainly calls the most attention to itself in terms of politicizing and polarizing people, other measures on the ballot and future legislation can affect Colorado voters significantly. Specifically, Denver workers compensation lawyers are looking at Pinnacol Assurance, which released proposed language for a law that would let it sell workers’ compensation policies outside the state of Colorado.

Greeley workers compensation lawyers will probably be the first to tell you that Pinnacol, as a state-chartered workers’ compensation insurer, is required to offer some level of workers’ compensation insurance to almost all companies. That means it’s probably the biggest insurance company and covers workers all over the spectrum of fields. Pinnacol could cover anything from construction companies to startups that just barely reach the minimum amount of employees after which a company is required to carry workers’ compensation insurance.

In December of 2015, Pinnacol announced that it planned to submit a proposal that would form a new company to sell workers’ compensation coverage in other states. Since state laws differ as they relate to workers’ compensation, this is a bold and almost unheard-of move for the Colorado workers’ compensation insurer of last resort. Pinnacol is, in fact, considered a state “political subdivision” so no matter what this change does, it cannot privatize Pinnacol.

Part of the reasoning behind Pinnacol’s move to provide workers’ compensation to states outside of Colorado is that other workers’ compensation insurers sell insurance in multiple states. Pinnacol policyholders, like companies that utilize Pinnacol but have multiple locations, had to have multiple insurance companies depending on the state. Pinnacol argues that this drove away business and kept the company from realizing its full potential.

The full language of the proposed legislation is on Pinnacol’s website. In 2012, the company tried and failed to privatize. Pinnacol says this new bill doesn’t call for privatization—simply the creation of a private subsidiary of Pinnacol. The distinction, it argues, is important.

Part of the worry about privatizing Pinnacol is that it will fundamentally change the way workers’ compensation insurance in Colorado is offered and available to the majority of people. Denver workers’ compensation attorneys often negotiate with Pinnacol to get injured workers the care they require. The insurance company pays for medical treatment, which is necessary because of work injuries. Pinnacol argues that the change would allow it to stay competitive and innovative. Many other private workers’ compensation companies sell insurance across state lines but Pinnacol is the best insurance at what it currently does.

Workers’ compensation is part of the worker safety net people don’t realize they need until it’s too late. When representing themselves at the polls, those who work and those who don’t should consider as many different aspects of themselves as possible. This means thinking ahead to the possibility of needing workers’ compensation insurance even if they don’t believe it’s likely that they’ll ever need the insurance.

If Pinnacol spreads itself too thin, there is a very real possibility that it will no longer be able to provide workers’ compensation insurance for so many companies at such a low cost. Business concerns aside, insurance companies exist to safeguard the people who buy insurance. In the case of workers’ compensation and Pinnacol, Pinnacol owes a responsibility to the businesses it insures and the workers who are injured and need medical care.

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.
Source: http://www.businessinsurance.com/article/20160217/NEWS08/160219837/comp-insurer-looks-to-sell-policies-outside-state-lines?tags=%7C70%7C92%7C304

Top Ten Most Costly Work Injuries Of 2016

Top Ten Most Costly Work Injuries Of 2016

Denver Workers Compensation Workers Compensation Blog

The Liberty Mutual Research Institute revealed 2016’s top ten causes of the most costly work injuries.

Here they are:

1. Overexertion involving outside sources. $13.79 Billion (Examples include lifting, pushing, pulling objects.)

2. Falls on the same level. $10.62 Billion (Slip and falls on slippery surfaces)

3. Falls to a lower level.  $5.50 Billion (Scaffold, ladder, stair falls)

4. Struck by Object or Equipment. $4.43 Billion

5. Other Exertions or Bodily Reactions. $6.5 Billion

6. Roadway incidents involving motorized vehicles.  $3.7 Billion

7.  Slip or trip without fall.  $3.8 Billion

8. Caught in/Compressed by Equipment or Objects. $1.95 Billion

9.  Struck against object or equipment.  $1.94 Billion

10. Repetitive Motions involving micro-tasks. $1.81 Billion.

Some work injuries cost more because of the nature of the injury.  Injuries requiring surgery will be more costly, not simply because of the medical care, but also because of the additional lost time during the recovery.  Injuries from lifting, in this study, may be more costly simply because those kinds of injuries are more common and numerous.  The injuries in this study included only those injuries where the employee missed six or more days of work.

When you’ve been injured on the job in Colorado, your primary concern is getting healed and back to your life. For the vast majority of injured workers that happens, but some workers sustain serious injuries that continue to interfere with their lives.  We’re here to help seriously injured works get the medical care and the Colorado Workers’ Comp benefits they deserve.  Don’t wonder, “What are my rights under Colorado Workers Compensation?”  Instead, call us and meet with an experienced Denver Workers’ Compensation attorney for a free consultation. Let us help with filing your Colorado Workers’ Comp claim- we can help get it approved.

 

 

 

Source:  http://imag e.email-libe rtymutual.com/lib/fe541570726d02757312/m/1 /2017+WSI.pdf

Case Update: If The Insurance Carrier Shuts Off My Lost Wage Benefits – Can I Get Penalties?

Case Update: If The Insurance Carrier Shuts Off My Lost Wage Benefits – Can I Get Penalties?

Denver Disability Denver Workers Compensation

MacDougal v. ICAO, Bridgestone Retail Tire Operations

The Court of Appeals put out an (unpublished) opinion affirming the denial of penalties against an adjuster for failing to reinstate lost wage benefits (TTD). On February 6, 2015, a Physician’s Assistant (PA) – not the actual Authorized Treating Physician – placed the injured worker at maximum medical improvement (MMI) and removed all restrictions – effectively clearing the worker for regular duty. However the section for permanent impairment was left blank..

The Insurance Carrier filed a Final Admission admitting to zero impairment that day. However eleven days later, on advice of counsel, the adjuster filed a General Admission of Liability (GAL). The GAL did not reinstate TTD benefits – relying on the PA’s release to regular duty.

On February 23, 2015 the Authorized Treating Physician (ATP) wrote a letter raising concerns about the PA’s medical note and noted that the injured worker would need permanent restrictions and an impairment rating. Because the ATP did not rescind the PA’s release to regular duty – the carrier did not reinstate TTD Benefits. When the ATP saw the injured worker in April, he placed the injured worker at MMI and impairment. (It’s unclear if the ATP provided permanent restrictions.)

The injured worker sought penalties against the carrier’s refusal to reinstate TTD benefits. The Administrative Law Judge determined that while the Final Admission was invalid because there was ambiguity of what, if any, impairment the injured worker had – the release to regular duty was not vague. Further, the ATP’s letter of concern did not expressly impose restrictions or retract the release to regular duty.

Given that confusion, the Court of Appeals agreed that claimant had failed to show that the adjuster acted unreasonably.

Work injury claims in Colorado are complex and fast paced. Don’t make the mistake of thinking you don’t need an experienced fighter in your corner. With everything there is to worry about when you suffer an on-the-job injury – let us make sure you are getting the benefits the law provides you. Get a free consultation on your workers compensation case here.

Case: MacDougal v. ICAO, Bridgestone Retail Tire Operations, 16CA0705 (Colo. App. 2016)

Worker’s Compensation Fraud 101

Worker’s Compensation Fraud 101

Denver Workers Compensation Workers Compensation Blog

 

Workers’ compensation entitles employees to certain financial assistance when they experience job-related injuries or health problems. However, some people take advantage of this system by falsifying the compensation claims for personal gain or for the benefit of another party.

While a Denver workers’ compensation lawyer can help you with your claim, it is still important for you to be able to recognize and identify possible false information in compensation claims to avoid being a victim of fraud.

Defining Workers’ Compensation Fraud

When an individual makes false statements or representation regarding important details in a worker’s compensation claim, he or she can be charged with workers’ compensation fraud. In Colorado, this is considered as a serious criminal offense that is punishable by up to 3 years of imprisonment, $100,000 in fines, community service and a permanent criminal record.

It’s important to note that compensation fraud does not only take place when the claimants fake and exaggerate their condition. Sometimes, the employer or a third party can misreport information in a claim. Whether the wrong information is a result of an honest mistake or is done intentionally, it could lead to workers or claimants being falsely accused of fraud, risking their chance of acquiring the benefits.

Common Types of Workers’ Compensation Fraud

The whole process of claiming workers’ compensation involves more than just the employer and the employee. It also includes health service providers, claim adjusters, and workers compensation lawyers. Compensation fraud can be committed by any of these parties.

Workers’ compensation fraud by applicant or claimant

This can include a worker exaggerating symptoms or an injury, making multiple claims possibly under multiple identities, claiming injuries that did not happen or were obtained outside of work, and failing to report secondary jobs and additional income.

Workers’ compensation fraud by the employer

It involves intentionally falsifying information to avoid compensating the employee for the injury, lying to prevent a worker from filing the claim, and misclassifying employees and under-reporting payroll for lower premiums.

Workers’ compensation fraud by the adjuster

This includes insurance adjusters tampering with paperwork to account for the denial of a claim or accepting payment in exchange for referrals to certain healthcare providers.

Workers’ compensation fraud by the provider

This can entail health care providers overbilling the services provided, billing for treatment or services that were never provided, or performing tests or treatment that are unnecessary to earn more money.

Workers’ compensation fraud by the attorney or lawyer

This can involve lawyers soliciting or helping an employee in filing false compensation claims. If you have an attorney that is filing false claims on your behalf, you need to find a new attorney to represent you and your case!

Related: Top 10 Workers Compensation Fraud Cases of 2014

Workers’ compensation fraud does not only cost companies huge amount of money; it could also result to legitimate claims being delayed or not being paid out properly. If you’ve been injured, you need to have a Denver workers compensation lawyer on your side. Our experienced lawyers, who have a comprehensive and thorough understanding of the workers’ compensation law, as well as the different issues and obstacles related to it, can help you file your claim properly. To learn more about workers compensation fraud and other workers compensation issues, consult with a Denver workers compensation attorney today for FREE.

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 experienced workers’ compensation attorneys here or call us at 866-356-9898 for your free consultation.

 

 

Denver Workers Comp Lawyer Mike Kaplan Explain Safety Rule Violations

Denver Disability Denver Workers Compensation Social Security Blog Workers Compensation Blog

There are 3 things that an insurance company has to prove when they accuse an injured worker of violating a safety rule after a work injury. Learn more about safety rules and workers compensation from Denver Workers Compensation Lawyer Michael Kaplan.

If you’ve been injured on the job in the Northern Colorado area, you need an attorney experienced with dealing with insurance companies who will try to avoid paying out benefits at all costs. Learn more at www.kaplanmorrell.com and get a FREE consultation.