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.

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 /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

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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 and get a FREE consultation.



Colorado Workers’ Rights to a Safe Working Environment

Colorado Workers’ Rights to a Safe Working Environment

Denver Disability Denver Workers Compensation Workers Compensation Blog

Naturally, some jobs may pose a threat to the safety of its workers. Common threats include physical dangers such as the risk of falling, or the hazards that may result from working with heavy machinery. More often than not, these risks are obvious. In the same sense, employees are usually aware of these hazards at the onset of work. However, there are also threats to the safety of employees which cannot always be seen, and therefore can be kept from their knowledge, like the hazards of exposure to toxic or unstable chemicals in the workplace. Unfortunately, although workers’ rights exist, many employees remain unaware. Read on as Denver Workers Compensation Attorneys Kaplan & Morrell explain how Colorado workers are entitled to safe place to do their jobs…

All employers are bound by law to inform their employees about their exposure to toxic chemicals in the workplace. Employers are also expected to have with them Material Safety Data Sheets which contain important detailed information about the chemical, how to properly deal with a particular substance, the risks to health resulting from exposure to the chemical, and standard protocols like first aid.

OSHA And The Lessons Workers Should Learn From A Superhero Movie

Likewise, proper warning labels and signage must be observed in the workplace, as with any product that could be a potential health hazard. Warning signs may be posted in areas where toxins are present but have poor ventilation, and warning labels are usually placed on packaging of toxic chemicals.

Non compliance of your employers with these legal requirements will subject them to higher authorities such as the Occupational Safety and Health Administration (OSHA). Any Colorado employee who contracts a disease or is injured in the workplace due to chemical exposure may file for workers’ compensation. Workers’ compensation is an insurance-based system for Colorado employees. It is a no-fault based system, meaning you will still be entitled to benefits even if the injury sustained was your own fault. Under workers’ compensation, an employee may avail of the following benefits:

Medical benefits – All medical expenses prescribed by the doctor will be covered by workers’ compensation.

Lost Wage benefits – workers’ compensation will replace a percentage of your salary during the period you were unable to work.

Disability benefits – disabilities incurred in the workplace will be categorized and you will be duly compensated.

Death benefits – death benefits include funeral and burial expenses as well as financial support for the families affected by the deceased’s lost wages.

Denver Workers Compensation Resources You Should Know

Colorado workers have the right to a safe working environment, and you have a right to just compensation. If you believe that your health may have been compromised, it would be best to talk to experienced and capable Colorado Workers Compensation Attorneys  about your rights and claiming your benefits. Kaplan Morrell attorneys have been helping Colorado workers for almost two decades now. Call us at 866 356 9898 for a FREE CONSULTATION.

Medical Marijuana & Colorado Workers Compensation Law: Three Things to Know

Workers Compensation Blog

Colorado Voters approved the decriminalization of Marijuana for medical purposes in 2000.   Under this amendment to the Colorado Constitution, individuals can follow a procedure to have a physician “recommend” medical marijuana in order to obtain a Medical Marijuana License for a “debilitating medical condition” defined broadly to include conditions include “severe pain” and “severe nausea.”

It has taken over a decade the issue to begin having ripples in Workers Compensation but there are three important things you should know:


The Medical Marijuana Amendment provides that “Nothing in this section shall require any employer to accommodate the medical use of marijuana in any work place.”  Thus far – at least in the Unemployment Claims context – the Courts are interpreting this to include even presence of marijuana in the bloodstream.  So long as the employer communicates and enforces a zero tolerance policy for testing positive for marijuana – then such workers will be denied unemployment.

As of April 2012 – there are no Colorado Court of Appeals or Colorado Supreme Court decisions deciding whether other employment protections may provide protection.


Workers Compensation carrier typically point to Section 10(a), “No governmental, private, or any other health insurance provider shall be required to be liable for any claim for reimbursement for the medical use of marijuana.”  Although there are rare individual cases where insurance carriers have voluntarily agreed to reimburse an injured worker – in lieu of paying for more costly narcotics – there has not yet been a case where al Administrative Law Judge has ordered such a benefit and been affirmed or reversed on appeal.

At some point – we expect a case to make its way through the system so that we can have some guidance on this issue.

Despite the wording of the Amendment, it may not apply to Workers’ Compensation Carriers since they do not sell “health” insurance.


Although it shields a person from prosecution for State and Local charges, the Federal Government has made it clear that it does not intend to be limited in pursuing Federal charges.  Most enforcement efforts have been focused on producers and sellers rather than the end user.

In Workers’ Compensation, expect the insurance carrier to seek the paperwork you provided the physician who wrote the recommendation for medical marijuana.  The carrier will hope you complained of pain in the same area you later injured at work, so that they can minimize the impact of your work injury.

It is not always easy to get workers’ compensation benefits, and if you have been – or are currently are – a medical marijuana patient in Colorado- you need the support and and experience of a Colorado workers compensation attorney immediately. Contact us here or call us at (866) 356-9898 for your free legal consultation.




Workers Compensation Deadlines

Workers Compensation Blog


This week we had two heartbreaking appointments with two injured workers who were devastated when we told them that their claims were closed.  Both of them were completely surprised, and each worker could could not have been more different.

Raul* has four years of schooling in Mexico.  He does not speak, read or write English beyond a basic level that he used for work in the construction industry. Raul injured his left knee and lower back and received lost wages, medical care, and a small impairment rating that was to be paid out in checks every two weeks until mid-August 2012.  He received a lot of papers from the insurance company.  Concerned he asked his brother to look at a paper.  His brother assured him that his case was still open and that he had until mid-August 2012 to decide whether to fight for more benefits.

His brother is not an attorney, and could not have been more mistaken.

Philip* has a College Degree and speaks, reads, and writes English fluently.  Working for a national shipping company, he experienced abdominal hernia and testicular problems.  He also received lost wages, medical care and an impairment rating.  He did not worry about his claim being closed because he was still going to the doctors and workers compensation was still paying for the treatment.

He was wrong.

Colorado Workers’ Compensation is a very complicated area of the law.  Often there are strict deadlines – some of which you are assumed to know – that once past – they can dramatically reduce your options and your benefits.  Even in cases where the carrier gives an injured worker notice of a deadline, often it is obscured and hidden in a very technical document.

What happened to Raul and Philip shows that it does not matter if you speak English, are highly educated, or can read your mail.  You can miss important deadlines without even knowing about it.  This is why we recommend that you consult with an attorney immediately.  Let the attorney worry about keeping your case open, helping you avoid complications and delays, and pursuing your benefits so that you can focus on getting better.  We always offer FREE NO OBLIGATION initial consultations.  When we can help we offer clients a contingent fee contract so that we do not collect attorney fees unless you prevail.

We help injured workers – even those whose cases may be closed – so please click HERE or call us at (866) 356-9898 to meet with us.

* We have changed the names to protect the privacy of our clients.

Nurses, CNAs and Workers Comp Claims

Workers Compensation Blog


“What happened?”

“Oh, it’s nothing. I just felt a little pull along my waistline when I was trying to reposition old Mr. Smithers.”

“You should probably report it to the Supervising Nurse.”

“Nah, it’s nothing. It’ll go away. I just started my job here and CNA’s are too easy to replace. I really need this job.”


How many times have you nurses and CNA’s heard this seemingly benign conversation take place on the job? Too many times to count no doubt, as little pulls, strains, aches and pains are part of the job in the medical field.

And how many times have you heard of, or experienced yourself, one of these ‘little’ bumps or strains turning into something bigger requiring medical attention? Again, probably more times than you can count.

Sure, you know you have a right to seek medical treatment and have the charges paid through workman’s compensation insurance, but maybe you hesitate to use the work comp insurance because you’re afraid of losing your job. What you might not know is that it is against the law for an employer to terminate an employee simply because they filed a work comp claim.

Nurses and CNA’s are particularly susceptible to work place injuries by the very nature of the job. You wouldn’t hesitate to report a needle prick because you know the possibility of long term consequences and it can be devastating. But a simple back strain (from lifting or pushing a patient) or a knee contusion (from slipping in the shower while helping your patient) can also cause long term, medical disorders. These types of injuries start as inconsequential, but very often become years long battles toward full recovery. The monetary costs can be enormous.

If you decided not to report your injury and a few weeks down the road you realize that this time your symptoms worsened, your claim will be questioned and possibly denied. The treatment costs and the lost wages could all fall on you.

Medical industry employers understand that workplace injuries occur. They will not be surprised when you do need to seek medical treatment for an on-the-job injury. Even so, the workman’s compensation administrator, an employee of the company, will try to lessen the employer’s workman’s comp rating (that determines the cost of their insurance coverage) by avoiding as many claims as possible.

If you feel you have been wrongly swayed against filing a workman’s compensation claim, you can get legal advice from Denver workers comp legal firm Kaplan Morrell. Remember, your own health and well being must be protected so that you can continue with your job duties. You chose the nursing profession because of your nurturing, selfless character. But you don’t want to take yourself out of the running by risking long term health issues because you did not (timely) report a work place injury.

Hopefully all of the endless safety training meetings have come in handy and have helped you avoid injuries. But in case the unexpected happens and you do experience a mishap on the job, know that workman’s compensation insurance is there for you.

Kaplan Morrell is available to answer all your workman’s compensation questions. Call (866) 356-9898 today to learn more about your rights as a medical worker or fill out the form below and we’ll set up a FREE workers compensation claim.

Getting Help for the Most Common Workers Compensation Injuries

Workers Compensation Blog

Last year, several thousand employees were hurt on the job in Colorado.  One employee in particular fell out of the back of a work truck and injured their back and has been working to get his spine repaired for the last year.  Other employees have suffered head injuries, debilitating illness or even death on the job.  Whether you work at a desk eight hours a day, or you are working in the oil fields, you are at risk to being injured and you have a right to workers compensation funds.

It is difficult to pinpoint exactly what the most common workplace hazards are, but according to the Bureau of Labor Statistics, there are an average of around 4 million cases of nonfatal injuries and illnesses reported within the private sector each year.  Of these injuries and illnesses, more than one million involved workers missing days of work.

Sprains, strains, tears, back problems and falls are the most common type of injuries.  Sprains alone account for almost 50% of all workplace injuries.  Many times, an employee will twist their back or sprain their ankle on the job and simply take a few sick days and walk it off, handing the responsibility of the insurance company on their own.  This definitely doesn’t have to be the case.  On-the-job injuries are an all too common occurrence in Colorado and around the U.S. but there is a compensation system exists to provide you with medical care and compensation if you’re injured on the job.

Let’s say you’re at work, doing your job and you slip on a wet floor or an icy step and you fall flat on a concrete floor.  This type of injury might seem solved with an ice pack and a few sore muscles, but long-term consequences can be much worse.  Once you pay for the doctor, medication, lost work, etc., a simple fall can be financially detrimental.  Slips and falls can be some of the most debilitating on-the-job injuries so that’s why it’s important you obtain all of the workers’ compensation benefits you’re entitled to under the law.  According to the National Safety Council, slips and falls account for 20% of disabling injuries and are the leading cause of death in the workplace.   If you slip and fall on the job you’re entitled to compensation and an attorney is the answer to getting you the assistance you deserve.

Workers injured on the job in Colorado are protected by Colorado workers’ compensation benefits.  In the U.S., workers compensation benefits are different in each state.  It is important to have a professional on your side who understands the details of the Colorado system.   If you’ve been injured because of your boss, a co-worker, in your place of business or as a result of your job duties you may be entitled to collect Colorado workers compensation benefits.  The exact nature of the injury isn’t even necessarily important, just the fact that it occurred as a result of your job or your work environment is enough to bring added benefits your way.

It is not always easy to get immediately approved for workers’ compensation benefits. If you’ve been injured from any type of work you need the support of all of the Colorado workers compensation benefits that you are entitled to.  To get what you deserve, you need an experienced Colorado workers compensation attorney on your side immediately. Contact us here and get the benefits you deserve.