The Usual Suspects: Who is Who in the Workers’ Compensation System

Aug 22, 2014 | WC & Other Laws

When we talk with injured workers, we find that they are often confused about who is who and who is doing what.

The law requires your employer to purchase insurance for its employees who are injured on the job.  This is called workers’ compensation insurance. The law called the Workers’ Compensation Act governs what losses are – or are not – cover (and to what extent).

Usually the employer purchases this insurance through an insurance company or carrier.  There are several insurance companies now in Colorado such as Pinnacol Assurance, Travelers, CIGNA, and many others.  Some large companies are self-insured, which means that although they don’t buy insurance they are large enough and financially secure enough to be able to pay for all benefits ordered.  These large companies will typically hire another company (called a Third Party Administer) to handle the claim and pay the benefits.

Whether it is an insurance carrier or a self-insured employer there will be a person assigned to your case who will be responsible for paying (and denying) all benefits.  This person is the adjuster and he or she represents the carrier as well as the employer.  Together, the carrier and the employer are referred to as the Respondents.

The Division of Workers’ Compensation (DOWC) is part of the State of Colorado Government.  The DOWC is responsible for making sure that the law is followed, that the appropriate forms are used in documenting your injury, and receives all of the major paperwork from the carrier regarding your work injury.

When there are disputes as to the amount or type of benefits you should receive under the law, we will go before an Administrative Law Judge to decide the issue if we cannot come to an agreement beforehand.  This person will decide based on the arguments and evidence presented by both sides.

Just as you will have an attorney, the insurance carrier will have an attorney.  I will be dealing with the adjuster and the other attorney, not with your employer. Your employer is rarely directly involved in workers’ compensation cases.

Making sure you get all the benefits you are entitled to receive under the law is hard enough already.  When you are injured and under financial and medical hardship, it is even more difficult to know who is who, and how to get your benefits.    Get the support you need from attorneys helping injured workers get Colorado workers’ compensation benefits. Contact us here and get the benefits you deserve.