A century old, our Workers’ Compensation laws are a trade-off between employees and employers about on-the-job injuries. Employees do not have to take their employers to civil court, nor do they have to show their employers are at fault, to be compensated for injuries. But the benefits employees can recover for these injuries are be limited. Employers must offer medical care and prompt disability payments, but in some cases, those payments are only a safety net.
If you have been injured on the job, there are three principal kinds of benefits available to you under the Colorado Workers’ Compensation system: medical benefits, temporary disability benefits, and permanent disability benefits. (Disfigurement benefits are also available but are very limited.) Typically, these benefits will be handled and paid by the employer’s Workers’ Compensation insurance company.
- Your medical treatment
Your employer is required to provide you with necessary medical care for your injury. But your employer is generally entitled to choose which doctors will provide that care. If you are injured, your employer (or, more likely, your employer’s insurance company) will probably send you to a specific doctor, or give you a choice from a limited number of doctors. But if you see a doctor other than one chosen by the employer or its insurer, they may not be required to pay for that doctor’s care.
For this and other reasons, it is very important that you give your employer written notice as soon as possible after your injury, and keep a copy. Even if you are certain your employer knows about your injury, if you give written notice, many later questions can be easily laid to rest. The notice can be as simple as a short letter to your supervisor or Human Resources department explaining when and how you got hurt.
If your employer or its insurance company sends you to a doctor, and you have concerns about that doctor’s care, you have the right to ask that your employer select a different doctor. But you can only make this request one time. An experienced attorney can help you decide whether to make this request.
- Wage loss benefits
If you must be off work for more than a few days because of your injury, your employer or its insurer must pay temporary disability benefits – payments that replace your wage loss. These benefits are paid out at a rate of only two-thirds of your average weekly wage, up to a maximum amount set by law. These benefits are not reduced for taxes. If you are able to return only to lower-paying or part-time work, temporary benefits are available to make up the difference between your reduced pay and your maximum benefit. Temporary benefits generally continue until you are able to return to full duty, or you are terminated from your job for a reason for which you are responsible, or your medical condition reaches a point called “maximum medical improvement.”
Maximum medical improvement is the point at which your condition is not likely to improve with further medical care. When your Workers’ Compensation doctor decides you have reached that point, he or she will also decide whether or not you have a permanent impairment. If your doctor believes that you do, you will receive a “rating” – a medical measurement of that impairment – and your employer or its insurance company will either agree to pay you a monetary benefit based on that measurement, or contest the rating.
- Permanent disability benefits
The monetary benefit you receive after your have reached maximum medical improvement is called a permanent disability award. In theory, this is meant to compensate you for your lost ability to earn a living by competing in the labor market with workers who are not disabled. In practice, the amount is determined by Colorado’s laws and regulations, by a system under which both you and your employer can challenge medical opinions, and by whatever agreement you are able to reach to settle your case.
In Colorado, when your employer or insurer agrees to pay you a permanent disability award, they will notify you on a form called a Final Admission of Liability. The form, usually pink, will be sent to you along with the medical documents on which the Final Admission is based, and other forms that allow you to object and to challenge the amount of benefits.
You have only thirty days to object. If you have any question about your Final Admission of Liability, or if you disagree with it, it is extremely important that you get legal advice as soon as possible. Once the thirty days have passed, your ability to challenge the result in your case will be severely limited.
- Other rights
You may contest any of the benefits that the employer or its insurance company extends to you or refuses to extend. This is normally done at a hearing before an Administrative Law Judge. But your doctor’s permanent disability rating, or his or her decision that you have in fact reached maximum medical improvement, must first be challenged through a process by which an independent physician reviews your case.
Your employer and its insurer may also be responsible for penalties if they do not comply with the workers’ compensation laws or specific orders of a judge.
If your employer and its insurer comply with the law, then medical care and temporary and permanent disability benefits are generally the only benefits for which you are eligible. You cannot, for example, sue your employer for pain and suffering or punitive damages. However, if a person or party other than your employer caused your injury, you may still be able to bring a lawsuit to recover other damages.