I received a comment on this from someone and I thought it deserved a posting on this Blog. First any impairment rating may or may not be correct. Any of the parties may be able to dispute the rating or number and this often happens for the claimant. Do not take the first impairment rating as the end of the story. It is often wrong and even a medical opinion you are at maximum medical improvement can be wrong. When you receive a rating consider questioning it (legally this is an involved process and best done by your attorney). In any event let's say that the rating you receive is a high one. Let's also assume you are not permanently and totally disabled (if you might think you are get with an attorney right away). Lastly let's assume it is truly a whole person rating as certain injuries are not. Even then if you receive say a valid 20% whole person impairment rating what is it worth? Believe it or not there are other variables to consider. There is an age variable. There is a variable for your wage. The lower your age the higher the worth of the impairment. The higher your wage the higher the worth of the impairment. These variables make it essential that the calculation be performed on a case by case basis. One person may get $1000 for every one percent whole person and another $4000 for each percent or even more. Colorado also puts limits or caps on how much you can get so there simply is no easy answer here. Finally if the insurer agrees with the rating they will file a Final Admission often seeking to close the case. Please realize you must also consider your future medical needs. Insurers will try to limit all benefits so take any Final Admission as an effort to end your claim or at least greatly restrict it. This means any Final Admission requires a very careful analysis to protect your interests. Do not accept it at face value without doing so. We almost always object to Final Admissions and take timely and appropriate legal action to advance the cause of the claimant.
I previously posted on some statutory changes but overlooked one which on a second look seems pretty significant. This is stated effective for claims filed on or after August 5, 2009. SB 09-168 amends Colorado Revised Statutes 8-43-201 on hearings to say that the party seeking to modify an admission or order has the burden of proof when it wants to modify it. The best example of this is that under current law the Respondents can come in at a hearing and assert compensability (that is question coverage even after they admitted the claim). Common sense says fine but it should be their burden to prove it after they admitted the original injury was on the job. Well under the current law it was always the claimants burden when the other side raised this issue. Having the burden could mean that in a close call situation the claimant months later could lose his entire case. You can bet Respondents knew this and used it to their advantage at times. Now the law is that it becomes a Respondent burden. A Judge can now be permitted to question the other side's reasons so claimants have a bit more law on their side now. Click here to see the law changes.
Just posted over at the Division of Workers Compensation website is a chart that sets forth the top dollars paid out on benefits. For example, the most you can receive in weekly temporary benefits is $807.24 and that only happens if you were making $1210.86 a week in wages or more. Few injured workers ever will be paid at that rate and if not they can be paid 2/3rds of what is determined to be their average weekly wage. Historically you do not pay taxes on the standard workers comp benefits so 2/3rds is close to your take home pay when you cannot return to work. Of course to obtain any benefits they must admit you were hurt on the job and are entitled to temporary total benefits. If your case is contested then as long as it is you are not paid such benefits. Moreover even if you are entitled to temporary benefits they will adjust them if they have you working part time. There are rules on all this but this post just lets you see what the top dollar figures can be. The rates are set each year and made effective every July 1st.
Here, from the Division of Workers Compensation website is an overview of recent Colorado legislation that affects injured workers, doctors, insurers and even Pinnacol Assurance (the largest quasi-public/private insurer in workers comp in Colorado. Also if you click here you can read the actual legislative changes. I notice that some of these legislative changes are because of cases that went against claimants. For example there is a change to allow psych impairments so as to get over the first statutory cap (yes there are caps limiting benefits). Another avoids the Division IME being attacked for not contacting the authorized treating physician so long as he has resolved certain differences with other doctors. These items have been ways for claimants not to receive adequate benefits. They allowed the other side to attack the claimants Division IME rating by saying the doctor did not contact some other doctor so his opinion could be overcome as not following the procedure in the AMA Guides. In another case the rating was kept under 25% and did not go higher because a psych rating was not added to make the rating higher. The difference can be many thousands of dollars. In any event the legislative changes are, by and large, helpful to claimants. Also Pinnacol has been in the news recently when it disputed the state effort to use some of its excess reserves towards the state budget. As I noted earlier Pinnacol is a hybrid mix of public and private elements. The state is going to seek more control over Pinnacol and some of this recent legislation seems to be setting up to do that. Lastly one change does seem unusual. An insurer IME must now be audio recorded which suggests that some of these IME's were misrepresenting what the claimant was saying during the examination. Regretably such matters often were so hostile that it led to making it mandatory to record the exam. These law changes are effective on different dates as indicated in the overview.
If you are interested in what the Division of Workers Compensation says is its guidance for adjuster's handling workers comp claims then click here for the guide. It may provide some insight for all of us. It gives us a basic understanding of the duties of the insurer. Many subjects are discussed and can help explain why a form has been filed and what are some of the deadlines. If the insurer or adjuster is taking some action or filing something you might want to check here for a better understanding of what and why it is taking place. Of course there is also a guide for employees which is also extremely useful in understanding the workers compensation claim process.
"...this is the cause of my life, new hope that we will break the old gridlock and guarantee that every American -- north, south, east, west, young, old -- will have decent, quality health care as a fundamental right and not a privilege." Ted Kennedy Aug 26, 2008 (Update: June 28, 2012 the US Supreme Court upholds Obamacare)
Do We Pass the Test?
"It was once said that the moral test of government is how that government treats those who are in the dawn of life, the children; those who are in the twilight of life, the aged; and those who are in the shadows of life, the sick, the needy and the handicapped."
I've been living in beautiful Colorado and practicing law for over 35 years. It's been a great place to raise a family. Originally from New York I settled here, married here and raised two daughters, Jenny and Mary. I practiced near downtown Colorado Springs but now consider myself "retired" so I am not taking any more legal matters, clients or cases but I appreciate being able to help as many clients as I could for so many years. Now I especially enjoy my retirement time with family including 4 special ones...a grandson, Max, twin granddaughters, Penny and Cici and last but not least grandson Eliot. You can contact me at my email address which is email@example.com.
In the past we offered free consultations in cases but we are not taking any more legal matters or cases as retirement calls. You can email us at firstname.lastname@example.org. We've been protecting injured workers for many years and truly went the distance for many people. We made a difference for most of them and stood up for right not might. If you need an attorney I suggest you find someone where you live who offers free consultations. Also I urge you to discuss your case with an attorney if at all possible. This field is technical and complex. I would even call it tricky so seek advice from an attorney. If that is not possible call the Colorado Division of Workers Compensation customer service section for helpful information.
The information in this blog is intended to represent my personal views and opinions. It is not intended to be specific or personal legal advice which should only be obtained by a consultation with an experienced attorney. All this blog provides is general information I consider important to me. It may be of interest to others but for any advice or advisory statements consult with an attorney not a blog.
Special Personal News on Cici, our grandaughter (September 2011)
Nearly 3 years ago our grandaughter Cici had a serious medical problem. Her survival was at risk and she was deprived of oxygen because of a tragic choking/swallowing problem. It is known as an anoxic brain injury. The recovery has been challenging and slow but some progress has been made. We are thankful to be part of her recovery. I remain truly grateful for the prayers and touching support provided by so many people to my daughter and the family. We are actively committed to Cici's recovery and to her loved one's for as long as it takes. You can follow this difficult but amazing journey on my daughter's and husband Matt's Blog. Where there is life there is hope. We've had tough times but we have also seen courage and love in action for her and also for others. For examples look below.