Colorado Drug Card

In that many Colorado residents on Social Security or with work injuries may have financial problems or even denials of coverage Colorado does have a Colorado Drug Card. Moreover anyone at all can obtain the drug card so it does not matter what your income. Locally KRDO did an investigation which can give you a better idea about the card. Does it work? Yes although not every pharmacy may know about it. Seniors and those on a tight budget should especially take heed. While it may not always be a big benefit the card is free to all and just let them know by asking for the discount. Additionally for injured workers there is the Injured Worker Pharmacy which has its own website. Apparently a number of attorneys do let their clients know about it so it is another resource that may lower the stress level for claimants. Often a claimant cannot obtain a medication and my view is that you should try to follow through with what your doctor has prescribed. It may turn out to be covered or not but your health should be a primary. In any event always keep receipts if you pay out of pocket as perhaps reimbursement may happen.
Also...El Paso County also has a free drug card that may be helpful too.

Unrepresented Claimants Revisited

In 2006 I posted on what resources were available for those who do not have an attorney to handle their case. That is now outdated. Sometimes attorneys will not take your case. There are many reasons for this and not always personal to your case. You may have a very good case but the attorney is busy or going in a different direction. Other times the attorney may conclude that your case has merit but does not fall into an area he wants to handle. Still other times an attorney decides there is not enough at stake to commit himself and his staff to your case. By all means keep looking for an attorney even going outside your locale if you have to do so. But if you must proceed on your own the state does provide useful information for you. You should contact the customer service people at the Division. They can assist when you do not have an attorney. There are many resources and much information available to you but I caution you to be thorough and not assume it is all common sense. Workers comp is a creature of statute, cases, rules and guidelines. All of this except the cases are available to you on the web. On this blog we often will post appellate cases. Also there are lower level decisions with caselaw you can review. Also read the publication for injured workers. At this link learn about non-lawyer workers compensation. Also at this link you can read an Overview of the Worker's Compensation Claim Process. Also from this page you can read more about representing yourself in proceedings including a non-lawyers guide. Be aware that anyone involved with a claim may also be involved with two agencies the Division of Workers Compensation and the Office of Administrative Courts. Information on this distinction can be read here. These links are important pages but really just explore what Colorado does have on the web so that you are as informed as you can be. A word of caution: represent yourself only as a last resort...this area of law is complex and difficult to navigate. But it is not impossible and if you must handle it yourself read the above and use customer service noted above.

Retaliatory Discharge and Temporary Benefits

In a recent Industrial Claim Appeals Panel decision I'll call Gaines there was a retaliatory discharge of an injured worker. The worker was hurt and complaining about the employer not filing a report of injury or providing further medical help. As a result she was taken off the work schedule. Since she was not working and attributed it to the reprisal for her work injury she sought temporary benefits. The hearing judge denied her such benefits saying a reprisal is not a reason for temporary benefits. She appealed and the Panel agreed that the reprisal alone is not a proper statutory basis for temporary benefits but then remanded the case to the hearing judge to address whether her possible restrictions from the injury should entitle her to temporary benefits. Apparently this was not fully looked at by the hearing judge. There was evidence of restrictions but the judge did not adequately address that issue. The reasoning here appears to say that a claimant has to show both a medical problem and loss of wage due to an inability to work or restrictions which impair that ability. A reprisal alone is not enough. However such a reprisal may result in a separate civil claim for retaliatory discharge. The point being made is there is a distinction between a reprisal for having a claim and actual time and wage loss due to an injury. Let's say you fall out of your chair, complain it hurts even if temporary and want to file a claim. Your boss then just takes you off the schedule. So you are fully able to work but in reprisal they give you no hours. Under the Gaines case, as I read it, you'd receive no temporary benefits because you can work and really have no injury. It may be wrongful but your loss of pay is due to reprisal not to the injury. My preference is that this loss due to reprisal or retaliation be able to proceed in the workers comp case rather then in a separate civil case. The reason is that any separate civil case can take many months but the worker is receiving no income directly due to a work injury incident. But my preference is not the law. It takes disability not just reprisal to obtain temporary benefits though in Gaines the remand was to force the hearing judge to decide the disability issue.

The latest data on Social Security appeals and judges

If you are wondering how long it may take to obtain a hearing once you appeal the answer depends on where you live. It is reported that in Colorado Springs the delay to a hearing or disposition is 431 days. While they have been trying for years to speed up the process over a year remains a long time to wait. An attorney may use that time to obtain more reports or assessments but the wait is still too long for many people. In Puerto Rico the wait is shorter. In one office (Mayaguez, PR) the wait is 177 days. Then again in Lansing Michigan you can take 566 days to a disposition. Yet have the claim in Livonia Michigan and the wait is 257 days. Seems not that complicated to smooth all this out but apparently it has been tough to achieve. Waiting too long is much tougher on the disabled so wish they'd get it right. I realize it can be a matter of staffing and numbers but when video hearings are now permitted I fail to see why such a huge variance is tolerated. Last you can look up the latest figures for any judge at the website that compiles this data. You can look up what each judge in Colorado Springs is doing with the cases he or she is handling. What I saw in the latest stats is that 4 out of the 5 judges are somewhat more favorable to claimants and one is statistically denying more claims then issuing favorable or partially favorable decisions. We all know that statistics can be misleading and the types of cases a judge may be involved in can make a difference. The problem is when we discuss the odds we have to say its 50 50 but for some judges your odds are over 60% of obtaining an award. No question the older you are and the more restricted you are the better your chances but each case requires a very individualized approach.

Does Charlie Sheen Have a Workers Comp claim?

Here is just some humor: Over at The Spoof they posted a bit of satire about Charlie Sheen filing a workers compensation claim. If so does the rehab at home become a medical benefit? Of course any temporary benefits would be quite limited. They allege that given his job entails a certain lifestyle his "research" into his character should be covered since he sustained injury. I am not sure what injury but he was hospitalized so does he have a claim? Some might say he was on a frolic or detour of his own. In Colorado would his treatment even be deemed authorized? So many issues so little time. I would bet that at any hearing there would be very interesting testimony.

Retired Prehearing Judge Ron Jaynes Passes Away

I was just notified today that retired Judge Jaynes passed away this morning after a long illness. There are no further details yet. Judge Jaynes retired in 2009. What most impressed me about him is that he was very down to earth and always polite. In a day and age when we are often having to pierce through a cloud of confusing details you always knew that he would try to keep it simple and understandable. He could do so with a sense of humor too. You can see him in this 2008 newsletter on page 3. Rest in peace.

Update: Services for Ron Jaynes are Friday, February 11, 2011 at 1:00 p.m. at Highline Community Church, 6325 South University Blvd, Denver.