A Caution on Workers Compensation

Every so often I get a comment from someone who wonders if the Colorado material posted here applies to other states. It is important to loudly say...no! While there are similarities between many states a workers compensation system is unique to each state. Colorado's system is a creature of state statutes and case law. It does not apply in any other state. Perhaps each state learns from the others or case law from one state may be an influence in a case in a different state. But the law in Colorado really depends on Colorado statutes and cases. The exception would be in federal cases involving federal employees. For those cases there is federal law. So if Colorado law applies to you then this blog and its references may be helpful in understanding things. But if you are in another state and its law applies then looking here may be of little benefit. Every state has its own laws in this field so for advice consult an attorney in your area. This blog makes for interesting reading but I must say it pertains only to Colorado. It also represents my views and my slant on the field. Legal advice should come from your attorney.

Health Coverage in Colorado

If you have had a work injury or disability you or other family members may need health insurance for any future problems. Perhaps you qualify for medicare once you are disabled or retire but what about your spouse? Perhaps you are running out of any continuation health coverage. For those of us in Colorado here are a couple of websites that provide information you may find useful. The first site is for those who are not insured. Is coverage possible? Yes so click here for this website. Anyone with a preexisting condition (and that means most of us) should not be unable to obtain insurance coverage. While many politicos preach about this way or that the fact is that times have been tough for the uninsured and those with preexisting conditions. Group coverage is fine until you lose your job. At this website if you have had coverage within the last 6 months you may be able to use the information to obtain further coverage. After all COBRA coverage does not last forever so this site may help you out. Last I did want to include a link to Andrew Mersereau of Premier Insurance. He has been quite helpful on a personal basis on health coverage. Don't be afraid to call an agent for help when you cannot do it yourself.

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.

The Survey

Insurers are now required to survey each claimant after the case is over as set forth in this rule just posted by the Division of Workers Compensation. This is then yearly reported by them. I wonder how many angry claimants will respond to the few questions posed to them. They relate to claimant satisfaction and this mandatory survey may reveal how many are dissatisfied. Many are not pleased by the process which originally was designed to promote the prompt and efficient delivery of benefits. Nowadays we have disputes all over the place which if not quickly resolved proceed to hearings and sometimes to appeals.

Brochure Now Required in all Workers Comp cases

A new Colorado statute has addressed a disclosure brochure to be provided to all claimants. It is a very concise disclosure on the subject of workers compensation. Seems like an advisory of the claim process and your rights as a claimant. That claim process is indeed quite complicated and the "brochure" seems designed to provide basic information and is required to be provided to you. No amount of disclosures will ever simplify the process but it does give the claimant a heads up on it. The problem with information is not that it is bad but that it can be incomplete. In workers compensation it is not possible to be completely accurate on all matters at all times. There are simply too many cases, too many rules, too many statutes and much more. For example there are tips for physicians and AMA Guides that are outdated but part of the workers comp process. Then as laws change you may come under old law or the new law or both. As recently as in the Nelson case we can see the clash of the old and new. Looking at the brochure I can say it is also not entirely accurate. One example is that it says an Admission will contain your wage but that is not always accurate. My office received a recently filed Admission without any wage figure. The point is this new Brochure can be helpful but also use your common sense and when possible obtain legal representation.

Colorado Labor Department on Twitter

Colorado presses on into the 21st Century! They twitter...or is it tweat? In any event these are short comments which you can access or have sent to you. The subjects vary a great deal but can include workers compensation, unemployment or other areas within the purview of the Colorado Department of Labor. My view is more is better then less...I recall the days when obtaining information was not so easy. Now we can do our legal research online. In the old days legal research was very time consuming and meant handling many big law books. You then copied pages by taking the book to the copier and page by page making a copy of a case. Now I can be on a laptop and directing a wireless printer to copy the case. With the development of the computer age we have seen an enormous increase in knowledge and efficiency even if at times we are all frustrated by technology. Just some 30 years ago we were in its infancy. In any event Colorado is active on the internet. It is making available many resources for all of us.

New Look for OAC website

It appears the Office of Administrative Courts has a new look. I have not had a chance to go through it all but it does seem more user friendly. The old site had the OAC Rules almost hidden. You had to know precisely where to look. This new look is very clean in appearance. It also has new material so check it out. Of course the staff at law offices often use the site so whether they will approve the new look remains to be seen. I can say it really was time for a change.

Testimony on Pinnacol at State Level

As this article from the Denver Post notes there has been testimony from injured workers on their treatment by Pinnacol Assurance, the state's largest workers compensation insurance carrier. Not all is negative but the key point could be that over the past several years Pinnacol had amassed quite a financial surplus. One view is that it did so by denials and reductions of benefits to those injured on the job. Of course another factor is the law changes that took place over the years. Many law changes tightened up on providing benefits. For example, despite the many denials of Social Security disability claims it can accept that you are totally disabled if based on your age, education, work experience/skills and restrictions you are not employable in a substantial gainful way. In Colorado it is tougher to establish permanent total disability. So law changes have played a role in reducing benefits over the past few years. Certainly this rewards all insurers not just Pinnacol. However Pinnacol is the largest so you can expect further proceedings on all this. The fact is insurers have many legal ways to keep benefits low for injured workers. Injured workers with hand, arm or leg injuries are often poorly paid permanent benefits, especially if they lose their trade/occupation. I can provide numerous examples of legal ways that are used to deny, delay and reduce benefits so hopefully all this will be reviewed as well.

Be Careful What You Post Online

Anyone with a workers compensation or Social Security disability claim would be wise to remember that what you post online may be accessed by others. So your profile on Facebook or elsewhere may come back to haunt you. We all know that many with claims are investigated and even videotaped but what you post online may also be subject to review. Here is an interesting article that makes the point very well. If you post about yourself and all your interests then that can raise a question about the severity of your disability. So a word to the wise...do not imagine you are invisible and won't be checked out. From digital cameras to Facebook or even other postings elsewhere you had best assume they will discover all this. In this digital age your life could be an open book so with any injury or disability I suggest you cease...that means STOP all such postings for the duration of your claim or at least be extremely careful what you post.
Postscript: August 23, 2009 Dollar Tree uses claimant's MySpace to bust his case.

Adjuster's Guide in Workers Compensation

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.

The Top Ten Reasons

Why do injured workers hire attorneys? Over at the Workplace Injury and Law Advocacy Group one writer set forth ten major reasons. Quoting from the article here is the list:

TOP 10 REASONS
10. Does not know the value of Permanent
Partial disability final payment.
9. Harassment from employer while on
restricted duty.
8. Has other legal issues (SSD, Short/Long
Term, ERISA subrogation, unemployment).
7. Poor Medical Care.
6. Fear of losing job or loses job.
5. Poor Treatment by adjuster/nurse case
manager.
4. Total Permanent situation.
3. Temporary Total Benefits not paid timely or
in correct amount.
2. Employer ignores Injury and refuses to
refer for medical treatment.
1. Changes in the law.

It is rather clear above that "protection" is the biggest single consideration. I would also like to add that an attorney can not only protect but also will seek to maximize your medical and compensation benefits. This can mean doubling, tripling or multiplying by over 10 times what the insurer says they still owe you. It can mean taking a claim when the insurance says you've been treated and released without impairment and obtaining more treatment and benefits. A decent attorney can not only protect but also increase your benefits considerably.

Community Resources

The link I am providing is to a directory of some 39 pages of resources available in the community. While developed for families it has a great listing of numerous community resources in the El Paso County area for anyone. It is in adobe or pdf format so it can be printed out but it may load slowly. My point in doing this is to provide a list with phone numbers for those who are financially stressed or needing assistance but have no idea where to turn. Look it over by clicking here.

Injured Worker Comments, Suggestions or Questions?

I've set it up so that anyone can comment or leave questions for me. Just click on the comments and leave your question or suggestion...but do so either anonymously or by first name only please. While I cannot guarantee an answer or reply I promise to look at any such comment/suggestion/question. Sometimes we just need to vent or provide our own personal views so if you feel the need then you are free to post your comment on our blog. For example I personally feel the workers comp system in Colorado can be improved upon with better laws. Change can come when we stand up and voice our concerns. Silence only validates the status quo. But if you need professional or individual advice and do not have a lawyer...call my office at 719-596-8900 or email me at workcomp@usa.net.