How Workers’ Compensation became an Administrative Remedy

Workers’ compensation is often viewed as a compromise between employers and employees. The employee gives up the right to sue for large awards in court in exchange for quicker, although normally lower, reimbursement for work-related injuries and illnesses. Workers’ compensation is a “no-fault” system so the employer gives up the right to argue the employee is at fault in exchange in spending years in litigation, and being exposed to a large verdict.

If you experience a life or limb threatening injury while on the job, seek immediate medical attention at the nearest emergency room, and then notify your supervisor in writing. A life or limb threatening injury means an injury that you believe threatens a part of your body or your life in such a way that immediate medical care is needed to prevent your death or serious damage. Normally, you need to notify your employer or supervisor, verbally and in writing, that you have been injured before obtaining any medical care. All injuries, no matter how small, should be reported to your employer.

Colorado law requires that you notify your employer in writing within four working days of an injury, even if you have advised your supervisor orally. You should keep a copy of your written notice. In the event you do not report your injury to your employer in writing within four working days, you may be penalized and lose up to one day’s compensation for each day’s delay, provided that your employer has posted a sign requiring four days written notice. You may still file a claim for benefits even if you are late reporting the injury to your employer.

You will be required to see the medical provider who your employer has designated for medical care in the event your employer has designated a medical provider before or at the time of the injury. If you do not go to your employer’s designated medical provider, it may result in nonpayment of your medical benefits and you may be responsible for your medical costs. If your employer does not direct you to a designated medical provider, your may seek treatment from the provider of your choice.

What Should A Colorado Employer Do After Being Notified That Am Employee Has Been Hurt?

Within ten days of your injury, your employer should file a report of the injury with its insurance company. This commences your workers’ compensation claim. If you lose more that three days or three shifts at work due to your injury or occupational disease or if your suffer permanent physical impairment or death from your injury or occupational disease, the insurance company has twenty days from the date an Employer’s First Report of Injury is filed (or should have been filed) with the Division to notify you (or your dependent) whether benefits will be paid.

The employer’s insurance company will either admit for your claim (a General Admission of Liability) or deny your claim (a Notice of Contest). The insurance company should put a carrier claim number and the adjuster’s name and telephone number on the notice you receive. No notification is required from the insurance company if you haven’t missed three days of work because of your injury.

Your claim may be denied by the insurance company for a variety of reasons. The employer’s insurance company may deny your claim if the adjuster has reason to believe that your injury is not work related or if it is believed that they do not have complete and accurate information. The claims adjuster may also deny your claim if he or she believes further investigation is necessary.

If the workers’ compensation insurance company denies your claim, you will be responsible for all medical bills associated with your injury or illness. In the interim, you may want to go through your private health care insurance policy if you have one.

What Should A Colorado Employee Do If The Employer Fails To Report The Injury to The Insurance Company?

If you do not receive an Admission of Liability from the insurance company or if your employer does not report your injury to the insurance company, you can file a claim to protect your future rights. After the Division of Workers’ Compensation receives your claim, a copy of the claim is sent to your employer’s insurance company with a letter asking the insurance company whether it will admit liability and pay you your benefits. You will receive a copy of this letter which will also assign you a workers’ compensation claim number. You have two years from the date of your injury or up to three years with an excuse such as lack of knowledge that your medical condition was work-related to file a claim with the Division of Workers’ Compensation. If you don’t file a Workers’ Claim for Compensation within this time period, you may be forever barred from receiving benefits.

There are some exceptions to the exclusive remedy of workers’ compensation exist. Exceptions vary from state to state so you should seek advice from an experienced workers’ compensation attorney familiar with your jurisdiction. To learn whether you can bring a lawsuit for your industrial disease or work injury instead of or in addition to filing a workers’ compensation claim, consult Attorney Mary E. Jeffers in Denver, Colorado.

In many states, a worker injured by the intentional action of his or her employer can sue the employer for the harm in addition to filing a workers’ compensation claim. Examples of such deliberate employer behavior triggering the right to sue may include the intentional exposing of the employee to a known hazard, assault, and intentional infliction of emotional distress. Other states have included in their workers’ compensation law an additional monetary award instead of allowing an additional lawsuit when an employer acts intentionally or maliciously to injure an employee.

Employees are not barred from suing their employers in Colorado for other bad behavior simply because they also have a work-related injury. Employees can sue for sexual harassment, damage to property, gender discrimination, race discrimination, defamation, and invasion of privacy.

A few states have adopted another legal basis for an employer lawsuit. This is known as the dual capacity or dual persona doctrine. This doctrine allows a worker to sue his or her employer when the employer has a second legal relationship to the worker and has hurt the worker in the context of the second relationship. Examples of when an employer may injure an employee outside the employment relationship is when it allows a dangerous condition on its property in violation of its duty of care as a landowner, when a company doctor in the provision of services commits medical malpractice or when it defectively manufactures a product for public sale and the product injures the worker.

An employer may also be subject to separate lawsuits for bad faith adjusting of a workers’ compensation claim, and for retaliating against an employee for bringing a workers’ compensation claim, such as by termination, demotion, or subjecting the employee to adverse working conditions. These lawsuits are recognized in Colorado.

In most states, as in Colorado, lawsuits against co-workers causing injury in the workplace are banned because co-employee injuries are included in the workers’ compensation system. The following are occupations and/or individuals excluded from mandatory coverage under Colorado law: certain casual maintenance or repair work performed for a business for under $2,000 per calendar year; certain domestic work, maintenance or repair work for a private homeowner that is not done full time; licensed real estate agents and brokers working on commission; independent contractors who perform specific for-hire transportation jobs; drivers under a lease agreement with a common or contract carrier; any person who volunteers time or services for a ski area operator; persons who provide host home services as part of residential services and support; federal employees (covered under federal laws), railroad employees (covered under federal laws); and Independent contractors in general.

If you are not being contacted by the adjuster regarding your claim or your claim has been denied, an experienced workers’ compensation attorney, Denver Personal Injury Lawyer - Mary E. Jeffers, in Denver, Colorado, can advise you of your legal options.

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