A brief, three-day stay in a hospital after a fall or other injury could cost over $30,000. Many group health insurance plans don’t cover injury-related costs. As a result, the injured victim could be left holding the bag.
The hospital stay is often just the start. Many job injury victims cannot work for several weeks or even longer. Most U.S. families live hand to mouth. For example, a third of Americans couldn’t pay cash for a $400 emergency expense. Therefore, a few weeks without a paycheck could be financially devastating.
These problems aren’t new. More than a hundred years ago, Colorado and other states began requiring companies to carry no-fault workers’ compensation insurance that addressed these issues. Today’s workers’ comp bureaucracy is much more complex. That is why, to obtain maximum benefits, an attorney who knows about workers’ compensation in Colorado should guide your case through the system from start to finish.
Basics of Workers’ Compensation in Colorado
Why did state lawmakers pass workers’ comp laws? We’re glad you asked. A hundred years ago, most jobs were dangerous, and most courts were clogged. A civil injury claim could take years to resolve, so workers gave up their right to sue in court if employers funded a no-fault insurance system that paid:
- Medical bills. Workers’ comp insurance usually pays all reasonably necessary medical bills. If the insurance company drags its feet, workers’ compensation in Colorado typically convinces doctors to delay billing until the case is settled.
- Lost wages. Most job injury victims receive two-thirds of their average weekly wage (AWW) as long as they are unable to work. The AWW is forward-looking as well as backward-looking. If a job injury causes a victim to miss an overtime opportunity, the AWW must reflect that loss.
These benefits may have a three-day waiting period. The waiting period doesn’t apply if, as is normally the case, the victim can’t work for more than two weeks.
“No-fault” means just what it says, at least in this context. It doesn’t matter if the victim was mostly responsible for the injury or even entirely responsible for it. If the injury happened at work, it’s covered.
“Work” is broadly defined in the Centennial State. For instance, suppose that Bill, a software engineer, twists his knee at a company softball game. The game has nothing to do with his job. However, Bill’s injury is work-related. The game benefited his employer. Healthier and happier workers are more productive workers. Therefore, an attorney who takes cases related to workers’ comp. in Colorado should be able to obtain benefits for Bill.
The fall described above is a classic example of a trauma injury. Other examples include work-related motor vehicle crashes (wrecks during morning and afternoon commutes usually don’t count), chemical burns, electrocutions and third-party assaults (such as a clerk shot during a robbery).
These incidents cause head injuries, broken bones and other injuries that are difficult and expensive to treat. Post-traumatic stress disorder (PTSD) and related nervous or mental injuries related to fright, stress or excitement are in a special category.
Medically, PTSD is a trauma injury. Extreme stress alters brain chemistry. The chemical imbalance causes symptoms like hypervigilance, depression, flashbacks, anger and nightmares. Like with most other brain injuries, the right combination of medicine and therapy makes these symptoms manageable.
However, the law hasn’t kept up with the science in this area. Under current law, only an emergency responder, 911 operator, or other person who audibly or visually witnessed a death or serious injury is eligible for PTSD and related benefits. The trauma must be directly related to the job. For that reason, if Sara develops PTSD because Bill’s leg injury is so gruesome, she’s not eligible for workers’ comp.
A workers' comp attorney in Colorado can also obtain benefits for occupational disease victims. These job-related injuries occur over the course of time. Hearing loss is the most common occupational disease. Other examples include repetitive stress injuries, carpal tunnel syndrome, and knee or joint problems.
Job Security and Workers’ Comp in Colorado
It’s illegal to fire or discipline workers who file job injury claims or encourage another person to file a claim. However, this law has some loopholes.
If a doctor clears a victim to go back to work, and the worker doesn’t go back, the boss could fire the worker for absenteeism. Frequently, if the victim doesn’t feel completely well, a workers’ comp attorney in Colorado helps the victim get a second opinion.
Refusal to accept a light-duty assignment is another possible loophole. As victims recover, many bosses make them come to work and watch the parking lot, make coffee or perform other menial tasks. If a doctor has cleared the victim for a light-duty assignment, the victim must do the job unless another doctor has a different opinion.
Workers’ comp attorneys in Colorado use this Legalese phrase to describe job injury claims that workers’ comp doesn't cover for one reason or another.
Some bosses don’t buy workers’ compensation insurance. If a worker gets hurt, the worker can then file a claim in civil court. Typically, the risk of getting caught is so low and the job injury rate is so light that an employer figures this gamble is worth taking. If the case goes to court, employers cannot use some of the best defenses. For that reason, an attorney has an easier time making a case for workers’ comp. in Colorado.
On a related note, some employers lie to insurance companies about payroll size and other risk factors. When insurance companies find out about these lies — and they almost always do — they usually deny coverage. Once again, a civil claim is an option.
Finally, many workers’ comp insurance policies exclude certain injuries, like injuries caused by a defective product. In these situations, an injured worker may sue the manufacturer and obtain substantial compensation.
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