Colorado workers who are injured while at work or become sick because of their job are covered, with very few exceptions, by the state’s workers’ compensation laws which make it mandatory for the vast majority of employers to provide protection for their employees with insurance cover. Workers’ compensation is not guaranteed even if it is a no-fault insurance. There are many reasons why workers compensation claims may be denied by the insurer. This does not mean that compensation is impossible as you can challenge the decision with or without the help of a workers’ comp. attorney. Workers' Compensation Law in Colorado Workers’ compensation in Colorado is administered by the state’s Division of Workers’ Compensation (DWC). You can make a claim directly with the DWC if your employer has failed to notify its own insurer about your workplace injury or illness. The DWC will also appoint a judge in the event that you challenge a denied claim or the amount awarded. Workers’ compensation laws in Colorado are designed to compensate a genuinely injured or sick worker for all medical costs incurred as a result of an injury or sickness that has happened at work. It also compensates for part of any lost earnings although there is no guarantee that a job will be kept while the employee is recovering or seeking treatment. It is important that you fill in forms correctly and stick to time limits when making a claim otherwise you may find that this becomes a reason for losing the right to compensation. Why Your Claim Could be Denied Your claim may be denied by your employer’s insurer for a number of reasons. They may claim that you did not submit your claim on time, or that you were not at work when the accident happened or that your sickness had nothing to do with your job. There may be a simple administrative error made by someone at your place of employment which explains why it was thought that you were not at work when an accident happened. This can usually be sorted out quite easily. More serious reasons which you may wish to challenge include any of the following allegations: that you didn’t use safety equipment provided or follow established safety procedures; that you deliberately caused an injury in order to obtain compensation; that you were drunk or had taken drugs which led to you being injured. The Colorado Workers' Comp Appeals Process If your Colorado workers' comp claim is denied or the award of compensation seems to low, you can challenge the decision by submitting a claim to the DWC. The DWC will appoint an Administrative Law Judge (ALJ) to hear your side of the story as well as listen to any evidence that the insurer has t back up their decision to deny your claim. The judge will make a decision about your claim at a hearing which is normally held at one of the DWC’s own offices. If the decision goes against you, you may still file a Petition for Review which is basically a form of appeal against the judge’s decision. It helps to have convincing evidence of your injury, how it happened, when and where it happened and medical reports which support your claim. This is even more important if your case eventually goes before an Industrial Claim Appeals Panel if the ALJ confirms the original decision made at the hearing. Why a Workers' Comp Attorney May be of Help A workers’ compensation claim should be straightforward but it is never guaranteed and you may find that your employer’s insurer makes it difficult for you to obtain the compensation you deserve. Contesting a denied claim can be a complicated and protracted affair. You need to fill in forms correctly, have sufficient documentation and ensure you do everything within rigorous time limits. You may find that this is so overwhelming that it is easier to get advice from a workers’ comp. attorney and let the attorney represent you at any hearings or trials you have to attend.
