Denver Workers’ Compensation Claim Requirements

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In Colorado, workers’ compensation is basically a no-fault system which provides specific benefits for injured workers with compensable injuries. According to Denver workers’ compensation claim requirements, applicable injuries are those which occurred within the course and scope of the injured workers’ employment.

As far as conditions or types of injuries, that is not really a concept in workers’ compensation has nothing to do with the type of injury or condition that an injured worker is claiming. The claim could be any injury or condition as long as it is an injury that arises within the course and scope of employment. To learn more about injury claim requirements, contact an established employee benefits attorney.

Workers’ Compensation vs Personal Injury Claims

A common misunderstanding regarding Denver workers’ compensation claim requirements is that filing a claim is the equivalent of suing their employer. Workers’ compensation claims are not lawsuits; they are really just insurance claims made with the workers’ compensation carrier. Sometimes, workers’ claims for compensation are also filed with the Department of Labor Division of Workers’ Compensation, but otherwise, they are just insurance claims.

Aside from just a type of claim, they are also different as far as damages or benefits owed. Meaning, what an injured worker is entitled to under the law is very different than damages sought under a personal injury claim.

In workers’ compensation, the benefits owed to an injured worker under the Workers’ Compensation Act are very specific and dependent on the unique facts of the situation. Regardless, injured workers are never entitled to pain and suffering in a workers’ compensation claim, whereas such damages are always present and significant in a personal injury claim or suit.

What are the Workers Compensation Claim Requirements?

The Colorado Workers’ Compensation Act is the statutory scheme that lays out the requirements for the workers’ compensation system in Colorado. In addition to the Act, attorneys and Judges rely on case law that has been developed through the years by Administrative Law Judge decisions and the Industrial Claims Appeals Office – that is the appeals court.

Further, attorneys and Judges must follow the Workers’ Compensation Rules of Procedure and the Office of Administrative Courts Rules of Procedure. If there is a certain situation not addressed by the Workers’ Compensation Rules of Procedure, we default to the Colorado Rules of Civil Procedure.

What is the Role of  Liability in Workers’ Compensation Claims?

Workers’ compensation claims are not based on fault, so liability is not really a concept aside from the conversation of whether a claim is compensable, and therefore whether the WC carrier is liable for benefits owed under the law. Fault or comparative fault is not part of the equation in workers’ compensation; things happen by accident and that is enough to have a compensable claim. However, there are circumstances in which an employee’s contribution to the injuries can affect their benefits.

What is Assigned Risk?

Assigned risk in the workers’ compensation context is that not all employers are able to obtain workers’ compensation coverage through the voluntary market due to a bunch of different factors like how long the company has been in existence, whether their operations fall within a high-risk industry, loss records that might be unacceptable to standard marketplace insurance.

Assigned risk plans are created by the state. In Colorado, they created Pinnacol Assurance, a workers’ compensation carrier, which ensures that all employers are able to obtain workers’ compensation coverage in compliance with the law. An attorney may be able to assist the applicant in their understanding of Denver workers’ compensation claim requirements.

Understanding Denver Employee Laws

The Colorado Workers’ Compensation Act is specific to Colorado. Workers’ Compensation laws and procedures differ by state, so every state should have their own statutory scheme and case law that would dictate their laws and policies.

The rules and regulations that govern workers’ compensation in Colorado are very specific and complex. It is not a system based on common sense and so the injured workers do not have the knowledge to discuss these issues with the carriers or attorneys that might be representing the insurance company.

Depending on the issues, having an attorney to represent a person on their workers’ compensation case can make a huge difference, especially if they are going to a Hearing in front of an Administrative Law Judge on issues of denial of benefits.