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Colorado Workers’ Compensation
Colorado Workers’ Compensation
Employee Union and Association Handbook
Employee Union and Association Handbook
Compliments of
Larry Compliments
Free and BradofUnkeless
Larry Free and Brad Unkeless
Attorneys at Law
Attorneys at Law
Specializing in Workers’ Compensation and Personal Injury
Specializing in Workers’ Compensation and Personal InjuryThis book belongs to _____________________________
Phone __________________________________________
Personal Phone Numbers
Name Phone__________________________
Attorneys at Law
Larry Free - Workers
Workers’ Compensation
Compensation
Greg Heron - Personal Injury and Social Security
Bill Keating - Personal Injury and Products Liability
Mike Keating - Personal Injury
Deirdre Ostrowski - Personal Injury
Steve Polidori - Personal Injury and Products Liability
John Poor - Personal Injury
Brad Unkeless - Personal Injury
Workers’ Compensation
Bob Wagner - Personal
Workers’ Injury
Compensation
For more than 30 years, Keating Wagner Polidori Free has been
committed to aggressively and successfully representing and protecting
the rights of injury victims. The rm litigates cases arising from serious
personal injuries, including Workers’ Compensation and Social Security
Disability.
We are known for results, not ads.
Our Workers’ Compensation attorneys assign experienced paralegals and
case managers to every injured worker. We use the latest technology to
organize all aspects of each case. For more information on the kinds of
work we do, please visit our website at www.keatingwagner.com
Your questions are welcome! Please call our Workers’ Comp team at:
(303) 534-0401
Our address is 1290 Broadway, Suite 600 – Denver, CO 80203
We are here to help you!Your Workers’ Compensation Claim Organizer 303 534-0401 Workers’ Compensation Lawyers: R Marshall ❏ Fogel Larry Free R Larry Free R Brad Unkeless ❏ Paralegal assigned to my case: ________________________ FKWPS Social Security Disability Lawyer: R Greg Heron Paralegal assigned to my case: ________________________ MEDICAL Authorized Primary Care Provider: __________________________________________ Phone: ________________________________ Address: _______________________________ Floor: __________________________ Surgeon: ______________________________ Phone: _________________________ Address: _______________________________ Floor: __________________________ INSURANCE Company Name: _________________________________________________________ Claim Number: _________________________ W.C. Number: ___________________ Adjustor: _______________________________ Phone: _________________________ UNION Union or Association Representative: _____________________________ Phone: ____________________________________________________
Table of Contents
Introduction
Our goals in representing you and other important information
Workers’ Compensation time line
Why should I read this handbook? 1
Why do I need a lawyer? 1
How will my attorney be paid? 1
What is Workers’ Compensation? 2
Injured workers’ 9 most common mistakes 3
When and how should I report my accident? 4
Who pays my medical expenses? 5
What if my claim for Workers’ Compensation benets is admitted? 6
What if my claim for Workers’ Compensation benets is denied? 6
Isn’t it obvious that I was hurt doing my job? 7
Can I sue the negligent person who caused my on the job injury and
still collect Workers’ Compensation? 8
What’s included in Temporary Disability? 9
When do my Temporary Disability payments end? 11
Can my Workers’ Compensation benets be reduced? 11
What should I do about Social Security, Pension or Disability benets? 12
What are my obligations to my employer? 12
Should I submit to a Functional Capacities Evaluation (FCE) before I am
released by a doctor? 13
What is a Permanent Impairment rating? What happens at the
end of my case? 13
What’s the difference between Permanent Impairment and Permanent Total
Disability? 14
What is disgurement? 14
What happens if I can never return to any type of work? - Permanent Total
Disability 15
Will my future medical care be paid by the insurance company when I
reach Maximum Medical Improvement? - Medical Maintenance 15
What do I do when I receive the Final Admission of Liability? 16
Can I appeal the Permanent Disability rating given to me by the Workers’
Compensation doctor? 16
If there is a dispute, can I go to court during my Workers’
Compensation case? 16
How does a case settle? 16
Can I re-open my claim after my case is closed? 17Introduction
Current Colorado Workers’ Compensation laws are difcult to understand.
Historically, the Workers’ Compensation system has been a political
battleground in the Colorado legislature. Special business interests often
prevail at the expense of the injured worker.
The system may not always provide adequate benets to those most in
need. Injured workers can feel caught in a maze as they endeavor to deal
with the complexity of the present law – more than 70 pages long.
We at Keating Wagner Polidori Free represent injured workers in
all elds of employment including, but not limited to:
Airline employees
Carpenters
Custodial workers
Educators
Fire ghters
Food workers
Iron workers
Law enforcement workers
Maintenance engineers
Medical personnel
Ofce workers
Operating engineers
Other construction trade workers
Package delivery
Plumbers
Public transportation employees
Stagehands
Truck driversOur goals in representing injured workers:
• To help workers receive fair compensation while off work, during
recovery.
• To maximize Permanent Disability awards.
• To help obtain quality medical care.
• To help injured workers understand that Workers’ Compensation
settlement values vary with each claimant and that these values are
not automatically set by the law.
• To help workers with an on-the-job injury caused by someone outside
of their company.
• To help injured workers obtain reimbursement for items such as
mileage.
Unfortunately, an injury can result in the loss of a job and even a career.
We can help identify this possibility early so workers can make appropriate
plans and make the most of their settlement.
We can help determine when to apply for social security, short and long
term disability, and retirement benets in order to minimize the reduction
of Workers’ Compensation benets.
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Please read this warning!
This Union and Association Workers’ Compensation
handbook is issued to provide basic information about the
Workers’ Compensation system, but should not be used as a
guide to handling your own claim .
Colorado Workers’ Compensation Time Line
This time line represents the order of events from an on-the-job accident
and injury until there is a disability rating. It may be helpful for your
reference as you learn more about the many aspects, events and terms
that are unique to Workers’ Compensation.
Date of Accident
Never say, “I don’t need to worry about
Workers’ Compensation. I’ll be okay in a
few days.”W
hy should I read this handbook?
An on-the-job injury could affect your ability to work and
support your family; an injury might alter your future
plans and goals. No one expects to be injured – so
being prepared is important.
Why do I need a lawyer?
• The Workers’ Compensation system
is complicated and most people
need a lawyer to protect their
rights and obtain fair compensation
benets.
• Insurance companies (and
sometimes employers) have lawyers
to defend their positions. Workers
deserve the same!
• Retaining a lawyer relieves the stress of being fully responsible for
making legal decisions that may affect the outcome of your case. Your
lawyer puts you on a level playing eld with the insurance company
and their lawyers.
How will my attorney be paid?
• Costly legal fees can discourage workers from hiring an attorney. To
avoid this problem, Keating Wagner Polidori Free charges a
contingency fee.
• A contingency fee is a reasonable percentage of the value of your
case.
• The advantage of this fee arrangement is that fees are strictly based
on the value of your claim and nothing more.
• Our rm does not charge for an initial consultation to discuss your
legal rights within the Workers’ Compensation system.
-1-W
hat is Workers’ Compensation?
Workers’ Compensation is a system which provides medical
benets and compensation to individuals injured in the course
and scope of their employment.
• If you suffer an on-the-job injury, you have the right to le a Workers’
Compensation claim. If you are eligible to le that claim, you cannot sue
your employer or a co-employee for damages, even if their negligence is the
cause of your injury.
• Workers receive the same benets
o even if they are negligent in causing their injury
o even if no one is negligent
o even if a co-worker’s negligence causes their
injury
• Workers’ Compensation benets are limited by law.
Because the system allows the payment of benets
regardless of fault, the benets are less than compensation in a non-work
related personal injury case where fault must be established.
Workers’ Compensation benets include:
• Payment of reasonable and necessary medical expenses.
• Temporary Total Disability (TTD) benets that pay 2/3 of a worker’s average
weekly gross wage, while not able to perform their job, before reaching
Maximum Medical Improvement (MMI).
• Temporary Partial Disability benets (TPD) that pay 2/3 of the difference
between a gross weekly wage at the time of injury and the worker’s present
modied duty wage before reaching MMI.
• A Permanent Partial Disability benet (PPD) – which is the value of a
permanent impairment at the time the worker reaches Maximum Medical
Improvement (MMI). MMI is when the worker’s medical condition, due to
injury, is stable and further medical care will not improve their health.
Workers are permitted to work for their employer, within
the worker’s doctor’s written restrictions, while receiving
Temporary Partial Disability benets.
Workers are not permitted to work while receiving Temporary
Total Disability benets.
-2-I
njured Workers’ 9 Most Common Mistakes
1. Not reporting an on-the-job injury due to an accident (such as falling off
a ladder or picking up a heavy box) or due to a work place exposure
(repetitive work such as an injury to a worker’s back from picking up
boxes over a period of time).
2. Not going to the medical clinic, or doctor designated by the employer.
3. Not immediately reporting all their injuries at the time of the accident.
4. Consenting to surgery without asking the surgeon the right questions.
5. Not obtaining a second surgical opinion, when necessary, in order to decide
whether or not to consent to surgery.
6. Not knowing if medical care is designed to help them return back to work.
7. Not understanding the types of Workers’ Compensation benets and
settlements they are entitled to receive.
8. Not understanding their legal rights.
9. Not understanding that it is improper for any
authorized medical facility or doctor to charge the
worker for medical care.
-3-W
hen and how should I report my accident?
“On-the-job” injuries include a single accident, workplace
exposure caused by repetitive work, aggravation of a pre-
existing injury or medical condition, heart attack, chemical or
other work site exposure.
• Immediately notify your supervisor of your injury.
• Your employer must post a sign in a prominent place stating that you must
report your injury in writing within four (4) working days after the
accident. Your foreman, supervisor or manager can ll out a written injury
report if you are unable to do so. Your employer is required to provide the
forms needed to report your accident or workplace exposure. However,
whether or not forms are available, always report immediately.
• If your injury arises from a single event, you should report the accident
immediately.
• If your injury is due to workplace exposure, such as wrist problems resulting
from checking groceries, report the injury date within four (4) days of when
you rst believe you are in need of medical attention.
• Failure to report your injury within four (4) days does not
legally preclude you from reporting the injury at a later time.
Late reporting, however, can result in suspicion that you were
not injured at work. Late reporting can result in denial of your
claim or loss of compensation for each day the injury is not
reported.
• You have a valid job related injury even when you have a
previous back injury or medical condition that is substantially aggravated
from an accident at your work or a workplace exposure.
For example, since childhood, a thirty-ve year old worker has lived with
degenerative disc disease. At age thirty, the disc problem worsened due to an
automobile accident during a vacation and a work related injury two months later.
A month ago, after falling from a ladder while working, the worker injured his
back – further aggravating previous back problems. Despite these issues, the
worker has a valid job related injury.
• Report to your employer and doctors every body part that you believe is
injured, no matter how minor. A minor injury can develop into a major injury.
Your failure to report these injuries can result in denial of
benets.
• If your employer fails to post a written notice of the
requirement for reporting an injury, you may not be required
to give written notice of your injury.
• The best advice, however, is to always give written notice.
-4-W
ho pays my medical expenses?
You must seek medical attention from a doctor at a medical
facility designated by your employer, or its insurance
company. Your employer must give you written notice of at
least two designated providers within 7 days.
• Your employer is responsible to pay all authorized reasonable and
necessary medical expenses as a result of your injury.
• These medical expenses can include medical examinations, surgery,
assisted transportation, therapy, nursing care,
hospitalization, rehabilitation services, prescriptions,
homecare, pain clinic care, mileage to medical
appointments and to your pharmacy, psychological
counseling, MRI, CT Scan, x-rays, medical supplies,
and medical appliances.
• If you are injured at work and you need immediate
medical attention, the law allows you to travel to the
nearest hospital or emergency facility even though the
facility is not designated by your employer.
• Except in cases of true emergency, if you seek treatment from a doctor that
has not been authorized by your employer, you will be responsible for the
bill.
• Disputes may occur between you and your employer’s insurance carrier
about what is reasonable and necessary medical care. These disputes may
be resolved between the insurance adjuster and your lawyer. If there is no
resolution, the conict can be litigated before a judge.
• Lawyers also have the right to try to negotiate
a change of a worker’s physician, as well as
to negotiate getting a second opinion from a
doctor or surgeon.
• Your authorized primary care doctor has the
right to refer you to other authorized doctors
who are specialists.
• You are not required to have elective surgery
in order to receive Workers’ Compensation
benets and a settlement.
• There are limits regarding how long your medical care can continue.
• In certain circumstances, your right to ongoing medical care can continue
after you have settled on the value of your permanent medical impairment.
-5-W
hat happens if my claim for Workers’
Compensation benets is admitted?
You will receive a written notice entitled “General
Admission of Liability” that provides written proof you
were injured on the job.
• A General Admission allows you to receive all legally required Workers’
Compensation benets, including medical benets and temporary disability
payments.
• A General Admission does not automatically mean
you will receive the correct temporary disability
payments or the appropriate medical care. An
attorney should review a General Admission of
Liability to make sure all benets due you are
correct.
• If your injury results from your use of alcohol or a
controlled substance, your Workers’ Compensation
benets may be reduced by one-half.
What happens if my claim for Workers’
Compensation benets is denied?
• You will receive a written “Notice of Contest” denying your claim. Usually
the denial means the insurance adjuster has questioned the validity of your
claim.
• Your claim may be denied for late
reporting. Again, late reporting of a valid
on-the-job injury creates a suspicion that
you did not get injured while performing
your job. Judges do not like late
reporting cases and a judge will then be
more inclined to deny your entire claim
and all of your benets.
• Report your injury immediately and do not forget to report every injured body
part, no matter how minor the injury seems at the time.
• Often, your attorney can provide the claims adjuster with eye witness
statements, or other competent evidence, to change the insurance
company’s denial of your claim to an admission. Nonetheless, if your claim
has merit, your attorney can request a hearing before a judge.
-6-I
sn’t it obvious that I was hurt doing my job?
Witnesses may disagree as to the circumstances of how you were
hurt. For example, a witness may claim you were not seen picking up
heavy boxes as you claim or that you already had a bad back, and you
never complained to anyone of an on-the-job injury. Evidence can be
discovered to overcome inaccurate witness accounts.
A denial of your claim can be due to inaccurate information or a lack of
understanding of the law by the insurance adjuster. For instance, on-the-job
injuries may happen:
• in an employee designated parking lot before you
clock in for work.
• in an employee designated parking lot after your
work shift has ended.
• in an employee designated locker room preparing
for work before you clock in to start work.
• in an employee designated lunch area.
• by being assaulted by a fellow employee through
no fault of your own.
• running an errand for the benet of your employer.
Even if you are negligent in causing your on the job injury, you are still entitled to
Workers’ Compensation benets.
-7-C
an I sue the negligent person who caused
my on-the-job injury and still collect
Workers’ Compensation?
• If you are injured while on loan to a subcontractor by a general contractor,
you can sue a negligent party not associated with your workplace who
injured you while you are working.
• Independent contractors must carry their own
Workers’ Compensation insurance. However,
signing independent contractor agreements does
not necessarily prove that you are an independent
contractor or that you have waived your right to prove
that you are an employee.
• In some instances you can sue a property owner or a
property lessee if you are injured at work.
• If you are injured due to the conduct of your employer or a co-employee, you
can receive Workers’ Compensation benets, but you cannot sue either of
them personally due to their negligence.
• You can sue a third party and also collect Workers’ Compensation benets.
Keating Wagner Polidori Free can help workers with third party claims
on-the-job injuries caused to workers by someone outside of their company.
For example, if you are driving a delivery truck while working and you are injured
when your truck is hit by a negligent driver who runs
a red light, you can collect Workers’ Compensation
benets and you can sue the negligent driver. However,
the Workers’ Compensation insurance company will
be entitled to a portion of the money collected from the
negligent driver based on the Workers’ Compensation
benets they have paid on your behalf.
-8-W
hat’s included in Temporary Disability?
Temporary Disability includes both Temporary Total Disability (TTD)
and Temporary Partial Disability (TPD) payments.
$ Temporary Disability benefits are paid until you are at Maximum Medical
Improvement (MMI) from all of your injuries due to your work related accident.
$ Temporary Total Disability (TTD) payments start after you are off work for
three calendar days or three shifts.
$ You will receive Temporary Total Disability payments if the primary care
physician states, in writing, that you are not to work, or imposes work
restrictions that your employer cannot comply with, such as light duty or
modified work within those restrictions.
$ You receive Temporary Partial Disability payments (TPD) when you are
released to light duty by the primary care physician and the employer
provides work that is available within your restrictions, but you are still earning
less than your gross wages at the time of your injury. If light duty work is not
available, you continue to receive TTD.
$ Temporary Disability payments end (including
both TTD and TPD) when you reach MMI, even
when your permanent restrictions preclude you
from your job.
$ Maximum Medical Improvement (MMI) is when
your primary authorized doctor finds that your
medical condition, due to your injury, is stable and
further medical care will not improve your condition.
$ Temporary Total Disability is two-thirds of your gross average weekly wage. A
fair gross wage can be averaged by including past wages going back a
reasonable period of time. An anticipated pay raise, just before your accident,
can be considered in raising your average weekly wage.
$ Your average weekly wage can include overtime.
$ Your average weekly wage can include the value of employer paid health
insurance benefits. The Colorado Supreme Court recently ruled that workers
who lost their employer paid health insurance benefits would be entitled to
having the cost of continuing the health insurance included in their average
weekly calculation. This is true even if the worker does not actually purchase
the insurance after his or her health insurance is terminated.
$ Sick and vacation benefits, paid to you by your employer, while you are
receiving temporary benefits, can be added to your Temporary Disability
payments and cannot be used to substitute for your Temporary
Disability benefits.
-9-• Your gross average weekly wage is very important in order to determine the
value of your temporary and permanent disability payments.
• In addition to your modied duty pay, you also receive Temporary Partial
Disability (TPD) benets, which is two-thirds of the difference between your
regular gross wages and your modied duty gross wages.
• If you are working at two jobs (concurrent employment) and you are injured
and cannot work either job, you will receive Temporary Disability benets
based on the gross wages of both jobs.
Example TTD:
Gross average weekly wage $600.00
Health insurance $100.00
Overtime $100.00
Concurrent employment $100.00
Total gross average weekly wage $900.00
= $900 x 2/3 = $600.00 - TTD Payable every two weeks 1200.00
Accrued Sick Leave Payable every two weeks $ 100.00
Accrued Vacation Pay Payable every two weeks $ 100.00
TOTAL paid every two weeks $1400.00
You are paid every two weeks for the days your doctor states that you cannot
work.
Example TPD:
Gross average weekly wage $600.00
Modied job wages $300.00
$300.00
= $300 x 2/3 = $200.00 - TPD
Total TPD $200.00 + Wages $300.00 = $500.00
TOTAL paid every two weeks $1000.00
• TTD and TPD payments are limited by law at a xed maximum amount that,
by law, changes every July 1st.
• TTD and TPD benets are not taxable.
• Employers are allowed to pay your full salary instead of temporary disability
payments.
- 10 -W
hen do my Temporary Disability payments end?
As we’ve discussed, there are two types of disability benets:
Temporary Total Disability (TTD) and Temporary Partial Disability
(TPD).
Payment of Temporary Disability (TTD and TPD) benets stops when:
• you return to regular or modied work
• you are given a written release to return to regular work by your authorized
treating doctor
• you begin modied work; after your doctor releases you to work with
restrictions, and you later refuse to report to work; you quit, or you are red
• your authorized treating doctor determines that you have reached Maximum
Medical Improvement (MMI). Again, MMI means that the injury or disease
causing your disability has become stable and no further medical treatment
will improve your medical condition.
If your employer’s Workers’ Compensation insurance company discontinues
the payment of TTD, you may be without any source of income unless you are
entitled to compensation for your permanent impairment or disability.
Can my Workers’ Compensation benets be reduced?
Yes, your benets can be reduced if any of the following conditions are met:
• You willfully fail to use a safety device.
• You willfully fail to obey a reasonable safety rule.
• When you were hired, you willfully misled your employer about your physical
ability to do the job.
• Your injury resulted from the use of drugs or alcohol.
• You owe child support.
• You return to full or part time work, and you are eligible to
receive TPD.
• You and/or your dependents receive Social Security
Disability benets.
• You receive a pension or other disability benet that
is funded by your employer. The reduction is only the
percentage of your employer’s contribution to your
pension.
• You receive Workers’ Compensation benets for the same injury from
another state.
• You receive Unemployment Insurance benets because you are not allowed
to receive unemployment benets and temporary disability at the same time.
- 11 -W
hat should I do about Social Security,
Pension or Disability benets?
Your attorney will advise you if, and when, you should apply for
Social Security Disability, a retirement pension or other disability benets
What are my obligations to my employer?
You must provide written notice to the insurance company of:
• a return to any employment
• any award for Social Security, pension or disability benet
Your employer, or insurance company, has the right to request that you apply for
Social Security Disability benets.
A notice that you will receive any of these benets must be sent to the insurance
company or the self-insured employer within twenty (20) days after you learn
of the payment or award. Failure to report may result in the suspension of your
benets and an obligation to pay back any overpayments.
Your attorney will assess and assist you with social security and pension issues
and questions.
- 12 -S
hould I submit to a Functional Capacities
Evaluation (FCE) before I am released by the
doctor?
• A Functional Capacity Evaluation (FCE) consists of a series of physical tests
and activities used to determine your permanent physical restrictions.
• The FCE can last from one hour to six hours.
• Sometimes the results of these evaluations
may not be accurate in assessing your physical
abilities or your restrictions.
• The compensation laws do not require that
you submit to an FCE; however, the employer
may require the evaluation as a condition to
your continuing employment at the time you are released from medical care
(MMI).
• We want to advise you regarding whether or not to agree to an FCE before
the doctor schedules you for the evaluation, as the results of an FCE may
adversely affect your chances of future employment.
What’s a Permanent Impairment Rating?
What happens at the end of my case?
When you reach the point that no additional medical care will improve your
condition, your doctor will place you at Maximum Medical Improvement (MMI). At
that time, your doctor will determine the percentage, if any, of medical impairment
caused by your injury.
This rating is based on a book issued by the American Medical Association that
contains guidelines for physicians to review when determining your rating, based
on your limited range of motion. The percentage of impairment has monetary value.
• When you reach MMI and are provided a Permanent
Disability Rating, your temporary benets will end.
• You can receive a settlement in one lump sum, subject to a
modest discount, instead of receiving payments every two
weeks over a lengthy period of time.
• If we disagree with your doctor’s impairment rating on the
date of Maximum Medical Improvement, we can contest
your claim by requesting a Division Independent Medical
Examination (DIME).
• There are time deadlines and limits when applying for a DIME. The DIME
request gives you another opportunity for a doctor to examine you and
re-evaluate your medical condition. The doctor will determine if you are at
Maximum Medical Improvement and recommend the same or a different
permanent disability rating.
- 13 -W
hat is the difference between Permanent
Impairment and Permanent Total
Disability?
There are 3 types of permanent impairment:
1. Scheduled Impairment: Loss of function affecting the toes, feet, legs,
ngers, hands, arms, eyes, vision or deafness.
2. Whole Person Impairment: Loss of function affecting the body parts such
as the spine, lungs, heart and mental impairment.
A scheduled, or whole person permanent impairment rating does not
preclude your returning back to work. It is your permanent physical
restrictions that determine your ability to return to the job that you held at the
time of your injury.
3. Permanent Total Disability: Inability to earn any wages.
• An impairment rating is provided by a doctor at the time you are at MMI.
Ratings are not automatically the same for similar injuries. The rating
determination provided by a doctor involves the measurement of your
range of motion at various positions. The doctor refers to a uniform
medical guide to determine your percentage of impairment based on
your limited range of motion measurements.
• Except for permanent total disability, awards for permanent impairment
do not include any wage loss that may have occurred as a result of
the injury or disease. Any award for permanent impairment is based
on functional impairment (measurement of your range of motion) as
measured by the authorized treating physician and is usually limited to
the part of the body that is affected.
• Your age and your average weekly wage are important factors in
determining the value of your permanent impairment.
• We will evaluate which of the three types of permanent impairment you
are entitled to receive as a fair compensation value.
• We will advise you if a scheduled rating can be converted to a whole
person rating which can result in a higher monetary award. Failing to
convert a scheduled rating, in a proper case, can result in the loss of
thousands of dollars of compensation. Shoulder injuries are the most
common injuries that may be converted to a whole person rating.
What is disgurement?
In most cases, if you have a scar, limp or other disgurement
caused by the injury, you may be entitled to a disgurement award
of up to $4,000.00 (or $8,000.00 in certain severe cases).
- 14 -W
hat happens if I can never return to any
type of work? - Permanent Total Disability
If your work related injury prevents you from returning to full or part
time employment, you would be considered permanently and totally disabled. In
the Workers’ Compensation Act, permanently and totally disability is dened in
only 14 words, ” . . . the employee is unable to earn any wages in the same or
other employment.”
• If you are permanently and totally disabled, you may be entitled to lifetime
Workers’ Compensation benets. The weekly amount of these benets
is the same as you would receive for temporary total disability benets.
This benet amount remains the same throughout your lifetime. However,
social security disability and pension payments may reduce your Workers’
Compensation benets.
• Employers and their insurance companies are
very reluctant to admit that an injured worker is
permanently and totally disabled.
• We have the expertise to negotiate and litigate your
permanent total disability case.
• The evidence required to prove a permanent total
disability claim is very complex. Expert testimony is
required.
• A vocational expert and a functional capacities
evaluator must be retained on your behalf.
• There are settlement options if you are permanently
and totally disabled. We will explain these options to you that may include
an annuity, a structured settlement, equal periodic payments or a cash
settlement.
Will my future medical care be paid by the
insurance company when I reach Maximum Medical
Improvement? - Medical Maintenance
• If the doctor who rates you recommends your medical care continue after
you are rated and released your medical care can continue.
• Examples of a need for continued medical care include a further need for:
o Prescriptions
o Physical therapy
o Doctors visits
o Future surgery
o Gym membership
o Medical supplies such as special braces and articial limbs
- 15 -W
hat do I do when I receive a Final
Admission of Liability?
After you are placed at MMI and are rated, you will receive a written
Final Admission of Liability stating the value of your permanent impairment, if
any. If your attorney disputes the value and the percentage of the impairment
rating, they can le an objection in writing to the Final Admission of Liability
within the required thirty (30) days and request a division independent medical
examination (DIME) and/or a trial. If an objection is not timely led, the case
automatically closes.
Can I appeal the Permanent
Disability rating given to me
by the Workers’ Compensation
Doctor?
Yes, there is a legal procedure that allows a
doctor who has no connection with your case
to examine you (Division Independent Medical
Examination).This doctor can state that you
are not at MMI, recommend further treatment, and determine a new permanent
I
disability rating.
f there is a dispute, can I go to Court at any time
during my Workers’ Compensation case?
Yes, a Judge can issue orders on:
• Whether or not you were hurt on the job
• Temporary disability
• Permanent disability
• Permanent total disability
• Medical benets
• Maximum Medical Improvement
The claimant has the burden of proof when the case is litigated before a judge.
How does a case settle?
• You may be able to settle all or part of your claim. There are many
circumstances where this type of settlement has advantages for you.
• When we negotiate settlements, we help you in determining if the settlement
is fair and advantageous.
- 16 -Can I re-open my claim after my case is closed?
• You cannot re-open your case if your claim for benets has been
permanently settled with a judge’s written approval. There are a few
exceptions such as fraud or mistake of material facts.
o You must re-open your case within six years from the date of
your injury or two years from the date of your last Workers’
Compensation payment that is due to you. Payments of medical
bills are not considered a payment that extends your re-opening
rights.
o To re-open your case, it is imperative that your medical condition
has worsened after your case was initially closed.
o If your claim is re-opened and you receive temporary disability
benets, payments will be based on your wages at the time of the
original injury. Re-opening your claim will not affect the award of
money already paid, unless the insurance company re-opens the
claim to recover an overpayment.
• When a claim is re-opened medical care, temporary disability, and
increased permanent disability can be paid.
- 17 -About the Authors
LAURENCE J. FREE
Larry Free is a native of Michigan and graduated from
Douglas County High School, Castle Rock, Colorado.
After attending Arapahoe Community College in Littleton,
he completed his bachelor of art degree at the University
of Michigan in Ann Arbor, Michigan – graduating with
Distinction.
Having attended on a scholarship, Larry received his law
degree from the University of Denver, College of Law in
1993.
Larry’s employment history includes sundry jobs in the food
service industry, cabinet making, carpentry, appliance repair, and delivery driving.
He originally joined the rm as a “runner”, worked as a clerk during law school
and became an associate following graduation. He was admitted to partnership
in 1999. He has practiced exclusively in the area of Workers’ Compensation
since 1995.
Larry’s interests include family activities, camping, really loud music (especially
concerts), reading, and original paperback and illustration art.
BRADLEY R. UNKELESS
A native of Florida, Brad Unkeless earned an undergraduate
degree from Florida State University, Tallahassee, Florida,
and a B.S. at University of San Diego School of Law, San Diego,
California.
He is licensed to practice law in the states of California and
Colorado as well as U.S. Tax Court, and U.S. District Court
- Districts of California and Colorado.
Brad’s early work experience included caddying, construction and surveying.
Brad was in private practice following graduation until 1983. He joined the
Hartford Insurance Company in 1983, where he served as senior trial attorney
before joining Fogel Keating Wagner Polidori Free in 2005.
Brad’s interests include golng, swimming and reading.
- 18 -NICK D. FOGEL
Nick is a Colorado native and earned his bachelor degree
from the University of Colorado, majoring in International
Affairs with an area of emphasis in Mandarin Chinese.
Nick then attended Law School at the University of Denver,
Sturm College of Law earning his Juris Doctorate. Nick
has served as a law clerk for several Administrative Law
Judges, State Senator Dan Grossman (chairman of the
Senate Judiciary and Homeland Security Committees),
Denver District Judge Michael A. Martinez, the Denver
District Attorney’s Office, and the Colorado District Attorney’s Council. Nick is
currently a member of the Colorado Bar Association, the Denver Bar Association,
the Colorado Trial Lawyers Association, the American Bar Association, the
American Association for Justice, and Minoru Yasui Inn of Court.
- 19 -1M 5-2012 V.10/2007
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