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WORKER’S COMPENSATION – LAW 101

Hello, I’m attorney Kyle Bachus. The legal world is full of overly complicated jargon and terminology that can be intimidating if you don’t know what it means. In my law 101 video series, I’m breaking down some commonly used legal terms so you can be informed and confident should you ever need to take legal action.

In this episode of law 101, we’re going to break down and tell you what workers’ compensation means in the legal world.

Workers’ compensation is a substitute system that’s been created by statute to resolve injury claims when somebody is injured on the job. Believe it or not years ago, maybe a hundred years ago, it depends on which state. If you were injured on a worksite, you had to sue your employer, right? That might be uncomfortable if you want to keep a job. So many states moved away from a traditional tort system for handling workers’ compensation claims and instead created a separate statutory system.

The work comp statute is in place of being able to bring a claim against an employer for an on-the-job injury. So long as the employer has purchased workers’ compensation insurance, and that’s the trigger for that immunity. If they purchase workers’ compensation insurance, they buy this immunity that then says the injured worker is only entitled to recover under the statutory scheme that’s created in each state. These benefits may vary state to state. But worker’s compensation benefits generally cover wage loss, but instead of a hundred percent; they usually cover about 66 percent of wage loss.

There’s generally a cap on how much wage loss per week you can get through workers’ compensation. Workers’ compensation benefits also cover long-term physical injury, but they only cover from a standpoint of what are you likely to lose in terms of future income based upon your injury. Workers’ compensation does not provide any compensation at all for pain or suffering or loss of enjoyment of life, or physical impairment. It does provide compensation for the work consequences of physical impairment, but there’s a statutory calculation that is applied based upon the percentage of permanent injury.

Workers’ compensation claims do not go to the traditional court system; there’s no right to jury trial. Workers’ compensation claims go through an administrative process. Through administrative law, judges that are appointed to handle and process worker’s compensation claims. There are circumstances where you could be eligible for both a worker’s compensation claim and a traditional tort claim, right? You could be driving down the road on behalf of an employer and be injured by somebody else who causes that injury. In that circumstance, your medical expenses and other worker’s compensation benefits, you get to recover those from your work comp claim. And then you can present a tort claim against the driver who caused the injuries.

Now you have to be aware of this too, subrogation, see that video on subrogation because that might apply to a worker’s compensation situation. But the good news about worker’s compensation is that worker’s compensation is available to a worker even if the worker is at fault. Well, if an employer fails to purchase worker’s compensation insurance, then you can pursue a claim against them outside the workers’ compensation system, and you apply all of what we learned in other videos when we talked about tort claims. Because traditional tort claims, negligence claims is how you would proceed.

I will tell you that employers view the relief or the immunities created by the work comp system in such a way that almost every employer buys into the work comp system. Because at the end of the day, it saves them a tremendous amount in terms of exposure to liability by buying in. So if you’re injured on the job, and you have a question about whether you have a work comp claim.

Exactly what benefits you might be entitled to under Colorado’s worker’s compensation statute or any other state worker’s compensation statute. We’re happy to answer those questions for you at Bachus & Schanker. To learn more about other law topics that can help you feel informed and confident about the law, make sure to check out more videos in this series.

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WORKERS’ COMPENSATION CLAIMS – FAQs

Workers’ compensation is medical care and replacement income paid to an individual if they are hurt at work. The injured worker does not have to prove that the employer did anything to cause the accident. An injured employee can choose to work with a workers’ compensation lawyer to get fair benefits through the system.

Workers’ compensation works by allowing an employee fast access to medical care and replacement income due to injury or illness on the job. The employee reports that they are hurt at work, and the employer submits the report to an insurer. Then, the employee receives payment for medical bills, rehabilitation, and replacement income until they are able to return to work. If they do not return to work, they receive long-term replacement income.

If an employee is injured at work, they have the right to report the accident to receive workers’ compensation benefits. Medical care should be available free of charge until the injured worker has reached the maximum medical improvement1. In addition, the employee has the right to a percentage of their average weekly wage as replacement pay while they are unable to work. Depending on the cause of the injury, the worker may also have the right to a third-party legal claim for negligence, recklessness, or intentional injury.

There may be some circumstances where workers’ comp covers injuries that happen outside of the workplace. If the injury occurs while the employee is traveling for work or away from their employment location at the request of the employer, the injuries may be covered even if they don’t occur at the primary place of employment.

Benefits available under workers’ comp include:

  • Medical evaluation
  • Emergency treatment
  • Diagnostic tests
  • Surgeries
  • Physical therapy, occupational therapy
  • Replacement income up to the average weekly wage maximum benefit rate
  • Impairment rate
  • Bodily disfigurement compensation
  • Death benefits
  • Burial Expenses

Colorado workers’ compensation pays a percentage of the employee’s average weekly wage up to the maximum benefit amount. CRS § 8-42-1022 creates rules for calculating the average weekly wage. If you can work in some capacity, your benefits are reduced, since workers’ compensation is meant to be replacement income.

If you permanently lose a body part or body function, you receive a scheduled loss award. A scheduled loss is paid by multiplying the percentage of disability rating by the number of weeks in the schedule for the type of disfigurement. A complete, permanent impairment not listed in the schedule triggers impairment compensation based on the impairment rating and an age factor.

In Colorado, you should report a workplace injury within four days of the incident. Reporting later than that means a loss of one day of benefits for each day of delay. In addition, you must file a claim for workers’ comp benefits within two years. The best time to report an injury to your employer is as soon as possible after it happens.

Inform your employer of your injury in writing. Sometimes, your employer will complete an injury form and give you a copy. If they don’t, turn in a written letter or email confirming that you were injured on the job. The purpose is to create a record that you made a timely report of your injury to your employer.

You should also directly report the injury to the Colorado Department of Labor and Employment, Division of Workers’ Compensation by completing the WC15 – Workers Claim for Compensation claim form.

The time limit to file a workers’ comp claim is two years. Your benefits are reduced on a continuing scale if you wait more than four days to report the injury. Then, you have two years to claim benefits. In unusual circumstances, the time limit may be extended to three years, but you shouldn’t count on this. The deadlines are usually four days to report the injury and two years to claim benefits.

The Colorado Workers’ Compensation Act3, Title 8, Labor and Industry, Article 14.5, Cost Containment is the workers’ comp law. C.R.S. § 8- 14.5-101 et seq. creates laws for a variety of topics governing on-the-job injuries including definitions of employees and employment and coverage available for workers’. See Colorado Workers Compensation Rules of Procedure4.

A worker can still get workers’ compensation payments if they acted negligently. Colorado law § 8-41-101 says that want of ordinary care is not a defense to a workers’ compensation claim if the employee’s actions were not willful. Negligence on the part of another employee does not excuse workers’ compensation payments, either.

Colorado law § 8-41-101 prohibits an employer from using assumption of the risk as a defense in a workers’ compensation claim.

If the employee’s regular employment and place of employment are in the State of Colorado, they may receive benefits through the Colorado workers’ compensation system even if their injuries occur out of state. Colorado law § 8-41-204 extends out-of-state coverage to workers based in the state for the first six months after they leave the state unless the employer files for an extension.

If you are permanently disabled, you continue to receive a share of your average weekly wage forever or until you are no longer totally disabled. Permanent disability payments5 begin once you have reached the maximum medical improvement from your injuries. This is when your injuries are not expected to get any better. The payments may be total or partial based on the severity of the disability.

If you don’t agree with a determination of your workers’ compensation benefits, you may ask for a hearing with the Office of Administrative Courts. It is a formal legal proceeding heard by an administrative law judge. You must present information and explain why you deserve certain benefits from workers’ compensation.

If your employer denies your workers’ comp claim, you can challenge the decision. You can contest your entitlement to benefits, and you can also challenge the amount. A workers’ compensation law firm can represent you throughout the entire process, including investigating, negotiating, and presenting your case at a hearing.

Workers’ compensation insurance pays replacement income to a worker when they are hurt at work. Unemployment pays a worker who loses their job through no fault of their own. An employee should not lose their job because they are hurt and claim workers’ compensation benefits. An experienced lawyer can help you evaluate your legal options if you are retaliated against for claiming workers’ compensation benefits.

A workers’ compensation lawyer represents an individual who is hurt at work. They help the person with all the steps of the claims process to receive the fair compensation they deserve under the law. A lawyer for workers’ comp is a trained advocate, knowing the details of the system to help injured workers receive justice.

SOURCES:

1Colorado Department of Labor and Employment (CDLE). Medical Providers. Retrieved 30 December 2021.
2CRS 8-42-102
3Colorado Department of Labor and Employment (CDLE). 2021 Colorado Workers’ Compensation Act. Retrieved 30 December 2021.
4Colorado Department of Labor and Employment (CDLE). Workers’ Compensation Rules of Procedure. Retrieved 30 December 2021.
5CRS 8-42-107

CHECK OUT MORE VIDEOS IN OUR LAW 101 SERIES