Menu

ICAO Sets Aside Permanent Total Disability Benefits Award for Failure to Endorse Issue at Time of Hearing on Permanent Partial Disability Benefits

In a claim handled by this attorney, the Industrial Claims Appeals Office recently set aside the Administrative Law Judge’s award of Permanent Total Disability benefits because the claimant failed to litigate the issue at the time the parties litigated the issue of Permanent Partial Disability benefits. Weibel v. The Kroger Company, W. C. No. 4-878-425-06 […]

Read full story Comments are closed

New Address for Office of Administrative Courts and Hearings in Colorado Springs

The Office of Administrative Courts has announced that it will be moving to a new location beginning August 1, 2015. The new address for will be 2864 S. Circle Drive, Suite 810, Colorado Springs, CO 80906. Hearings temporarily will be held on the 10th floor until construction of the courtrooms has been completed.

Read full story Comments are closed

Court of Appeals upholds Administrative Law Judge’s application of “Significant Causative Factor” Test to Deny Permanent Total Disability Benefits to a Worker Without Prior Permanent Restrictions

In a prior post I analyzed an Order of an Administrative Law Judge which denied Permanent Total Disability benefits to an injured worker because the Administrative Law Judge found the injury was not a significant causative factor to her overall disability and inability to earn wages even though the claimant did not have any prior work […]

Read full story Comments are closed

Today OSHA Celebrates National Young Worker Safety Day

Today, regulators and safety advocates across the U.S. are celebrating National Young Worker Safety Day to help educate younger workers, informing them that they have the same rights as any other worker. While OSHA and other agencies are hoping to teach young workers how to stand up  for their rights, safety advocates are focused on […]

Read full story Comments are closed

New OSHA Alliance Intended to Protect Safety & Health of Transgender Workers

Officials at the Occupational Safety & Health Administration (OSHA) have recently formed a new alliance with the National Center for Transgender Equality (NCTE) in an effort to “foster safer and more healthful American workplaces.” According to the press release, this new alliance will exist for two years, focusing over this time on: Providing opportunities for […]

Read full story Comments are closed

Division of Workers’ Compensation Electronic Filing Moved to New Web Address

Effective immediately, the Division of Workers’ Compensation electronic filing (EDI) has moved to a new web address: https://wwws.coworkforce.com/ColoWC2/. You should change your bookmarks accordingly. When you navigate to the new website, you will need to change your password. All passwords must be 8 characters in length, contain at least one (1) letter and one (1) number […]

Read full story Comments are closed

Today, Workers’ Memorial Day Honors Deceased Workers

American laborers form the backbone of our economy — but our economic growth should never come at the cost of their safety or well-being. Those who work every day to put food on the table, provide for their families, or care for their fellow citizens should know their country has their back. Today, as we […]

Read full story Comments are closed

Legislature Proposes New Tax to Fund Family and Medical Leave Insurance Program

The House is proposing the creation of a family and medical leave insurance program that would establish a new tax on the wages of each employee in the state to create a fund to “provide partial wage-replacement benefits to an eligible individual who takes leave from work to care for a new child or a […]

Read full story Comments are closed

Court of Appeals Affirms Denial of Compensability Under Personal Risks Doctrine

The Court of Appeals recently affirmed an Administrative Law Judge’s denial of compensability for an arm injury under the “idiopathic injury” theory. Duran v. Industrial Claim Appeals Office, ___ P3d ____ (Colo. App. 2015)(14CA0425, March 26, 2015). In Duran, the claimant sustained a fractured arm while unhooking his seat belt while on a work errand. […]

Read full story Comments are closed

Workplace Emergencies: OSHA’s 7 Components of Effective Response Systems

No matter how careful workers may be, accidents can happen, and they can sometimes result in workplace emergencies that require prompt responses to prevent further injuries and/or fatalities. This is when having effective safety and health managements systems in place can save lives. Just what makes a safety and health management system in a given […]

Read full story Comments are closed

Colorado Workers’ Compensation Claim Timelines: A Helpful Overview

Workers compensation benefits can provide you with essential financial support while you recover from a workplace injury – but the journey to getting them can be complicated, especially considering that: There are various timelines that have to be met in order for claims to proceed smoothly. Missing Colorado workers compensation claim timelines can result in […]

Read full story Comments are closed

Division of Workers’ Compensation to Soon to Issue “Medical Treatment Guidelines Reference Guide for Adjusters”

  The Division of Workers’ Compensation’s All About Claims newsletter indicates that the Division of Workers’ Compensation is working on a new electronic reference guide for adjusters entitled “Medical Treatment Guidelines Reference Guide for Adjusters.” The four most important elements to be featured in the new guide include: procedures or services which require Prior Authorization […]

Read full story Comments are closed

REMINDER: Statutory Changes to the Designated Provider List

Effective April 15, 2015, § 8-43-404(5) will require employers to increase the number of physicians which must be offered to an employee on the Designated Provider List from two to four physicians, corporate medical providers or a combination of both, where available. At least one of the designated providers must be at a distinct location […]

Read full story Comments are closed

Claimant’s Attorney’s Negligence May Be a Reasonable Excuse for Failure to File a Claim Within the Two-Year Statute of Limitations

Section 8-43-103(2) creates a two-year statute of limitations to file a claim for compensation. However, the statute also extends the statute of limitations to three years where it is established that a “reasonable excuse exists for the failure to file” a claim for compensation. An attorney’s negligence in filing the claim for compensation timely may […]

Read full story Comments are closed

Employee’s Cost of Converting Health Insurance Under COBRA

Section 8-40-201(19) provides that the term “wages” shall include “the amount of the employee’s cost of continuing the employer’s group health insurance plan and, upon termination of the continuation, the employee’s cost of conversion to a similar or lesser insurance plan.” Recently, an employer raised an interesting defense to the claimant’s request to increase his […]

Read full story Comments are closed

2015 Colorado Workers’ Comp Insurance Premiums Won’t Increase for Many Employers

2015 Colorado workers’ comp insurance premiums will not cost more for the average employer, as the “loss costs” of these premiums did not spike for the first time since 2010. As the Colorado Division of Insurance (CDI) recently noted, this is due to the fact that a substantial number people who experienced workplace injuries ended […]

Read full story Comments are closed

5 Simple Tips for Preventing Winter Slip and Falls at Work

The cold and icy conditions of wintertime in Colorado can increase the chances that people will experience slip and fall accidents anywhere – including at work. In fact, as the Bureau of Labor Statistics reports, over the past year, workers compensation claims in the U.S. that were related to injuries from winter slip and fall […]

Read full story Comments are closed

CMS Issues Notice of Hydrocodone Combination Product Coverage Changes for WCMSA Proposals Submitted on or after January 1, 2015

In October 2014, the U.S. Drug Enforcement Administration rescheduled all hydrocodone combination products from schedule C-III controlled substances to C-II controlled substances. C-II controlled substances require new prescriptions at intervals no greater than 30 days, though a practitioner may issue up to three consecutive prescriptions in one visit (essentially authorizing the patient to receive a […]

Read full story Comments are closed

New Program Will Try to Reduce Fatal Falls for Cell Tower Technicians

Fatal falls are a big problem for cell tower workers, but a new national program will try to reverse this trend and save cell tower technicians’ lives. The Telecommunications Industry Registered Apprenticeship Program, which was developed with the help of the Federal Communications Commission (FCC), the Department of Labor (DoL) and AT&T (to only name […]

Read full story Comments are closed

Is Workplace Noise Exposure “A Growing National Problem”? The ATA Thinks So…

Each year in the U.S., roughly 30 million American workers are exposed to excessive noise in their workplaces, according to the National Institute of Occupational Safety and Health (NIOSH). Such dangerous levels of consistent workplace noise exposure can put workers at risk of sustaining serious injuries, including: Tinnitus Hyperacusis Deafness Physical and emotional stress. The […]

Read full story Comments are closed

Holders of Certificate of Insurance Required to be Notified of Cancellation of Workers’ Compensation Policy

The Court of Appeals recently remanded a case back to the Administrative Law Judge to determine whether Pinnacol Assurance should be estopped from denying coverage to a subcontractor because Pinnacol failed to notify the general contractor and the owner of rental property that Pinnacol cancelled the policy. Hoff v. Industrial Claim Appeals Office, ___ P.3d […]

Read full story Comments are closed

Changes to DWC Electronic Filing

The Division of Workers’ Compensation announced that starting on November 1, 2014 the EDI online application will be moving to a new server. When you access the program you will be redirected to the new server website. Therefore, if you have a bookmark or shortcut to the application on your computer or web browser, you will […]

Read full story Comments are closed

Travel to and from Work Compensable if Job Requires Use of Automobile

Colorado has recognized a longstanding rule that injuries sustained by workers traveling to work from home (and while returning home), are not compensable because they are not seen as arising out of employment. In 1999 the Colorado Supreme Court recognized that the facts of any particular case may justify an exception to this general rule, […]

Read full story Comments are closed

Notice of Rule Hearing – Proposed Changes to W.C.R.P. 5 – Claims Adjusting Requirements

The Division of Workers’ Compensation has scheduled a public hearing to to address the proposed changes to W.C.R.P. 5 – Claims Adjusting Requirements. The hearing will be held in the 12th Floor Conference Room at 633 17th Street in Denver. The public hearing will be held in accordance with the provisions of the Colorado Administrative […]

Read full story Comments are closed

New Information re: Collection of Prescription Drug Information for WCMSAs

On October 6, 2014, the Centers for Medicare and Medicaid Services will be implementing a change to its online portal which will allow users to enter prescription drug information directly into the portal, which will allow users to “input and calculate the proposed prescription drug portion of the WCMSA proposal.” A new informational alert titled […]

Read full story Comments are closed

Muddying the Waters on What Constitutes Horseplay

In Trujillo v. Lowe’s, W. C. No. 4-932-395 (July 29, 2014), the claimant was injured when he engaged in a “chest bump” with a co-worker to celebrate the completion of a particular job duty. It has long been settled law that an injury caused by “horseplay” does not arise out of or occur within the […]

Read full story Comments are closed

Preventing Workplace Back Injuries with Office Ergonomics (Pt. 2)

Picking up from where Preventing Workplace Back Injuries with Office Ergonomics (Pt. 1) left off, here we will continue discussing how sedentary workers can minimize their risk of developing workplace back injuries. While the first part of this blog focused on some of the specific risks these workers face, below, we will point out the […]

Read full story Comments are closed

Preventing Workplace Back Injuries with Office Ergonomics (Pt. 1)

Back injuries can be some of the most painful and debilitating types of workplace injuries people can sustain, as these impairments can end up impacting people’s abilities to move around or even sit for extended periods of time. Despite the fact that many back injuries arise from a single accident or traumatic incident, in some […]

Read full story Comments are closed

Medical Fee Schedule Addresses Compound Medications

Recently I have had a number of clients inquire about the exorbitant cost being charged by pharmacies for compound medications – usually topical anti-inflammatory agents combined with topical local anesthetics. Pharmacies have been charging upwards of $3,000 or more for a one-month supply, depending on the agents/ingredients in the compound medication. Surprisingly, all of these […]

Read full story Comments are closed

Workers’ Compensation Benefits vs. Social Security Disability Benefits (Pt. 2)

Continuing from where we left off in Workers’ Compensation Benefits vs. Social Security Disability Benefits (Pt. 1), below we will resume our discussion regarding some of the important differences between Social Security disability benefits and workers’ compensation benefits for people who’ve sustained permanent impairments as a result of workplace accidents and injuries. In addition to […]

Read full story Comments are closed

Workers’ Compensation Benefits vs. Social Security Disability Benefits (Pt. 1)

When a workplace injury is severe enough to result in permanent impairments, the injured person may be able to seek compensation for his injuries and losses via the Colorado workers’ compensation system and/or via the Social Security disability system. While the amounts of these benefits can differ (as can the process of obtaining these benefits), […]

Read full story Comments are closed

CMS Issues Updated WCMSA Reference Guide

On June 3, 2014, the Centers for Medicare and Medicaid Services (CMS) issued an updated Workers’ Compensation Medicare Set-Aside Arrangement (WCMSA) Reference Guide. The following sections of the Guide have been enhanced or added: 4.1.4          Hearing on the Merits of the Case: Section added to reflect the April 22, 2003 WCMSA […]

Read full story Comments are closed

Calculation of Lump Sums in Excess of $60,000

In a previous post I reported that effective July 1, 2014, the legislature amended § 8-43-406(2) to increased the maximum amount of all lump sums to $80,000, for all dates of injury prior to July 1, 2014 (and to adjust that maximum amount on July 1 of each calendar year).  W.C.R.P.  5-10(B)(1) requires the respondents to […]

Read full story Comments are closed

Statutory Changes – Designated Provider List

Effective April 15, 2015, § 8-43-404(5) will require employers to increase the number of physicians which must be offered to an employee on the Designated Provider List from two to four physicians, corporate medical providers or a combination of both, where available. At least one of the designated providers must be at a distinct location […]

Read full story Comments are closed

Statutory Changes – Reimbursement to Claimant to Attend an IME

The legislature amended § 8-43-404(1)(b)(I) to require a respondent to reimburse a claimant for uncompensated wage loss up to $75.00 per day for attending an independent medical examination requested by the employer/insurer. Note that the amendment requires reimbursement only for “uncompensated” wage loss. Thus, if the employer pays an hourly employee (or does not charge […]

Read full story Comments are closed

Division Posts 2014 Compensation Rates – New Lump Sum Maximum

The Division of Workers’ Compensation has posted the new compensation rates, effective for injuries on or after July 1, 2014: Maximum Compensation Benefit Rate: $881.65 per week. Scheduled Impairment Rate: $277.03 per week. Whole Person PPD Rate: $484.44 per week. Disfigurement: $4,673.47/$9,345.38. Lump Sums*: $81,435.67. *The Colorado Legislature amended §8-43-406 to increase the aggregate of […]

Read full story Comments are closed

“Significant Causative Factor” Applied to Deny Permanent Total Disability Benefits to a Worker Without Prior Permanent Restrictions

It has long been the law that although a claimant is not required to establish that an industrial injury is the sole cause of an alleged inability to earn wages, the claimant must nonetheless demonstrate that the industrial injury is a “significant causative factor” in her alleged permanent total disability. Under this test, the Administrative […]

Read full story Comments are closed

Failure to Pay Mileage Reimbursement Timely not a Violation of W.C.R.P. 16-11(A)

The Industrial Claim Appeals Office reversed an Order of an Administrative Law Judge awarding penalties for a violation of W.C.R.P. 16-11(A), based on the insurer’s failure to reimburse a claimant timely for mileage expenses. The Industrial Claim Appeals Office reasoned that although W.C.R.P. 16-11(A) provides that an uncontested bill submitted by a “provider” is due […]

Read full story Comments are closed

CMS Adds Self-Administration Page to Its Website

The Centers for Medicare and Medicaid Services (CMS) has added a new web page to its website designed to assist individuals in self-administering Workers’ Compensation Medicare Set Aside Arrangements (WCMSAs).  Materials available on the new page include: • New Self-Administration Toolkit for WCMSAs; • Account Expenditure for Lump Sum Account (Attestation Letter); • Account Expenditure […]

Read full story Comments are closed

SSDI Offset Calculated Using 52 Weeks

In a decision likely to save the insurance industry hundreds of cents per year, the Industrial Claim Appeals Office finally has settled the issue of how to calculate the SSDI offset properly. In Keel v. Transportation Technology Services, W. C. No. 4-897-030 (April 1, 2014), the Industrial Claim Appeals Office rejected the claimant’s argument that […]

Read full story Comments are closed

DWC Posts Form for Abandonment of Claim

In a prior post, I addressed the recently-added three subsections to W.C.R.P. 7-1, including subsection subsection (E), which provides that an insurer may file a final admission of liability based on the claimant’s voluntary abandonment of a claim if the claimant: (1) is not receiving temporary disability benefits; (2) provides written notice (in a forthcoming Division form) […]

Read full story Comments are closed

5 Things to Know about Workers’ Compensation Fraud (Part 2)

Wrapping up our two-part blog 5 Things to Know about Workers’ Compensation Fraud, below is some more important information regarding workers’ compensation fraud. If you have specific questions regarding workers’ compensation benefits and would like to know more about your rights and options, contact the Law Office of Steven J. Picardi. We are happy to answer […]

Read full story Comments are closed

5 Things to Know about Workers’ Compensation Fraud (Part 1)

Workers’ compensation benefits are intended to provide injured workers with financial support as they focus on recovering from on-the-job injuries. Despite the fact that this system has limited resources and that many people who apply for these benefits have a real need for them, there are some people who may try to take advantage of […]

Read full story Comments are closed

Fatal Work Injury News: Deadliest Cities for American Workers

Smaller cities that are focused on a certain industry tend to be the most dangerous for American workers, as they are where the most fatal work injuries and occupational illnesses tend to arise (according to data gathered by various federal agencies). In fact, recently released data indicates that the following are the deadliest cities for […]

Read full story Comments are closed

Supreme Court Sets New Standard of Compensability for Unexplained Falls

The Supreme Court of Colorado recently issued an opinion which significantly changes the traditional analysis of claims based on an unexplained fall. City of Brighton v. Rodriguez, 2014 CO 7, 318 P.3d 496 (Colo. 2014). In the underlying case, the claimant fell while walking down a set of stairs.  The employer filed a General Admission […]

Read full story Comments are closed

Updated Life Tables Required for WCMSAs

The Centers for Medicare and Medicaid Services (CMS) has announced that it will begin referencing the Centers for Disease Control’s Table 1: Life Table for the total population: United States, 2009, to calculate life expectancies for all Workers’ Compensation Medciare Set-Aside Agreements, effective March 31, 2014. The CDC’s 2009 Life Tables may be found here.

Read full story Comments are closed

Recent Changes to the Workers’ Compensation Rules of Procedure

On January 21, 2014, the Director of the Division of Workers’ Compensation adopted changes to Rule 5-5 (admissions of liability) and Rule 7. To see the new changes to both Rules, click here. The amendments are effective on March 17, 2014. You may remember that the legislature recently amended Section 8-42-107.2(4)(c) to require the Division IME Unit […]

Read full story Comments are closed

DWC Prehearings and Settlement Unit Address Change

Effective immediately, all correspondence sent to the Prehearings and Settlement Unit should be sent to the 4th Floor: Division of Workers’ Compensation Prehearings and Settlement Unit 633 17th Street, 4th Floor Denver, CO 80202 In addition, on February 13 and 14, 2014, the Division of Workers’ Compensation’s Prehearings and Settlement Unit is moving its offices […]

Read full story Comments are closed

Mileage Rate Increase

The rate for mileage increased to $.53 per mile effective January 1, 2014.  If you want to bookmark W.C.R.P. 18-6 Division Established Codes and values, click here.

Read full story Comments are closed

Cold Weather Injuries and How Outdoor Workers Can Avoid Them

If you work outdoors, then the winter season can be a particular dangerous time, especially if you are in the Midwest or Northeast, as the record-breaking cold temperatures have made it riskier than ever to be outside for extended periods of time. Whether this is your first winter working outdoors or you have been facing […]

Read full story Comments are closed

An Administrative Law Judge Has No Authority to Extend the Time for a Respondent to Take a Position on a Division IME Physician’s Impairment Rating

It has long been settled law that if the respondent fails to file an Application for Hearing timely challenging the opinions of the Division IME physician, the opinion becomes binding. Leprino v. Industrial Claim Appeals Office, 134 P.3d 475 (Colo. App. 2005)(the requirements of §8-42-107.2(4) are jurisdictional and if the parties fail to request a […]

Read full story Comments are closed

Ladder Safety Tips to Prevent Fall Injuries

Fall injuries are reportedly the number one cause of workers’ compensation claims in the U.S., as each year more than 9 million American workers seek hospital treatment after sustaining a fall accident. While many of these fall accidents occur due to slips or trips that cause people to take a tumble without falling from some […]

Read full story Comments are closed

New Website Address for Electonic Filings

In an e-mail sent by the Colorado Division of Workers’ Compensation on Friday, November 22, 2013, the DWC announced that is working with the Governor’s Office of Information Technology to upgrade and migrate the EDI (electronic filing) website. The decision to migrate the system was influenced by the number of recent outages experienced. This migration […]

Read full story Comments are closed

CMS Publishes New WCMSA Reference Guide

The Centers for Medicare and Medicaid Services (CMS) has updated its Workers’ Compensation Medicare Set-Aside Arrangement (WCMSA) Reference Guide to document the current WCMSA review process and provide more detailed information on the actions performed by the Workers’ Compensation Recovery Contractor (WCRC).  The updated Reference guide can be found here. The following sections of the […]

Read full story Comments are closed

The Affordable Care Act (a/k/a Obamacare) affects Workers’ Compensation Medicare Set-Aside Arrangements

Due to the passage of the Patient Protection and Affordable Care Act (Obamacare), effective January 1, 2014, all restrictions on barbiturate indications will be lifted and any medically accepted indication will have coverage under the Medicare Part D Benefit. Therefore, CMS will begin allocating barbiturates for all medically accepted indications within WCMSAs (barbiturates currently are […]

Read full story Comments are closed

An Overview of Whole Person Ratings

When you are injured while working and sustain some type of permanent disability or impairment as a result of this injury: You will be entitled to workers’ compensation benefits. Compensation for your permanent impairment will be based on either an extremity rating or a whole person rating. While extremity ratings are generally used in cases […]

Read full story Comments are closed

The Respondents May Bear the Burden of Proving Previously-Admitted Maintenance Medical Treatment No Longer Reasonable and Necessary

It long has been settled law that where the respondents file a final admission admitting for maintenance medical benefits, the respondents are not precluded from later contesting their liability for a particular treatment. Snyder v. Industrial Claim Appeals Office, 942 P.2d 1337 (Colo. App. 1997). Moreover, when the respondents contest liability for a particular medical […]

Read full story Comments are closed

An Order Denying an Attempt to Overcome a Division IME Physician’s Findings on MMI Only is not an Appealable Order

As documented in a previous post, the Industrial Claim Appeals Office again dismissed an appeal for lack of a final order where the Administrative Law Judge made found that the respondents failed to overcome the Division IME physician’s opinion on Maximum Medical Improvement but did not enter an order requiring the respondents to pay a […]

Read full story Comments are closed

DIME Physician’s Opinion on Causal Relationship May Have No Presumptive Weight in Hearing on Permanent Total Disability Benefits

It long has been settled law that the Division IME physician’s opinion concerning the cause of a particular component of a claimant’s overall impairment must be overcome by clear and convincing evidence. The Industrial Claim Appeals Office appears to have departed from that rule of law in a recent decision which stated that the determination […]

Read full story Comments are closed

Workers’ Compensation Fraud (Part 2)

As a continuation of Workers’ Compensation Fraud (Part 1), the following provides some further information regarding illegal workers’ compensation claims. While Part 1 of this blog provided a comprehensive definition of what constitutes workers’ compensation fraud, here in Part 2, we will focus on the criminal penalties for those who are charged with and convicted […]

Read full story Comments are closed

An Administrative Law Judge May Deny a Penalty on the Merits for Failure to Plead Specific Grounds for Penalty

In Lovett v. Stroup Insurance Services, Inc., W. C. No. 4-808-092 (August 30, 2013), the Industrial Claim Appeals Office recently held that an Administrative Law Judge’s denial of a penalty for failure to plead the specific grounds for the penalty allegation in the merits was a denial of the penalty on the merits, rather than […]

Read full story Comments are closed

An Order Denying “Compensability” Only is Not an Appealable Order

In a decision that stretches the bounds of legal reasoning, the Industrial Claim Appeals Office recently issued an opinion holding an Administrative Law Judge’s order finding a claim not compensable did not deny the claimant a benefit. Abenth v. Northside Christian Church, W. C. No. 4-893-024 (September 12, 2013). The court recognized that the statute […]

Read full story Comments are closed

Workers’ Compensation Fraud (Part 1)

While fraud generally refers to the criminal act of intentionally deceiving some entity in order to further one’s personal financial gain, workers’ compensation fraud is specifically defined as the act of intentionally making false statements or representations to the Division of Workers’ Compensation in Colorado in order to secure payments or any type of benefit […]

Read full story Comments are closed

Updated CMS Regional Contacts – Revised

The blog post dated July 22, 2013, published the updated Centers for Medicare and Medicaid Services regional contact list for Workers’ Compensation Medicare Set-aside Accounts. CMS recently revised the regional contact information. The regional contacts for Colorado now are listed as Ian Fraser, Annie Lam, and Sandee Olson, who can be reaced at (415) 744-4907. The revised list […]

Read full story Comments are closed

New Social Security Administration Release of Information Form

In July 2013, the Social Security Administration revised the Consent for Release of Information form, used to obtain information regarding an individual’s receipt of Social Security disability income benefits, Supplemental Security Income benefits, or Medicare benefits.  The fillable form can be found here. Please note that this form is not the authorization required by the […]

Read full story Comments are closed

Traumatic Brain Injury Facts and Statistics (Part 2)

Continuing from Traumatic Brain Injury Facts and Statistics (Part 1), here is some additional important information for workers who may have sustained a mild to moderate TBI on the job. While Part 1 of this blog focused on defining what traumatic brain injury is, how it can happen at work and what the symptoms of […]

Read full story Comments are closed

Clay Thornton, Esq., Leaving Picardi Law Firm

After almost five years with the firm, Clay Thornton, Esq., is leaving Picardi Law Firm on July 31, 2013.  Clay is leaving to take a position with the Colorado Attorney General’s office, where he will be helping to build a new workers’ compensation unit. We wish Clay the best of luck at his new position. […]

Read full story Comments are closed

Updated CMS Regional Contacts

The Centers for Medicare and Medicaid Services has updated its list of regional contacts for Workers’ Compensation Medicare Set-aside Accounts. The regional contacts for Colorado are listed as: Tom Bosserman (415) 744-4907 Ian Fraser (415) 744-3665 Tina Lim (415) 744-3673 Irene Cheng (415) 744-3582 The full list of regional contacts for each state can be […]

Read full story Comments are closed

All Authorized Treating Physicians Must Refuse to Treat in Order for the Right of Selection to Pass to the Injured Worker

Under §8-43-404(5)(a), C.R.S., the respondent is afforded the right in the first instance to select a physician to attend the claimant. However, the statute implicitly contemplates that the respondent will designate a physician who is willing to provide treatment. Therefore, if the physician selected by the respondent refuses to treat the claimant for non-medical reasons, […]

Read full story Comments are closed

Traumatic Brain Injury Facts and Statistics (Part 1)

Traumatic brain injury (TBI) refers to any condition in which a temporary or permanent brain dysfunction arises due to a violent blow to the head or some object penetrating the skull. While a number of events can result in traumatic brain injuries, when TBIs occur on the job, the following factors or incidents may be […]

Read full story Comments are closed

Division of Workers’ Compensation Proposed Changes to Procedural Rules 16 and 18

The Division of Workers’ Compensation will be holding a public hearing to discuss proposed changes to two Workers’ Compensation Rules of Procedure: Rule 16 (Utilization Standards), and Rule 18 (Medical Fee Schedule).  The hearing is scheduled for August 6, 2013, at 9:00 a.m. The hearing will be held in the 2nd Floor Conference Room at […]

Read full story Comments are closed

2013 Amendments to Colorado Workers’ Compensation Act

As always, there are several amendments to the Act this year. The Division has posted an advisory memorandum that can be found at the following link. Senate Bill 13-157 clarifies the definition of statutory-employer as it applies to injuries occurring on the premises of a “buyer of goods.” As discussed in a separate posting to […]

Read full story Comments are closed

Statutory Changes to the Division IME Procedure

The Division IME statute has been amended to include a new timeframe and procedure for responding to a DIME report. The Division has posted an instructive memo that can be found here. In a nutshell, a respondent’s time to respond to a Division IME report no longer is based upon the date the physician mails […]

Read full story Comments are closed

Very Little Required to Avoid Closure Pursuant to Final Admission

Posted by: Clay Thornton, Esq. Date: June 26, 2013 In Crigger v. Denver Health, W.C. No. 4-770-747 (ICAO, May 6, 2013), the respondent filed a final admission of liability admitting for Permanent Partial Disability benefits based upon the Division IME’s findings. Within the statutory period for objecting, the claimant filed an application for hearing listing […]

Read full story Comments are closed

Workers’ Compensation Medicare Set-aside Account Submission Errors

The Centers for Medicare and Medicaid Compliance (CMS) has issued a document titled WCMSA Top Submission Errors and Helpful Hints which lists the most frequent errors contained in WCMSA proposals as well as tips/hints to increase the likelihood of a speedy approval of a WCMSA. The document can be found by clicking here.

Read full story Comments are closed

An ALJ Cannot Order Reimbursement Between Carriers on a Closed Claim

Posted by: Clay Thornton, Esq. In Tennapel v. Bowie Resources, W.C. Nos. 4-779-040 & 4-844-545 (ICAO, April 5, 2013), the claimant suffered an industrial injury with the first employer, and that claim became closed pursuant to final admission. Subsequently, the claimant suffered a similar injury with a subsequent employer. At this point, an IME opined […]

Read full story Comments are closed

Statutory Cap Does Not Apply Until the Act Permits Respondent to Terminate Temporary Disability Benefits

Posted by: Clay Thornton, Esq. In United Airlines v. Industrial Claim Appeals Office , 2013 COA 48, 12CA1443 (COCA) (March 28, 2013), the claimant suffered an admitted injury and the employer admitted for temporary disability benefits. Temporary disability benefits were ended when the claimant was released to return to work. At this point in time, […]

Read full story Comments are closed

Benzodiazepines and Barbiturates Now Included in WCMSAs

Effective June 1, 2013, the Centers for Medicare and Medicaid Services (CMS) will require all Workers’ Compensation Medicare Set-aside Agreements (WCMSAs) include the cost of a claimant’s benzodiazepine and barbiturate prescription medications. This change is likely to increase the cost of WCMSAs significantly, since there are many drugs falling under the benzodiazepine or barbiturate classes […]

Read full story Comments are closed

Proposed Legislation Changing Time to Respond to Division IME Report

Section 8-43-203(2) currently requires respondents to either file an admission of liability consistent with a Division IME physician’s opinion or request a hearing challenging that opinion within thirty days of the date of mailing of the report from the Division IME physician. However, the deadline for respondents to take action has been made uncertain due […]

Read full story Comments are closed

Penalties for Failure to Reimburse Claimant for Medical Treatment

Posted by: Clay Thornton, Esq. Date: March 26, 2013 In Ringler v. King Soopers, W.C. No. 4-121-888-11 (ICAO, March 13, 2013), the ICAO affirmed an Order of the ALJ which granted a penatly of 8% of the amount of a medical bill for which the claimant sought reimbursement, and denied the claimant’s request for a […]

Read full story Comments are closed

Employer Required to Tender Designated Provider List Even When Employee Declines Medical Treatment

Section 8-43-404(5)(a) affords the employer or insurer the right in the first instance to select a physician to treat the injury. The statute requires the employer or insurer to “provide a list of at least two physicians, … in the first instance, from which list an injured employee may select the physician who attends said […]

Read full story Comments are closed

Request for Re-evaluation of Medicare Set-aside Arrangements

The Centers for Medicare and Medicaid Services (CMS) has announced that it will re-evaluate an approved Medicare Set-aside Arrangement if the claimant or the submitter believes that the CMS determination (1) contains obvious mistakes, such as mathematical errors or a failure to recognize that medical records already submitted show a surgery CMS priced already has […]

Read full story Comments are closed

Division Repeals Requirement for Final Payment Notice

In what is sure to be relief to almost everyone, the Division of Workers’ Compensation has repealed W.C.R.P. 5-11(B), which required adjusters to file a Final Payment Notice within 60 days after the claim has closed. Therefore, effective April 1, 2013, Final Payment Notices no longer are required to be filed.

Read full story Comments are closed

Colorado House Bill Seeks to Prevent Employers from Requiring Employees to Release Passwords to Social Networking Sites

Posted by: Steven J. Picardi, Esq. Date: February 11, 2013 The Colorado House of Representatives has introduced a bill which would prohibit an employer from requiring an employee or applicant for employment to disclose a user name, password, or other means for accessing a personal account or service through an electronic communications device (the bill […]

Read full story Comments are closed

Bill Proposes Amendment to Liability of Statutory Employer

In an effort to expand workers’ compensation coverage to employees of uninsured subcontractors or lessees injured while performing services for an insured general contractor, § 8-41-401(1)(a)(I) of the Workers’ Compensation Act of Colorado provides that any person, company or corporation which conducts any business by leasing or contracting out any part of its work to […]

Read full story Comments are closed

Penalties for Failure to Contest or Pay Medical Bills Timely

Many insurers and third-party administrators utilize the services of third-party vendors to process payment or denial of medical bills. A recent Industrial Claim Appeals Office case awarding penalties against a self-insured employer for failure of the third-party vendor to process payment or denial of medical bills within the deadlines imposed by the Workers’ Compensation Rules […]

Read full story Comments are closed

CMS to Utilize Updated Life Tables for Life Expectancy on MSAs

The Centers for Medicare and Medicaid Services (CMS) has announced that effective January 19, 2013, it will begin referencing the Centers for Disease Control (CDC) Table 1: Life table for the total population: United States, 2008, for Workers’ Compensation Medicare Set-aside Arrangement (WCMSA) life expectancy calculations. This means that for any newly submitted WCMSA proposal […]

Read full story Comments are closed

Mileage Rate for 2013

Just a reminder that the Medical Fee Schedule (W.C.R.P. 18) increased the reimbursement rate for mileage to $.052 per mile, effective for travel on or after January 1, 2013.

Read full story Comments are closed

Attorney’s Fees for Failing to Introduce Evidence at Hearing in Support of Endorsed Issue

Section 8-43-211 (2)(d) provides “if any person requests a hearing or files a notice to set a hearing on issues which are not ripe for adjudication at the time such request or filing is made, such person shall be assessed the reasonable attorney fees and costs of the opposing party in preparing for such hearing […]

Read full story Comments are closed

Administrative Law Judge Cannot Extend Time to Challenge Division IME Findings; Improper Communication in a Division IME not a Basis to Strike Report as a Matter of Law

The Industrial Claim Appeals Office recently held that an Administrative Law Judge does not have jurisdiction to extend the thirty-day time limit to file an Application for Hearing to challenge the findings of a Division IME as found in § 8-42-107.2(4). Almanza v. Johnson, W.C. No. 4-713-132 (December 7, 2012). In Almanza, the respondents became […]

Read full story Comments are closed

Bill Proposes Creating a Presumption that Heart Attack of a Firefighter Caused by Work

Posted by: Steven J. Picardi Date: December 6, 2012 The Workers’ Compensation Act of Colorado currently excludes disability or death caused by a heart attack from the definition of “accident”, “injury”, and “occupational disease”, unless it is shown by competent evidence that such heart attack was proximately caused by an “unusual exertion” arising out of […]

Read full story Comments { 0 }

Authorized Treating Physician’s Restrictions not Dispositive in Claim for Permanent Total Disability Benefits

Posted by: Steven J. Picardi, Esq. Date: December 3, 2012 Steve Picardi recently obtained a major victory for his self-insured client, obtaining an Order which denied the claimant’s request for permanent total disability benefits despite the opinion of the authorized treating physician that Claimant was limited to sedentary duty in a remote mountain town with […]

Read full story Comments { 0 }

Medical Treatise re: Long-term Outcomes of Lumbar Fusion in Workers’ Compensation Claims

Posted by: Steven J. Picardi Date: November 6, 2012 A study published in 2010 in the international medical journal SPINE compared the outcomes of 725 work comp lumbar fusion cases to 725 randomly selected work comp chronic low back pain patients not undergoing surgery. While this may be something that will come as no surprise […]

Read full story Comments { 0 }

Settlement of Claims Against Statutory Employers

Posted by: Steven J. Picardi Date: October 24, 2012 In an effort to ensure that an injured worker will receive workers’ compensation benefits even when his actual employer fails to maintain workers’ compensation insurance, Section 8-41-401 provides that any person or company conducting any business by contracting out any part of its business to any […]

Read full story Comments { 0 }

Deadline to Request Specific Findings Jurisdictional and Cannot Be Extended

Posted by: Steven J. Picardi Date: October 19, 2012 The Court of Appeals recently revisited and affirmed prior case law holding that the deadline to request entry of Specific Findings of Fact, Conclusions of Law and Order (a prerequisite to any appeal) is jurisdictional, and the failure to request specific findings within the deadline divests […]

Read full story Comments { 0 }

Picardi on Faculty of Continuing Legal Education Seminar

Steven J. Picardi, Esq., is on the faculty of the continuing legal education seminar Workers’ Compensation Hearings: Techniques and Strategies for Success , presenting the topic “Avoiding Ethical Obstacles.” The topic will focus on avoiding conflicts of interest and the ethical considerations of contacting witnesses and other individuals in a workers’ compensation claim. The seminar […]

Read full story Comments { 0 }

Division’s Request for Information on Old Claims

Posted by: Steven J. Picardi Date: October 3, 2012 Many of you may have received inquiries from the Division of Workers’ Compensation Claims Management Unit requesting information on the status of claims which the DWC classifies as “open” claims. There have been a number of questions raised to the DWC regarding what information the DWC […]

Read full story Comments { 0 }

Disfigurement for a Limp

Posted by: Steven J. Picardi Date: September 30, 2012 Section 8-42-108(1) permits an Administrative Law Judge to award disfigurement benefits up to a maximum of $4,000 if the claimant is “seriously, permanently disfigured about the head, face or parts of the body normally exposed to public view. . . .” It is settled law that […]

Read full story Comments { 0 }

Attorney’s Fees for Requesting a Hearing on Unripe Issues

Posted by: Steven J. Picardi Date: September 17, 2012 Section 8-43-211(2)(d) provides, “if any person requests a hearing … on issues which are not ripe for adjudication at the time such request or filing is made, such person shall be assessed the reasonable attorney fees and costs of the opposing party in preparing for such […]

Read full story Comments { 0 }

Denver Workers Compensation Attorney

Welcome to my website.  I can help you with all of your Workers Compensation questions in Denver and all of Colorado.

Read full story Comments { 0 }