Blog

October 6, 2021
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 […]

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October 6, 2021
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 […]

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October 6, 2021
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 […]

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October 6, 2021
“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 […]

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October 6, 2021
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 lump sums granted to […]

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October 6, 2021
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 […]

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October 6, 2021
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 […]

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October 6, 2021
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 […]

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October 6, 2021
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 […]

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October 6, 2021
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), […]

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October 6, 2021
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 […]

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October 6, 2021
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 […]

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October 6, 2021
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 […]

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October 6, 2021
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 […]

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October 6, 2021
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 […]

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