Suffering an injury on the job may be a shock, but you are not alone. So far this year, over 6,000 workers in Colorado have filed more than 15,000 workers’ compensation claims. It happens quite often, and it can happen to you. Here’s what you need to know.
When you are hurt on a Colorado company’s property or while engaged in company business, you may have the right to compensation for your injuries via workers’ compensation insurance policies your employer holds. However, this is not an automatic payment, and the insurance company might still deny benefits based on the specific circumstances of your case. If this happens, you should consult with an experienced workers' compensation attorney.
Workers’ compensation is a statutory system that provides benefits to injured workers quickly, without requiring the employee to take legal action. It also protects employers by preventing employees from filing suit against them, in most cases (we’ll address this below).
It is a “no fault” system, meaning you can access the benefits even if you may have contributed to the cause of the accident without meaning to (contributory negligence).
Most employers purchase workers’ compensation insurance to cover workers’ compensation obligations. That insurance pays the benefits the employer would otherwise owe the injured employee.
Generally, most people who are employed should be covered by workers’ compensation in Colorado.
All public and private employers in Colorado, with limited exceptions, must provide workers’ compensation coverage for their employees if one or more full or part-time persons are employed, including family members.
A person hired to perform services for pay is presumed by law to be an employee. This includes all persons elected or appointed to public sector service and all persons appointed or hired by private employers for remuneration.
Certain employment situations may not be covered by workers’ comp. The following is a partial list of occupations and/or individuals exempt from mandatory coverage under the Workers’ Compensation Act:
Source: Colorado.gov Insurance Requirements for Employers. This is not an exhaustive list.
To ensure that you receive maximum workers’ comp benefits for your injuries, you must do the following:
When you are hurt on the job, the Colorado Department of Labor and Employment says that your company should investigate the accident immediately. All relevant facts should be gathered and ready to share with the insurance company upon request.
Colorado state law requires your employer to tell the insurance company about your injury within 10 days, regardless of how minor. This is done by the filing of an Employer’s First Report of Injury form.
This does not necessarily mean that the company admits to the facts being reported about the incident. It is simply a statement that the employee is making an injury claim. If your employer is questioning whether your injury is work related, this should be included on the first report form.
The insurance company is required to report your accident to the Occupational Safety and Health Administration (OSHA) within 24 hours. It must fill out form 300 to report your illness to the federal agency.
Workers’ comp is very valuable if you are injured, but getting full benefits can be tough.
With few exceptions, no matter who caused the accident, work-related injuries in Colorado are covered by workers' compensation. The most common workers’ comp injuries are:
Your benefits can be reduced if any of the following circumstances occurred:
In Colorado, you are entitled to have your authorized medical expenses covered. Also, workers’ compensation will provide some reimbursement of the wages you have lost. Major benefits are:
Most people like to think well of the company they work for. They gave you a nice turkey at Thanksgiving, after all, right? So, you may think that your company will do its best to help you with your injury, and take care of your medical bills and family needs.
Don’t be too sure.
Your company may be a great place under normal conditions. But an expensive workplace accident case isn’t an example of ‘normal conditions.’
Workers comp is insurance. And insurance premiums go up for a business after making claims.
The first concern of a business is with profits and losses. If the company is public, it also answers to shareholders who are very sensitive to investment returns and losses. Don’t be shocked if your company is mostly concerned with protecting itself when you are hurt.
So far we have covered only workers’ compensation for getting benefits for your workplace injuries. But there are other options.There are accident situations where you could sue for damages that were caused by your injuries.
Workers' compensation statutes in most states, including Colorado, limit a workers' remedies for work-related injuries; thus, workers' compensation coverage is referred to as the "exclusive remedy" available to an injured worker. The exclusive remedy provision is considered strong in Colorado. According to the American Bar Association If a court wishes to allow a tort action against an employer (i.e., for sexual harassment), it will make findings that the injury is not covered by workers' compensation.
An employer who chooses not to obtain required coverage will not be protected by the "exclusive remedy" provision. If your employer does not carry workers' compensation but is supposed to under Colorado law, you could sue your employer to gain compensation to help with your workplace injuries.
While some states do not allow an employee to sue for intentionally causing your injuries, Colorado does allow you to take legal action against an employer. This applies for exceptionally egregious conduct by your employer. Some examples are:
There may be cases where another party, such as the manufacturer of a machine used in the course of your work, may be liable for your injuries. Employers will usually stay out of the case if you decide to sue a third party, but they may also join you in bringing legal action. (If your employer knew that the product was broken or not working correctly, you could also possibly sue your employer.)
If you are fired after filing a workers' compensation claim, you may have basis for a lawsuit. Colorado follows the legal doctrine of "employment-at-will", which states that, unless otherwise required in a contract, an employer is not required to give advance notice of termination. Additionally, the employer is not required to give a reason for the firing.
However, there is an exception called Violation of Public Policy, which, among other exceptions, states that an employee cannot be terminated for filing a workers' compensation claim or bringing or threatening a lawsuit.
Workers’ compensation insurance carriers in Colorado are obligated to investigate an employee's claim, or pay the benefits he or she is entitled to under state law. If insurance companies do not perform this duty, or mislead the employee in any way, they are considered to be acting in “bad faith” and can be sued for both economic (medical costs/lost wages) and non-economic (pain and suffering) damages.
Colorado allows courts, rather than state administrative agencies, to consider claims of workers' compensation bad faith. In Colorado, the insurance carrier is directly and primarily liable to the employee. This means you can sue the insurance company when it takes the following actions:
A case often cited in bad faith lawsuits is the Colorado Supreme Court’s decision in Travelers Insurance Co. v. Savio in 1985. In that case, the court ruled that the state’s workers’ compensation laws do not preclude an employee from bringing a common law tort action against a workers' compensation insurance carrier for bad faith.
The employee in the case, William Savio, had fallen from a ladder while working as a journeyman electrician for his employer. He injured his right ankle in the fall and his doctor could not determine whether or not he would ever be able to work as an electrician again.
Savio sought vocational rehabilitation and training, which he claimed that his employer's workers' compensation insurance company, Travelers Insurance Co., "delayed and denied … without a reasonable basis, and at the time of delay or denial knew that there was no reasonable basis for that delay or denial."
The Colorado Supreme Court concluded that the Workmen's Compensation Act did not bar Savio's common law action against Travelers for bad faith processing of his workers' compensation claim.
Remember that workers’ compensation can be useful, but the amounts can be quite low and you don’t get paid for your pain and suffering. It’s smart to talk to an attorney who knows personal injury law and workers’ compensation law for Colorado.
There are times you need a lawyer for a workers’ comp case, and times you don’t. If you are needing a lawyer for your claim, it’s important to have a good attorney who is experienced in workers’ comp to rely on. He or she knows that many larger employers have HR directors, risk managers and others to ensure the company pays as little as possible when a worker is hurt in the workplace.
Also, you can be sure that your employer has a workers’ compensation insurance company well-staffed with attorneys to help keep ‘costs down.’ That means paying you as small of a claim as possible.
Even if you don’t intend to bring a lawsuit, a workers' comp attorney can help you with your claim.