Compensability and Withdrawing Admissions of Liability – Fraud – Respondents Demonstrated that the Claimant Lied about the Details of an Alleged Work Injury To Obtain Benefits

Claimant was a cook for a fast food restaurant.  He reported a work injury on November 28, 2014.  Specifically, the Claimant reported that he was randomly assaulted by several men when taking out the trash.  Due to the fact that Claimant specifically reported he did not know the men involved with the assault, the incident [...]

Compensability and Withdrawing Admissions of Liability – Fraud – Respondents Demonstrated that the Claimant Lied about the Details of an Alleged Work Injury To Obtain Benefits 2020-07-02T09:30:47+00:00

TTD not payable when Claimant fails to attend a demand appointment after being ordered to attend, and setting demand appointments is not dictating medical care.

Claimant had an accepted injury to his right shoulder in 2015.  After appropriate treatment, he was placed at MMI by his orthopedic treater on July 11, 2019.  The treater noted that Claimant was stable for an impairment rating, but none was undertaken at that time.  That treater is Level II accredited, and therefore was tasked [...]

TTD not payable when Claimant fails to attend a demand appointment after being ordered to attend, and setting demand appointments is not dictating medical care. 2020-07-02T09:27:48+00:00

Insurance Coverage Denied Were Employer Materially Misrepresents The Scope of its Work in its Applications for Insurance, and Fails to Provide Notice of its Work in a State Not Endorsed for Primary Coverage

Claimant’s employer was a subcontractor on a large construction project.  The employer applied for worker’s compensation coverage and in the application for the policy, confirmed no work was done at heights on exterior buildings above two stories.  The employer had already begun work on the project when the application was submitted. The project was actually [...]

Insurance Coverage Denied Were Employer Materially Misrepresents The Scope of its Work in its Applications for Insurance, and Fails to Provide Notice of its Work in a State Not Endorsed for Primary Coverage 2020-07-02T09:25:15+00:00

Compensability—The quality of expert opinions outweighs quantity

Claimant was a police officer for the City of Glenwood Springs who claimed he sustained a compensable head injury when he hit his head attempting to arrest a suspect.  On the night of the incident claimant and four other officers wrote incident reports detailing the incident as well as injuries sustained by the officers involved [...]

Compensability—The quality of expert opinions outweighs quantity 2020-07-08T15:35:38+00:00

Premises Liability

Under the “coming and going rule,” workers’ compensation claims are not compensable if a claimant is injured while going to or coming from work. Such travel is not considered to be “performance of services arising out of the course of employment.” The issue in Rose Vigil v. Healthcare Services Group, was whether the ALJ erred [...]

Premises Liability 2020-07-02T09:00:19+00:00

Scope of Employee’s Duties – Workplace Assault

In Stanfield v. Maru, The court was tasked with determining whether the ALJ erred in finding that Claimant sustained a compensable injury while engaging in a non-traditional work duty. Claimant worked as a sushi chef at a restaurant.  On July 4, 2019, a former employee came into the restaurant visibly intoxicated.  Claimant told the former [...]

Scope of Employee’s Duties – Workplace Assault 2020-07-02T08:56:21+00:00

Incident v. Injury

It is a standard and reinforced concept in workers’ compensation that claims may be compensable when injuries arise out of employment risks or neutral risks.  In Washburn v. City Market, the Industrial Claims Appeals Office (“the Panel”) decided whether the ALJ erred in finding that this workplace incident did not rise to the level of [...]

Incident v. Injury 2020-07-02T08:51:37+00:00

Compensable Risks per City of Brighton Case

It is well-known that compensability relies on whether an injury arose from either employment risk or neutral risk categories as defined by City of Brighton v. Rodriguez, 318 P.3d 496 (Colo. 2014).  If an injury arises out of a purely personal risk, such an injury will not be compensable under workers’ compensation.  In Parks v. [...]

Compensable Risks per City of Brighton Case 2020-07-02T08:48:28+00:00

Injuries Resultant of Reasonable Treatment

In a workers’ compensation claim, an employer “shall furnish such medical, surgical, dental, nursing, and hospital treatment…as may be reasonably needed at the time of injury or occupational disease and thereafter during the disability to cure and relieve the employee from the effects of the injury.”  The issue addressed by the Industrial Claims Appeals Office [...]

Injuries Resultant of Reasonable Treatment 2020-07-02T08:44:18+00:00

Independent Contractor Analysis

The Colorado Workers’ Compensation Act (“the Act”) excludes independent contractors from presenting compensable claims.  However, in some cases, it may be difficult to determine whether a claimant should be considered an employee or an independent contractor.   In Holsinger Drywall Inc. v. ICAO, the Court of Appeals decided that in order to determine whether a [...]

Independent Contractor Analysis 2020-07-02T08:39:29+00:00