Overcoming the DIME – Errors that are not the Basis for the DIME Physician’s Decisions are Insufficient to Overcome the DIME

The Administrative Law Judge (ALJ) concluded claimant failed to overcome the division-sponsored independent medical examination (DIME) by clear and convincing evidence. The Panel affirmed.  Claimant was a senior configuration analyst who suffered from numerous conditions and injuries prior to claiming a work-injury in 2014 including arthritis, severe back pain, headaches, and cervical strain. Claimant alleged [...]

Overcoming the DIME – Errors that are not the Basis for the DIME Physician’s Decisions are Insufficient to Overcome the DIME 2020-03-06T10:33:03+00:00

Worker Classification – Independent Contractors v. Employees

In Pella Windows, the Court of Appeals considered whether the nine-part independent contractor test adopted by the Colorado Supreme Court in Industrial Claim Appeals Office v. Softrock Geological Services, Inc., 2014 CO 30 as applied to an unemployment case can also be applied in workers’ compensation cases. The Court of Appeals held that it can.  [...]

Worker Classification – Independent Contractors v. Employees 2020-03-06T10:29:44+00:00

Compensability – An Incident that Occurs at Work Does Not Necessarily Make it a Work-Related Injury

The Colorado Court of Appeals affirmed the Administrative Law Judge’s (ALJ) Order upholding the denial and dismissal of claimant’s benefits claim after determining no compensable injury had occurred.  It is deeply rooted in workers’ compensation law that in order to have a compensable injury, the claimant must show that the injury “arose out of” and [...]

Compensability – An Incident that Occurs at Work Does Not Necessarily Make it a Work-Related Injury 2020-02-28T08:51:58+00:00

Proportionality – New Standard for Determining Fine Proportionality

The Court of Appeals set aside and remanded a claim to determine what constituted a “proportional fine” for the employer’s failure to carry the requisite workers’ compensation insurance.  The employer-petitioner failed to obtain the requisite workers’ compensation insurance as mandated by C.R.S. § 8-43-409 for the members of its construction company. The Director ordered employer [...]

Proportionality – New Standard for Determining Fine Proportionality 2020-02-28T08:49:53+00:00

Safety Rule Violations – Plead your Plausible Purpose!

The Colorado Court of Appeals affirmed the Administrative Law Judge’s (ALJ) order reducing claimant’s non-medical disability benefits by 50% pursuant to C.R.S. § 8-42-112(1)(b).  Under Colorado law, it is well-established that a safety rule violation results in a 50% reduction in workers’ compensation benefits. As a defense to this general rule, a claimant must show [...]

Safety Rule Violations – Plead your Plausible Purpose! 2020-02-28T08:43:17+00:00

Compensability of Mental Impairment

Administrative Law Judge (ALJ) denied compensability of claimant’s claim and request for temporary disability and medical benefits. The Industrial Claims Appeals Office (the Panel) reversed the decision and remanded the case for the ALJ to consider issues involving medical benefits and timely reporting of an injury. In Montoya, claimant worked as a sheriff’s deputy until [...]

Compensability of Mental Impairment 2020-01-13T10:52:43+00:00

Petitions to Review

Administrative Law Judge (ALJ) granted respondent’s motion for summary judgment. The Industrial Claims Appeals Office (Panel) dismissed claimant’s petition to review as jurisdictionally untimely. Colorado law provides that a petition to review must be filed within 20 days after the date of the certificate of mailing of the order, and unless so filed, the order [...]

Petitions to Review 2020-01-13T10:45:04+00:00

Benefits – Recovery of Over-payments

In Peoples, the Court of Appeals was tasked with determining whether an employer’s listing of an over-payment on a final admission of liability (FAL) constitutes an attempt to recover the over-payment pursuant to C.R.S. § 8-42-113.5(1)(b.5)(I). The Court held that when a claimant’s temporary total and permanent partial disability benefits exceed the statutory benefit cap, [...]

Benefits – Recovery of Over-payments 2020-01-13T09:01:16+00:00

Appealing a Final Order

The Administrative Law Judge (ALJ) determined claimant was responsible for the cancellation fee charged by respondents’ expert witness after the hearing was vacated. In Pribble, the claimant sustained an admitted injury and was subsequently placed at maximum medical improvement (MMI) and given a zero percent impairment rating. Respondents then filed a final admission of liability [...]

Appealing a Final Order 2020-01-13T08:55:36+00:00

Compensability

It is well settled that to prove a compensable injury, claimant carries the burden to establish by a preponderance of the evidence that an injury arose out of and in the course of employment. An injury arises out of employment when it stems from an employee’s work related functions and is sufficiently related to those [...]

Compensability 2020-01-13T08:53:12+00:00