Safety Rule Violation

The Colorado Workers’ Compensation Act provides for a 50% reduction in compensation benefits where the injury results from the claimant’s willful failure to obey a reasonable safety rule instated by the employer. A claimant’s conduct is “willful” if he or she intentionally does the forbidden act, regardless of whether the claimant had the rule “in [...]

Safety Rule Violation 2019-02-01T15:12:03+00:00

Appeals of Medical Utilization Reviews and Weight Afforded the MUR Panel

Under the Medical Utilization Reviews (“MUR”) provision of the Act, either the claimant or the respondents may seek review of a MUR panel’s recommendation and a Director’s order before an ALJ. When doing so, the conclusions of the MUR committee are “afforded great weight,” and the party disputing the finding by the MUR committee has [...]

Appeals of Medical Utilization Reviews and Weight Afforded the MUR Panel 2019-02-01T15:09:57+00:00

Conservator or Guardian Services to Permanently Disabled Employees

The principal purpose in requiring an employer to provide medical benefits under the Workers’ Compensation Act is to allow an injured worked to reach maximum medical improvement and maintain that status. This is reflected in C.R.S. § 8-42-101(1)(A)’s language requiring “[e]very employer . . . [to] furnish such medical . . . treatment . . [...]

Conservator or Guardian Services to Permanently Disabled Employees 2019-02-01T08:27:51+00:00

Temporary Disability and Responsible For Termination

It is well settled that when a temporarily disabled employee is responsible for the termination of the employee’s employment, the resulting wage loss is not attributable to the on-the-job injury. The underlying policy as it applies to the Workers’ Compensation Act is to introduce the concept of “fault.” An Administrative Law Judge (ALJ) utilizes this [...]

Temporary Disability and Responsible For Termination 2019-02-01T08:24:36+00:00

Repayment of Over-Payments

The claimant suffered a compensable injury. She told the claims representative that the injury resulted in an inability to work. Relying on the statements of the claimant, the respondents began paying temporary total disability (TTD) benefits. Despite claimant’s statements, she was actually working two jobs while also cashing TTD checks. In total, the claimant received [...]

Repayment of Over-Payments 2019-03-05T11:27:24+00:00

Temporary Total Disability

Termination for cause: Panel rejects its prior interpretations of Longmont Toyota to affirm award of temporary disability. A claimant is entitled to temporary total disability (TTD) benefits when an industrial injury caused the claimant’s wage loss. It follows that when a claimant is terminated for a volitional act (e.g., failing a drug test), the wage [...]

Temporary Total Disability 2019-01-21T15:06:40+00:00

Overcoming The Division Independent Medical Examination

Secret agent Claimant? Claimant’s surreptitious recording relied upon by ALJ to overturn Division Independent Medical Examination (DIME) opinion. Claimant sustained a compensable injury to her left knee and was eventually placed at maximum medical improvement (MMI) and rated. Respondents filed a final admission of liability consistent with the impairment rating opinion and claimant proceeded with [...]

Overcoming The Division Independent Medical Examination 2019-01-21T15:07:23+00:00

Reopening a Denied Claim?

A claim never determined to be compensable cannot be reopened based on a change in condition. In Amin, the Colorado Court of Appeals held that a claim cannot be reopened based on a change in condition when the claim was never determined to be compensable in the first place. Here, the respondents filed a Notice [...]

Reopening a Denied Claim? 2019-01-21T15:22:40+00:00

Quasi-Course And Scope Doctrine Covers Claimant’s Injury Sustained When Working Out On His Own At Planet Fitness

In Martin, the claimant sustained a compensable injury for which surgery on his shoulder was needed. The ALJ found that at some point his treating surgeon and physical therapist had outlined some strengthening exercises for claimant to do on his own. He joined Planet Fitness (not prescribed by an authorized provider and not paid for [...]

Quasi-Course And Scope Doctrine Covers Claimant’s Injury Sustained When Working Out On His Own At Planet Fitness 2019-01-21T15:25:34+00:00

Compensability—Quasi Course and Scope of Employment

An injury sustained on the way to and from a medical examination is compensable, even if the claimant performs a personal errand along the way - as long as the personal deviation ends prior to the injury. In this case, claimant’s compensable claim required multiple surgeries. He lived in Grand Junction but had to drive [...]

Compensability—Quasi Course and Scope of Employment 2019-01-29T08:28:26+00:00