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 [...]
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 [...]
Once an employer or insurer overcomes the DIME, an ALJ has the authority to determine claimant’s MMI status and permanent impairment rating as questions of fact.
In Destination Maternity, the Colorado Supreme Court considered whether the Administrative Law Judge (“ALJ)” had authority to place a claimant at maximum medical improvement (“MMI”) after concluding the employer had overcome the findings of the Division Independent Medical Examination (“DIME”) physician that the claimant had not reached MMI. The Colorado Supreme Court ultimately held that [...]
Fall at work not determined unexplained and claim found not compensable—the importance of medical evidence.
This case involved a worker that worked as a maintenance worker in a ski resort area. As part of his duties he was at times required to go into private apartments to repair items. Claimant alleged he was in a unit checking on a leak based on a “strange noise” he heard while he was [...]
Compensability – Claimant was unable to prove a compensable work injury due to an aggravation of pre-existing condition/special hazard condition based on his testimony alone where evidence established injury and need for treatment were not causally related to work incident.
Compensability – Claimant was unable to prove a compensable work injury due to an aggravation of pre-existing condition/special hazard condition based on his testimony alone where evidence established injury and need for treatment were not causally related to work incident. Claimant was a truck driver with a significant pre-existing history of right foot problems. Claimant [...]
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 [...]
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. [...]
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 [...]
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 [...]
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 [...]