Contributed by The Babcock Law Firm
The process for filing a work injury claim and navigating a workers’ compensation case can be confusing at best. Below, we have a timeline outlining what you can expect and how to best handle your claim.
1. Report Your Injury
Colorado workers’ compensation laws indicate that injured workers have four working days after injury to report the incident, and this report must be in writing. If you are unable to report yourself, a relative or friend can also do so.
2. Seek Medical Care
Your employer should provide you with a list of medical providers who are covered under their workers’ compensation insurance. Choose one, and use them as your treating position for all injuries associated with your claim. If you are not provided a list of providers, you may choose one for yourself. If possible, talk with a lawyer before deciding on a provider since they can have great influence over your case.
3. Your Employer Reports Your Injury
In the state of Colorado, your employer must report your injuries to their insurance provider within 10 days. Additionally, your employer must report the injuries to the Colorado Division of Workers’ Compensation if your injuries cause you to miss more than three shifts of work.
4. Your Claim is Accepted or Denied
After your employer reports your injuries to their insurance company, the insurance company will have 20 days to look over the claim and any statements you provide. Then, they will decide whether to accept or deny the claim.
The main reasons a claim is denied are: 1) the insurance company does not have enough accurate information about the incident or your injuries, or 2) the insurance company does not feel that the injury was solely work-related.
It is very important to make sure you receive a definitive answer from the insurance company as to whether your claim has been accepted or denied. This way, you can hold them accountable to pay for all of your treatment and loss of income. Otherwise, should the same injury show up months or years later, the insurance company could try to say they aren’t responsible for any wage loss benefits of medical treatment because they never officially accepted or denied the claim.
5. Seek Legal Counsel
If your claim is denied by the insurance company, your best bet is to involve an experienced workers’ compensation lawyer. From there, here is what your claim process should look like:
- Filing A Claim – Your workers’ compensation attorney will file a Claim for Compensation for you and begin the process of trying to get the compensation you need to cover medical bills and lost wages. This process could take anywhere from 4-12 months to be resolved.
- Gathering Evidence – Gathering evidence can sometimes take around 2-3 months. This evidence includes statements from those involved (physicians, witnesses, coworkers, etc.). Arguments are then formulated for the hearing.
- Insurance Company Presents Evidence – The insurance company will also have the opportunity to present their own findings. The insurance company will often gather testimony from your employer as well as medical experts to find evidence that supports their claim denial.
- A Judge Decides – Most cases are settled before a judge is called to decide. Options like mediation can allow both parties to work together to reach a favorable decision for everyone without soliciting a judge.