Colorado rules about workers’ compensation are very exacting. After suffering an injury on the job or receiving a medical diagnosis directly related to work, most workers will be covered by their employer’s workers’ compensation insurance. The injured party has the right to receive paid medical attention related to the injury or medical condition. Depending upon the circumstances, there are also pay benefits available to help the injured worker offset the loss or reduction in wages due to the temporary disability. If the injury results in a permanent total or partial disability, the worker may even negotiate a lump sum settlement.
However, it is a mistake to think that workers’ compensation is a one-way street. Employers also have rights and will often use them to their advantage. One of the most common tactics employers and their insurance providers will resort to is to challenge the worker’s medical records, often in an effort to prove the injury was due to a pre-existing condition. Another push-back is to challenge the worker’s needs for continuing medical attention and physical therapy.
Remember, you will probably be seeing the doctor your employer tells you to
For many younger workers on their first job, getting injured will be a new experience. Many are surprised to learn they are expected to see a doctor pre-approved by the insurance provider, rather than their own family physician. Workers’ compensation doctors are placed on an “approved” list by the Colorado Department of Labor and Employment, which oversees the state’s workers’ compensation system. In many cases, the injured worker’s own doctor is not on the list.
It may seem as if the doctor you see is working for your employer, not you
Workers’ compensation doctors will be required to keep records of your diagnosis and your response to treatment. Their ultimate goal is to sign off on a record stating that you have reached maximum medical recovery and can return to work, either in your old position or in a reduced capacity. The doctor will also be the one who determines whether your disability is a permanent partial or permanent total disability. Many workers find themselves disputing the doctor’s decision to sign off on maximum medical recovery before they feel they are fully recovered from the injury. In that sense, it may seem as if the doctor cares more about the employer’s costs than the worker’s health and well-being. The doctor’s final sign-off can be challenged, often successfully.
Your medical records are your responsibility
It is in your best interest to make sure your medical records are up-to-date and accurately reflect the diagnosis, treatment plan and prescription medications related to your injuries. If there are any previous conditions that affect your recovery, your workers’ comp doctor should also note whether he or she feels they affect the extent of your injury or your timeline for recovery. Throughout your treatment, keep an eye on your records and discuss any notes you don’t understand or which you feel don’t accurately reflect the circumstances. The doctor will be responsible for getting you back on your feet and back to work; but you are ultimately responsible for your own long-term health needs. Don’t be afraid to ask questions and get help
If this is your first job or your first experience with the Colorado workers’ compensation system, there will be many process steps that may seem confusing. You have every right to ask questions but don’t expect your employer to necessarily put your needs in front of their own. If you feel you aren’t getting straight answers, it makes sense to seek out your own representation. After all, employers have the insurance providers on their side.
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