| Workers' Compensation
Injured Workers
Did You Know that...
- workers’ compensation
is the oldest form of no-fault insurance?
Workers' compensation is the oldest form of
no-fault insurance. Before workers' compensation law was
established, there was little recourse for workers injured on the
job. A worker could sue in court, but had to prove negligence. The
outcome was uncertain and could take years to resolve. This was
costly both to the employer and the worker, often with little
benefit to either party. The evolutionary move toward workers'
compensation began during the Industrial Revolution as mechanization
brought an increase in work-related injuries. It was a new legal
concept, liability without regard to fault. First established in
Germany in 1856 and adopted soon after by England and most of
Western Europe, workers' compensation was enacted in Colorado in
1915. By 1920, all but eight states had workers' compensation laws.
The last state mandated workers' compensation coverage in 1947.
Return to top
Return to Quick List
Return to Home Page
- in a workers’ compensation dispute, the burden of proof is on the injured worker
to demonstrate entitlement to benefits?
Under Colorado law, when a disagreement arises
as to whether an injured worker is entitled to receive workers’
compensation benefits, the final determination will be based on the
individual facts of a claim and a preponderance of the
evidence--that is--which side can offer the most convincing evidence
as to how the injury occurred and whether benefits are due. In
practice, this generally means that when an insurance company has
denied liability (responsibility) for payment of benefits, or has
failed to respond, it will be necessary for the injured worker to
move the claim forward (prosecute) by requesting a hearing and
presenting sufficient evidence to prove that benefits should be
paid.
Because it is unlikely that either side will be
permitted to introduce evidence after the hearing, it is important
to be fully prepared and to comply with all (notice, filing and
exchange of information) requirements. For information about
representing yourself at hearing, or for general information on the
hearing process, see the brochure:
So, You are Thinking of Representing Yourself in your Workers’
Compensation Case... Also,
the rules governing this process may be found under
Rule VIII,
Workers’ Compensation Hearings. In addition, a partial list of
workers’ compensation attorneys provided by the Colorado Bar
Association, may be obtained by clicking on:
Workers’ Compensation
Attorney List
Return to top
Return to Quick List
Return to Home Page
- the Division’s Claims
Management Unit reviews admissions of liability to insure benefits
are calculated, paid and terminated correctly?
In 1991, the Colorado workers’ compensation
system underwent significant legislative reform. As part of an
effort to increase efficiencies, contain cost and reduce litigation,
the General Assembly declared that active management of workers’
compensation claims should be practiced by Claims Managers at the
Division of Workers’ Compensation. Their job would be to educate,
review, audit and close cases, “to promote speedy and uncomplicated
problem resolution...and to otherwise manage claims.”
Anticipating the need for strong administrative
oversight, a computer system was developed to identify discrepancies
and calculation errors on Admissions of Liability (admissions). The
purpose was to provide a “first cut” automated review of admissions
which could then be forwarded to Division Claims Managers for
further review. This process has come to be known as the “error
letter process.”
When a discrepancy or calculation error is
identified, an error letter is generated to the insurance company as
the primary recipient with copies to the injured worker or claimant
and attorneys for both sides. The error is described in the text of
the letter as well as any action that is required to be taken. All
letters are reviewed by a Claims Manager prior to mailing.
Additional errors may be noted during the Claims Manager’s review. The insurance adjuster is
then required to respond and the response will be reviewed
by a Claims Manager to ensure compliance.
Return to top
Return to Quick List
Return to Home Page
|
