Admission
of Liability |
- A
written statement by an insurer accepting responsibility for payment of
workers’ compensation benefits outlined in the admission.
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Claimant |
- A worker or a dependent of a deceased worker pursuing
a claim for benefits under the Colorado Workers’ Compensation Act.
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Carrier |
- An insurance company that provides (underwrites)
workers’ compensation insurance coverage.
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Director |
- The Director of the Colorado Division of Workers’
Compensation.
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| Division |
- The Colorado Division of Workers’ Compensation.
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EDI
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- Electronic Data Interchange.
This signifies the electronic transmission of information between
businesses.
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Insurer |
- Insurance company or self-insured employer.
For purposes of this section, insurer may include a third party administrator adjusting claims on
behalf of insurance company or self-insured employer.
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| Liability |
- Responsibility for payment of benefits.
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| Offset |
- Something that takes the place of something else. Party - A person or group representing one side of a question
or dispute, such as in the case of an employer or a claimant.
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| Petition |
- A formal request.
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| Fillable pdf |
- Adobe Reader is used
for this form.
You may type in the form on your computer and print.
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| Printable
Only pdf |
- Print the form only.
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| MS Word |
- Save the form onto your computer's hard drive and print.
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