What type of benefits could I receive if I'm injured on-the-job in Colorado?
What specific workers' compensation benefits you receive largely depends on the severity of your injury, how long it takes to treat it, what care is required for the long term and whether it causes permanent impairment or not.
Most full and part-time employees who work for the state of Colorado or in the private sector are covered under this insurance from the time they start working. However, there are a few instances where someone is not eligible for workers' compensation benefits. Examples include:
Part-time maintenance/repair workers performing less than $2000 in work for a business in a year
Licensed real estate agents working on commissions
Independent contractors who perform specific jobs
Federal and Railroad employees (subject to federal workers' comp laws)
If you're a full or part-time employee at a business in Colorado, you're in all likelihood covered under workers' compensation.
Continue reading to learn more about what these benefits are and in what situations they apply.
Colorado Workers' Compensation Benefits
Below you will find an explanation of the various benefits workers' compensation offers. Each is covered in more detail below but the main benefits include: medical, temporary disability, permanent disability, disfigurement awards and death benefits.
Under workers' compensation law in Colorado, all medical expenses connected with an on-the-job injury are to be paid by your employer, or their workers' comp insurer to be more accurate. These benefits must be provided at no charge to the injured employee.
Medical benefits pay all reasonable and necessary medical expenses connected with an on-the-job injury – doctor's appointments, hospitalization(s), x-rays, MRIs, therapy, prescriptions and other necessary supplies…even transportation costs to and from treatment is covered (an often overlooked but important benefit).
Since the inception of workers' comp in Colorado, courts have interpreted medical benefits very broadly, including treatments one would not ordinarily consider to be connected with an on-the-job injury.
For example, an employer was required to pay for their injured worker's cancer treatment since the disease was preventing them from undergoing back surgery stemming from a work injury.
This bottom line is this – there is no time or monetary limit on workers' compensation medical benefits. They are supposed to be paid as long as there is hope for improvement in your condition, whether that only takes one visit with a doctor or the rest of your life.
Temporary Disability Benefits
During the course of your treatment, you may have to miss work and/or your physician will restrict your job duties. If these restrictions prevent you from performing your pre-injury job and earning your pre-injury wage, you are entitled to receive wage loss or temporary disability benefits.
There are two types of temporary disability benefits: temporary total disability and temporary partial disability benefits.
Temporary total disability means you are completely prevented from working and pay 2/3 of your average weekly wage up to around $800 per week (limits change each year).
Temporary partial disability means you can still work, but in a limited role. Your employer offers limited duties within the scope of the doctor's restrictions, likely at a reduced wage. In this case, temporary partial disability benefits will pay 2/3 of the difference between your pre-injury wage and what you're being paid from the part-time or modified employment.
Permanent Disability Benefits
At a certain point, your condition will stabilize and quit improving…your condition is not expected to improve with additional medical treatment (although you may receive ongoing medical treatment to maintain your condition). When this time comes, your permanent disability benefits will be determined.
This event is what's known as Maximum Medical Improvement (MMI). Once a doctor declares you have reached MMI, they need to determine if you're back at your pre-injury condition or whether you have permanent impairment. If you have permanent impairment, workers' compensation benefits in Colorado pay either permanent partial disability or permanent total disability benefits up to a limit.
Fundamentally speaking, permanent partial disability means you have some condition that will be a permanent part of your life but you are still able to hold down a job. Permanent total disability on the other hand means your condition is so severe that you are unable to work at all.
Most workers' comp cases in Colorado fall into the first category.
To determine the amount of permanent partial disability benefits, the doctor assigning the MMI designation refers to the American Medical Association's Guides to the Evaluation of Permanent Impairment, 3 rd Edition (Revised) , or “AMA Guides” to assign ratings to parts of the body affected by the injury. They may assign an injured arm, shoulder, neck and psychological rating for example.
Doctors then take these ratings and convert them to their respective “whole person” equivalent using the appropriate tables in the AMA Guide. They then take each of these numbers and add them together to arrive at your total whole person rating.
Your permanent partial disability award can be as low as a few dollars or as high as $150,000 – it all depends on the whole person rating. (We'll talk a little more about limitations to these benefits in the next section)
Permanent total disability on the other hand is much more cumbersome, and for good reason. Besides factoring permanent work restrictions as a result of an injury, there are other factors that influence this decision. An Administrative Law Judge (ALJ) with the Colorado Office of Administrative Courts comes in and also looks at the injured worker's education and experience as well as their labor market to determine if there are any jobs realistically available to the worker.
If an injured worker has limited education and experience and lives in an area with few available jobs, they are more likely to be declared permanently and totally disabled.
Permanent partial and permanent total disability awards are payable in weekly installments, a lump sum payment or a combination of the two.
If your injury causes scars and/or disfigurement exposed to public view, you may be entitled to a lump sum disfigurement award. The amount of a disfigurement award is determined by an ALJ whose determination is based on the severity and visibility of the scar.
For injuries occurring after July 1, 2007, the maximum standard disfigurement award is $4000 - $2000 for injuries prior to 07/01/2007...extensive disfigurement is capped at $8000 for injuries occurring on or after July 1, 2007. In fact, disfigurement awards change each year to adjust for inflation.
If the unthinkable happens and a worker dies in an accident or as a result of their on-the-job injury or occupational disease, their surviving dependents are entitled to death benefits. Generally speaking, death benefits pay 2/3 of the worker's weekly wage –how long death benefits last depend on the dependents' relationship to the deceased.
Surviving spouse – receives death benefits for the rest of their life or until they remarry.
Dependent children (including adoptions) – receive death benefits until age 18 or 21 if they're in school or can prove dependence on the worker.
Others (parents, grandparents, siblings, children over 18/21) – Can receive death benefits if they can prove either partial or whole dependence at time of worker's death. Partial dependents receive benefits equal to the amount they were dependent on the worker for.
If the deceased worker has more than one surviving dependent, their benefits will be equally divided between the dependents for the period of time they are entitled to Colorado workers' compensation death benefits.
Additionally, employers are required to pay up to $7000 in burial and funeral expenses and they are responsible for any and all medical bills connected with the injury.
Finally, even though dependents are not entitled to Colorado workers' compensation death benefits if a worker dies from a non-work related accident or illness, they can receive some benefits if the worker was receiving workers' compensation benefits at the time of their death. In this situation, a dependent can receive a portion of the benefits already awarded to the deceased worker prior to their death.