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Colorado Workers' Compensation Benefits

Colorado Workers' Compensation Benefit Limitations

With the exception of medical benefits that pay all expenses connected with treating your on-the-job injury, there are limitations to certain other types of benefits – namely temporary disability and permanent partial disability benefits.

Benefit caps are determined by several factors but fundamentally speaking, caps depend on the impairment rating the physician assigns to you once you reach Maximum Medical Improvement (MMI). Doctors arrive at this impairment rating through a process we described in the previous section outlining permanent partial disability benefits.

Benefit caps do not apply until the doctor assigns your impairment rating but can affect what you ultimately receive in permanent partial disability benefits. For injuries occurring on or after January 1, 2006, benefit rate caps are as follows:

Doctor's impairment rating is 25% or lower - $75,000

Doctor's impairment rating is higher than 25% - $150,000

For injuries occurring before January 1, 2006, benefit caps are $60,000 and $120,000 respectively.

As we said, benefit caps do not take effect until your doctor declares you have reached MMI and assigns an impairment rating.

Just how do these caps apply to how much I ultimately receive?

Say for example you're being treated for an injury for an extended period of time and receive $50,000 in wage loss/temporary disability benefits. You finally reach MMI and the doctor assigns a 15% impairment rating, which may be worth an additional $40,000 is permanent partial disability benefits.

Since you have already received $50,000 and the cap for a 15% impairment rating is $75,000, you will only receive $25,000 in permanent partial disability benefits. In fact, if what you receive in wage loss benefits exceeds the cap before you even reach MMI, you will receive no permanent partial disability benefits.

Colorado workers' compensation caps can even come into play if you have to reopen your case, which you can do provided you retain the right to do so at the conclusion of your case and you're within the applicable time period for reopening. For our example, let's say symptoms stemming from your injury re-appear a couple years after the insurer issues their "final admission of liability" and around four years since the initial injury.

Your impairment rating of 22% caps your benefits at $75,000 – you received $50,000 in wage loss benefits and an additional $25,000 in permanent partial disability benefits.

The resurgence of your condition means you have to miss work again. But since you reached the $75,000 cap, temporary disability/wage loss benefits will not start immediately since the workers' comp insurer will need to "offset" the permanent partial disability benefits you already received.

In the example above, wage loss benefits will not resume for 50 weeks. Insurers arrive at this number by dividing the permanent partial disability award of $25,000 by the weekly wage loss rate of $500 in this example.

Next: Workers Compensation Benefits for Independent Contractors >>

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"I am very happy with how my case went. I went through the facts of the case once with Stephanie, signed a form here and there, and was able to focus on getting healthy again and moving forward with my life. I was worried there would be a lot of work and stress involved in this case for me personally. I was very grateful to everyone at Babcock because they knew that I would prefer they handle the bulk of everything and just contact me when it was really necessary. I had already been through a lot of stress with my employer and didn't want to relive that stress again in this case. They saved me a lot of headaches by being excellent advocates for me. In the end we were victorious based on two factors, we were on the right side of truth, and Babcock Law were excellent representatives for me."

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"Mack did a great job and was only lawyer to take case since Colorado laws are very poor for injured workers. I was very frustrated to learn how bad the state of Colorado laws are. Mack was patient explaining what the state allowed for injured workers. Mack explained how he works every year to try and get new laws in place for injured workers. Knowing what Mack told me. I have to laugh when i see the tv commercials for personal injury lawyers saying we will take your case. Mack did a very good job. Hopefully Dr John Burris and others like him will be subject to the plenty of the law one day."

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"I was fortunate to be recommended this firm and to meet with David Ong. David provided an excellent service and helped me through the complexities of workers comp. It took away so much of the additional stress associated with my injuries and enabled me to get a fair settlement for the case. My only regret is that I did not know of The Babcock Law Firm earlier on in the process. I highly recommend this firm and appreciate the friendly and empathic attitude shown by all of the staff I came across."

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