The CO Workers’ Comp Claim Process: From Initial Filing to Appeal

It isn’t just workers in high-risk jobs like construction or firefighting who are at risk of work-related injuries or occupational illnesses—they can happen to anyone. There are so many “what ifs” that hang over your head when it comes to how you’ll take care of yourself and your family if you’re injured on the job, so it’s crucial that you know the steps you need to take to get the compensation you deserve.

In this article, we’ll walk you through the process for filing a workers’ compensation claim so you’ll know what to expect and how to protect your rights.

Need help filing a workers’ comp claim in Colorado? Reach out to the knowledgeable Denver workers’ compensation attorneys at Babcock Tucker.

How to file a Colorado workers’ comp claim

Below are the steps for filing and appealing a workers’ comp claim in Colorado.

Report the injury to your employer

A worker failing to properly report an injury to their employer within the required 10 days has resulted in many denied workers’ comp claims. You should notify your employer about the accident in writing as soon as possible, even before contacting an attorney. The longer it takes you to report the injury, the harder it will be to definitively tie the injury to an incident at your job.

See an employer-approved doctor for treatment

After informing your employer about your injury, you need to see an employer-approved doctor for a diagnosis and treatment. Your employer should provide you with a list of at least 4 “designated providers” to choose from. 

When you visit the doctor, be thorough and honest when you recount what happened and how you feel. Do not exaggerate or downplay your injuries, as this can lead to insufficient care, extended recovery time, and inadequate compensation. Be sure to tell the physician about any pain you’ve felt since the incident, no matter how small, because it could be associated with the injury as well.

It’s a good idea to get all of your injuries documented in writing, so be sure you write down any symptoms you can think of on your intake form in addition to mentioning them during your appointment. This can help eliminate issues with a doctor ignoring symptoms.

File a claim

Once you’ve notified your employer about your injury in writing, they are required to notify their insurance company within 10 days. If your injury causes you to miss more than 3 days of work, your employer is also required to report it to the Colorado Division of Workers’ Compensation.

You are also required to file a claim with the Colorado Division of Workers’ Compensation by submitting form WC 15 “Worker’s Claim for Compensation” within 2 years of the accident, although this should be done as soon as possible.

Insurance company decision

After receiving notification from your employer, the insurance company has 20 days to review your claim and either accept or deny it. If your claim is accepted, all medical bills should go directly to the employer’s insurance company. If your claim is denied, you will be responsible for payment of any outstanding medical bills that you have incurred.

If you are temporarily unable to work during your recovery, you will receive wage loss benefits equal to two-thirds of your average weekly wage paid directly to you every 2 weeks. You will not be eligible to receive these temporary disability benefits for lost wages unless you have missed more than 3 days or 3 shifts.

File an appeal

There are many reasons an insurance company might deny a claim. Some common reasons are if it’s lacking complete information and needs to be investigated further, if they don’t believe the claim is work-related, or if the injury wasn’t reported on time.

Regardless of the reason for the denial, you have the right to appeal through workers’ comp adjudication, but the process can be rather complicated. Gathering the right evidence will be crucial, so it’s highly recommended that you hire an experienced workers’ compensation attorney to help you build a strong case.

It can take some time to get a hearing before a judge—as long as 3 to 6 months—and there are multiple steps that need to happen before the hearing.

Discovery process

The discovery process exists to exchange information between your attorney and the insurance company, including facts and evidence for hearings. You should expect the following questions:

• What was the cause of the injury?
• What was your pay when you were injured?
• Did you report the injury to your employer?
• Were there any witnesses?
• What is your medical history?
• What does your employment history look like?

Yes, many of these questions may feel invasive, but they are often necessary to confirm that your injury is work-related and ensure you receive the proper compensation.

Please note that during a workers’ compensation appeal, your adjuster might request medical records from the past 10 years. Typically, only information relevant to your case is required—mental health records, for example, wouldn’t be needed for a back injury claim.

Don’t worry if you have a pre-existing condition. Having one doesn’t automatically disqualify you from receiving workers’ comp benefits. However, it can make the process more complex, so having a workers’ comp attorney is crucial to protecting your rights.

Mediation

Many workers’ compensation cases proceed to mediation after discovery, often resolving the claim without the need for a formal hearing. Mediation is a structured negotiation process where both parties—represented by their attorneys and guided by a neutral mediator—discuss options for reaching a fair workers’ comp settlement. The mediator helps facilitate communication, clarifies misunderstandings, and encourages both sides to find common ground.

Mediation can be especially helpful in workers’ comp cases, as it allows for flexibility and compromise, often leading to a faster resolution than a lengthy court process.

Mediation is also beneficial because it lets you have more control over the outcome of your case, rather than leaving it up to a judge’s decision. For many, it means quicker access to benefits and the opportunity to avoid the stress of a hearing. In fact, mediation often results in an agreement, providing both sides with a more satisfactory outcome and allowing you to focus on recovery rather than ongoing litigation.

Hearing before a judge

If mediation doesn’t resolve your case, the next step is a formal hearing. In this setting, an administrative law judge will review the evidence from both sides, hear witness testimony, and make a binding decision on your workers’ comp benefits. If the judge doesn’t rule in your favor and you believe the decision is unfair, you have the right to appeal. This must typically be done within 20 days. 

During an appeal, both parties submit briefs. The judge may re-evaluate the decision or refer the case to the Industrial Claim Appeals Panel, which has 60 days to respond. Further appeals can go up to the Colorado Court of Appeals and, in rare cases, the Colorado Supreme Court, though most cases are resolved long before reaching this level.