Benefits Available Under a Workers’ Compensation Claim

An employee who is injured at work or who has an occupational disease as a result of their employment is entitled to specific benefits under the Colorado Workers’ Compensation Act.  Those benefits fall into five categories: medical benefits, temporary disability benefits, permanent disability benefits, disfigurement and death benefits.

Medical Benefits under Workers’ Compensation

An employer is required to provide all medical benefits needed to cure and relieve the effects of an injury or occupational disease suffered by an injured worker.  These medical benefits must be provided without any deductible, co-pay, co-insurance or other financial obligation from the injured worker. 

The medical benefits provided under workers’ compensation certainly include all of the medical treatment you would typically expect in connection with an injury, i.e. doctor’s appointments, hospitalizations, medications, therapy, x-rays, MRIs, surgery, etc.  The definition of the medical benefits an employer is required to provide, however, has been interpreted very broadly by Colorado’s courts and judges and has been determined to include medical treatment you may not commonly think of in connection with a workers’ compensation claim.  For example, an employer was required to treat an injured worker’s cancer that was preventing the worker from undergoing a back surgery needed due to a work injury.  Another employer had to treat injuries sustained in a car accident an employee was involved in while driving to a medical appointment for a work-related injury.

An important and often overlooked medical benefit required in a workers’ compensation claim is transportation to and from medical appointments.  Your employer will either provide you with transportation in the form of a shuttle service or bus or cab vouchers, or they will reimburse your for the mileage you drive yourself.

There is no time limit or monetary limit on the medical benefits provided under a workers’ compensation claim.  Medical treatment can be as short as one appointment or as long as an entire lifetime and can cost anywhere from a few dollars to several millions.

Temporary Disability Benefits under Workers’ Compensation

Injured workers are commonly given work restrictions while they are undergoing medical treatment for an injury or occupational disease.  If these restrictions prevent the injured worker from performing their pre-injury employment and earning their pre-injury wages, the injured worker will be entitled to wage loss benefits called temporary disability benefits.  If the injured worker is completely prevented from working, the injured worker will receive temporary total disability benefits equal to two-thirds of the injured worker’s average weekly wage.  If the injured worker is able to work part time, or if the employer offers modified duty within the worker’s restrictions, and the injured worker is earning less than their pre-injury income, the injured worker will be entitled to temporary partial disability benefits equal to two-thirds of the difference between the injured worker’s pre-injury average weekly wage and what the injured worker is earning from the part-time or modified employment.

Permanent Disability Benefits under Workers’ Compensation

With time and medical treatment an injured worker’s condition will improve.  At some point, the injured worker’s medical condition will stabilize and stop improving.  This point in time is known as maximum medical improvement.  Once an injured worker reaches maximum medical improvement, the injured worker’s treating physician will determine if the injured worker is back to their pre-injury condition or if the injured has permanent impairment.  If the injured worker has permanent impairment, the injured worker will be entitled to permanent disability benefits.  Permanent disability benefits fall into one of two categories, permanent partial disability benefits or permanent total disability benefits.

A vast majority of cases where an injured worker is entitled to permanent disability benefits involve permanent partial disability benefits.  In these cases, the injured worker’s treating physician assigns a percentage for the permanent impairment the person has sustained.  The impairment percentage is calculated using guides issued by the American Medical Association and generally includes amounts for range of motion loss and for specific disorders or conditions.  The percentage assigned by the physician is then plugged into one of two mathematical equations to get the amount of permanent partial disability benefits the injured worker is entitled to.  Permanent partial disability awards can be as little as a few hundred dollars and as large as $150,000.

If an injured worker is unable to return to any gainful employment of any kind as a result of a work injury, that injured worker is permanently and totally disabled.  An injured worker who is permanently and totally disabled will receive two-thirds of their average weekly wage for the rest of their life or until they are no longer permanently and totally disabled.  While a worker’s permanent work restrictions as a result of an injury weigh heavily in determining whether the injured worker is permanently and totally disabled, other factors also influence this determination.  A judge will also look at an injured worker’s education and work experience, as well as the injured worker’s labor market, to determine what jobs are realistically available to the worker.  Generally, an injured worker with limited education and experience, and who lives in an area with less available jobs, is more likely to be permanently and totally disabled.

Disfigurement Awardsunder Workers’ Compensation

An injured worker who has permanent and visible scarring as a result of a work-related injury will be entitled to a disfigurement award.  Disfigurement awards can be as large as $8,000, are determined at the discretion of a judge, and are based on the severity and visibility of the scarring.

Death Benefits under Workers’ Compensation

If an injured worker is killed in a work accident or dies as a result of a work-related injury or occupational disease, that injured worker’s dependents are entitled to death benefits.  Death benefits equal two thirds of the injured worker’s average weekly wage and continue for different periods of time depending on who the surviving dependents are.  A surviving spouse receives death benefits for the rest of the spouse’s life or until the spouse remarries.  Dependent children, including adopted children, receive death benefits until they reach eighteen years old, or twenty-one years old if they are still dependent on the injured worker or if they are still in school full time when they reach eighteen years of age.

Surviving spouses and children under eighteen years old are presumed to be dependents of a deceased worker.  Parents, grandparents, siblings, and children over eighteen or twenty-one years old can be entitled to death benefits if they can show they were either wholly or partially dependent on the worker.  Partial dependents will receive benefits equal to the amount they were dependent on the worker.

In the event a worker leaves more then one surviving dependent, the death benefits will be fairly divided between the surviving benefits for the period they are entitled to benefits.  How the benefits are divided among the dependents is within the discretion of the Director of the Division of Workers’ Compensation or a judge.

An employer will also pay funeral or burial expenses up to a maximum of $7,000 for an injured worker who is killed in a work accident or dies as the result of a work-related injury or disease.  The employer is also responsible for the medical bills in connection with the injured worker’s death.

While the dependents of an injured worker whose death is not caused by a work accident or injury are not entitled to death benefits, these dependents can be entitled to some benefits if the worker was receiving workers’ compensation benefits at the time of his or her death.  In these cases, the dependents can receive a portion of the benefits that have already been awarded to the injured worker prior to death.

Talk with Us Today – a Free, No-Risk Consultation

We invite you to discuss the details of your workers’ compensation claim with a lawyer at The Babcock Firm, whether you’re in Denver, Boulder, Aurora, Broomfield, Louisville, Lafayette, Golden, Thornton, Westminster or another Colorado city. If your case falls within our practice area and we feel our representation can benefit you, an attorney will meet with you for an in-depth consultation, at no charge. We are here to help you secure a successful outcome. Learn more about how representation works and then contact us today.

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