Benefits and Payments to Colorado Employees

Denver, CO (WorkersCompensation.com) -- One of the many items Simply Research subscribers have access to is Colorado's recently published Injured Worker Guide, a tool to help workers understand the ins and outs of the workers' compensation system.

Here are some highlights from that guide regarding what benefits are available to injured workers in the Rocky Mountain State.

Reimbursements

If you spend money on your care, the respondents should reimburse you in most cases. They
may reimburse you for travel expenses, such as mileage and parking. They may also cover the
cost of medical supplies and over-the-counter medications recommended by your doctor. You
will need to request reimbursement in writing and should talk about it with your adjuster. Keep
track of your receipts and mileage to and from the pharmacy and your authorized medical visits.
These should be sent to your adjuster within 120 days from the date of the expense. Keep copies
for your records.

Average Weekly Wage

Workers’ compensation benefits are based on your average weekly wage. It is calculated from all
of your wages, including overtime, vacation, sick pay, and earnings from the job where you were
injured and earnings from any additional jobs you had at the time of your injury. If your health
insurance is canceled, your average weekly wage is increased by your COBRA benefits
(continuing group health benefits provided under a group health plan for limited periods of time
under certain circumstances).

Lost Wages

If your claim has been accepted (or admitted) by the respondents and you are losing time from
work because of your injury, you may be entitled to either Temporary Total or Temporary Partial
Disability benefits. The respondents will not pay lost wage benefits until you have missed three
shifts from work. This “waiting period” will be reimbursed if you miss more than two weeks as a
result of your injury.

Temporary Total Disability (TTD) is paid at two-thirds of your average weekly wage every two
weeks. TTD is due if the doctor takes you completely off of work or if the doctor gives you
restrictions that your employer cannot accommodate. If you are having difficulty performing
your duties, contact your doctor immediately. You cannot take yourself off of work. If you stop
working without your doctor’s approval, you may not receive benefits for this lost time.
Temporary Partial Disability (TPD) is paid when you return to work but you are not earning your
normal pay or working your regular hours due to your injury (including missed work for medical
appointments). The amount of TPD you will receive is determined by subtracting the amount you
were paid from the amount you would have been paid if you hadn’t been injured. Contact your
adjuster to let them know you are not earning your pre-injury wages.

Permanent Disability Benefits

Once you have been placed at Maximum Medical Improvement (MMI), your doctor determines
the amount of loss in the form of a percentage. If your doctor is unable to do this, they may refer
you to another doctor who can. Impairment is the permanent loss of function of a body part or
system. For instance, you may no longer be able to use your hand the same way you did prior to
being injured. Your doctor determines the amount of loss you should receive.
There are two types of disability awards. For loss of function to your toes, feet, legs, fingers,
hands, arms, eyes, vision or hearing, you would receive a “scheduled” impairment.
For loss of function to your spine, lungs, or mental, you would receive a “Non-Scheduled” (whole
person) impairment. For questions regarding permanent impairment or permanent disability
benefits, you can contact Customer Service at 303-318-8700 or 1-888-390-7936.

Permanent Partial Disability

Permanent Partial Disability (PPD) or medical impairment benefits are those benefits that
compensate a claimant for permanent loss of function or impairment to a particular body part.
The amount of PPD you will receive will be calculated using the percentage of loss determined
by the doctor and the Colorado State statute.

Permanent Total Disability

Permanent Total Disability (PTD) means you are unable to earn any wages for the rest of your
life. Benefits for PTD are paid at the same amount as Temporary Total Disability (TTD).

Disfigurement

You may be entitled to a disfigurement award if your injury results in serious and permanent
disfigurement, like scarring on parts of your body that are visible to the public or a permanent
limp. Contact your insurance adjuster to discuss your request for a disfigurement award. Your
adjuster may choose to refer you to the Division of Workers’ Compensation to file your
disfigurement request.

You may file the Request for Disfigurement Award (Photo) (WC 193) through the Division of Workers’
Compensation at cdle.colorado.gov/dwc. You must deliver copies of the form and photos of
your disfigurement to your adjuster and submit the original form with photos to the Division of
Workers’ Compensation. If you prefer to appear before a judge, or if you disagree with the award
given to you by the Division of Workers’ Compensation, you may file an Application for
Disfigurement Hearing with the Office of Administrative Courts. This form may be downloaded
from oac.colorado.gov/oac-forms.

Before filing the Application for Disfigurement Hearing, make sure that it has been at least six
months from the date of injury. If you had surgery, then it would be six months from the date
of your surgery. If a Final Admission has been filed, you have 30 days to request a disfigurement
hearing even if it has been less than six months from the injury or surgery.

Fatality

If someone dies because of injuries received on the job, workers’ compensation provides
bi-weekly payments to the surviving dependent(s) and reimbursement for at least some
funeral costs, up to a maximum adjusted annually by the Director of the Division of Workers’
Compensation. The weekly amount of death benefits is calculated the same way as Temporary
Total Disability (TTD) benefits.

A surviving spouse is entitled to lifetime payments, or until remarriage.

Surviving children may be eligible for payments until age 18, or age 21 if the child is a full-time
student. If there is no spouse or child, other relatives such as a parent, grandparent, sister or
brother, may be eligible for partial benefits.

If the deceased is under the age of 21 with no dependents, the surviving parents may be entitled
to benefits.

If the dependents are receiving survivor benefits through social security, their workers’
compensation may be reduced.

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