Your Insurance Adjuster May Not Be On Your Side

The Colorado Workers’ Compensation Act can be described as a jungle of law, rules and court rulings. It is difficult for the newcomer to understand. As an injured worker, this is probably the first time you have dealt with complexities of workers’ compensation law.

Your insurance adjuster, however, has dealt with these issues many times. Be careful that you know the law before you make any decisions or before you agree to anything the adjuster may tell you, including giving a recorded interview to the adjuster. Hiring an experienced workers’ compensation lawyer can help ensure that your rights are protected.

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At the Eley Law Firm in Denver, we are always on the side of the injured worker. We have never represented an employer or an insurance carrier, and we never will. Here are some examples of what your adjuster may not tell you, but you are welcome to call us and get the answers you need.

Can I Choose Or Change My Treating Physician?

In Colorado, your employer may choose to select a doctor who will treat your work-related injury. Not every employer elects to do so, however, so you may still be able to select a doctor of your choosing. Your attorney will help guide you through this process to ensure you get the care you need.

Whether you or your employer selects a treating physician, however, the doctor cannot be changed without both parties’ consent. For example, if your employer or its insurance company tells you they want you to go to another doctor for treatment, and you visit the doctor for treatment, the law will more than likely view this as giving consent. If you are being told by your employer or insurance adjuster that they are changing your doctor, call your attorney right away.

What About Mileage To And From Treatment?

You can be reimbursed for the mileage you drive to and from treatment so long as it is a treatment that is prescribed by your doctor. The same is true for trips to and from physical therapy, health clubs or other treatment as necessary to treat your injuries.

It is important to keep detailed records of the miles you travel. This information will need to be sent to your company’s insurance carrier to receive payment. Our firm has mileage forms that you can use and will assist you with this at no charge.

Are Fringe Benefits Included In The Average Weekly Wage?

The wage loss benefits you receive for your time off work are based upon your average weekly wage. For example, if your doctor’s restrictions prevent you from working, you are entitled to receive two-thirds of your average weekly wage in temporary total disability benefits, up to a yearly adjusted limit.

Fringe benefits that you receive as part of your pay package, but which you don’t get when you are off work, can be included in the calculation of your average weekly wage. For example, if your employer-paid insurance is terminated because you are off work, the cost of that insurance should be included in your average weekly wage. The same is true with employer-provided meals and lodging. Make sure that your adjuster knows that you have lost these benefits and what it would cost you to replace them so that you will receive the correct amount of temporary total disability benefits. These additions to your calculated wage will also increase what you receive in permanent disability.

A workers’ compensation attorney can help you decide which benefits you are entitled to be compensated for. If you have questions on your fringe benefits, please contact the Eley Law Firm in Denver.

What Is An Independent Medical Exam, And What Are Your Choices?

After your treating physician has placed you at maximum medical improvement (MMI), either you or the insurance company can ask for an independent medical exam (IME). The issues the second doctor determines are usually the date of maximum medical improvement and the extent of your permanent disability. Both of these issues can greatly affect your benefits.

If you can’t agree on a doctor to perform this exam, the Division of Workers’ Compensation will provide a doctor for you. Do not be quick to agree with the claims adjuster about a doctor to perform the IME. There are many doctors who receive a large percentage of their business from insurance companies and employers. If you agree to see one of these doctors, you could be very disappointed. The IME doctor’s opinion can only be overcome in court by “clear and convincing” evidence. This is a difficult burden to meet. You can usually get an opinion regarding a doctor by calling a workers’ compensation attorney such as Clifford Eley from the Eley Law Firm.

Know Your Workers’ Comp Rights · Free Consultation

These are just a few examples of the rights you have that might go unprotected. Unlike you, the adjuster has dealt with these things many times. If you have questions regarding these or other issues, contact our firm for a free consultation. Call our Denver office at 303-785-2828 or fill out the email form on the Contact page. We look forward to hearing from you.

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