Navigating the Maze of Workers' Comp

Imagine you’re in a maze with another person. You don’t know the way, but they do. The maze is constantly changing, and there are traps along the way. And the goal is to get through it first.

“That’s the work comp system,” says Michael Kaplan, an attorney at Kaplan Morrell in Denver. “You’re against the adjuster, and I’ll give you one guess who wins that race if you don’t have assistance.”

The process can be confusing, attorneys say, but they have some helpful tips if you are hurt on the job.

Report the Work Injury Right Away

Regardless of the circumstances of your workplace injury, it’s always best to report it as soon as possible.

“A delay in reporting just creates problems that you don’t need,” says Janet Frickey, a workers’ comp lawyer at The Frickey Law Firm in Lakewood. “And do it in writing or a form that can be verified. That’s the first thing.”

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What Happens if You Don’t Report the Injury Promptly

Report the injury immediately, even if it happens on a Friday afternoon, Frickey adds. If it goes unreported until Monday, “People think, ‘They probably got hurt over the weekend,’ so that’s one of the red flags that comes up. Always report it. Even if you think it’s nothing and you feel better, at least you’re covered.”

Report it to your employer and insurance carrier. If you’re concerned about how your case is progressing, file a claim with the Colorado Division of Workers’ Compensation.

The law changes literally monthly. The statutes and procedures are so draconian — there are so many ‘gotchas’ out there — so go with someone who does this all the time.

Seek Medical Treatment for the Workplace Injury

Your employer should urge you to seek medical care. While the law dictates they have that right to select the doctor, they must provide four options within seven days. “If they don’t, you can seek treatment from whomever you wish,” Kaplan says.

Attorneys say it ‘s important to be honest and follow what the doctors say, but be wary. “There’s a conflict of interest between the doctors, the injured worker and the employer’s insurance company,” Kaplan says. “The doctor doesn’t want to bite the hand that feeds him — which is that massive referral source in the insurance company.”

For example, if you have a shoulder or hip injury, a healthcare provider may diagnose it as solely an arm or leg issue, while an attorney may argue its implications in your neck or back. “A 10% impairment rating on your arm is worth $5,800, while your neck could be $50,000 to $80,000. There’s a big discrepancy there,” Kaplan says.

Workers have the right to change to another doctor on the list within 90 days from the date the accident occurred. Changes of physician and requests for second opinions are common issues handled by workers’ compensation attorneys.

Be Aware of Changes in Workers’ Comp Law

“The law changes literally monthly. The statutes and procedures are so draconian — there are so many ‘gotchas’ out there — so go with someone who does this all the time,” Kaplan says.

“It’s a little like dealing with the IRS,” Frickey agrees. “You want someone who understands all the nuances.”

That said, “You don’t always need an attorney,” adds Frickey. “If your employer gives you everything you need and you’re feeling better, you may not need me.”

For those people, Frickey recommends the Department of Labor and Employment website. It has information on how to represent yourself and, should you need it, a list of workers’ comp attorneys recommended by the state bar. 

“Think of it as a minefield,” Kaplan says of workers’ comp law. “There are a lot you can hit that compromise your rights and your claim. I act as a guide to prevent you from hitting those mines.”

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