In a May 11, 2011, memorandum, the Centers for Medicare and Medicaid Services (CMS) reiterated its guidance regarding CMS’ Workers’ Compensation Medicare Set-Aside Agreements (WCMSA). The May 11, 2011, memorandum confirmed submission of a WCMSA proposal to CMS for review and approval is a recommended process. Historically, there have been no statutory, or regulatory, provisions…
The Colorado Division of Workers’ Compensation is vigorously investigating whether contractors on construction sites are properly carrying workers’ compensation insurance and verifying coverage of any subcontractors. In Colorado, all employers are required to carry workers’ compensation insurance for their employees. Any person, company or corporation contracting any work out is construed to be an employer.…
The Division recently adopted changes to Rule 11, W.C.R.P., which governs the Division Independent Medical Examination process. These changes took effect on March 2, 2023. Unfortunately, some of the changes to Rule 11 have the potential to substantially increase the cost of Division IMEs to all our clients. As such, we wanted to advise you…
We have all heard the grim news; a school in Parkland, a concert in Las Vegas, a nightclub in Orlando, a church in Charleston, a movie theater in Aurora. The scenes have become far too common. While we may think of the scenes of these places as serving a specific function, such as education, the…
BACKGROUND On February 26, 2018 Industrial Claim Appeals Office (ICAO) issued an opinion captioned Yeutter v. CBW Automation, Inc. and Pinnacol Assurance, W.C. No. 4-895-940. The decision sparked great interest in the workers’ compensation community and was a primary topic of discussion at the recent Spring Update CLE as well as the latest Case Law…
2017 saw more legislative action related to workers’ compensation than Colorado has seen for the past few years. Three bills were introduced in the Colorado Legislature and all three passed. One of the newly enacted bills, HB 17-1229, was enacted on June 5, 2017, with an effective date of July 1, 2018 (subject to exception)[1]. …
An incident takes place within the course and scope of claimant’s employment. Claimant is confirmed to have sustained an injury but does not miss any time from work. No permanent impairment is anticipated. What the adjuster has is characterized as what most of us refer to as a “med-only claim.” Throughout the course of the…
One of the questions I hear frequently about the Colorado workers’ compensation system from risk managers, insurance adjusters, and even some medical professionals is: “Why does Colorado still use the AMA Guides Third Edition, Revised, when calculating impairment?” In other words, why do Division Level II accredited physicians providing impairment ratings to injured workers use…
Why is it important to know if the person working for you is an employee or an independent contractor? Because the answer determines if he or she must be covered by your workers’ compensation insurance policy. An incorrect guess exposes you to substantial penalties under Colorado’s Workers’ Compensation Act. A worker’s status as an “employee”…
The Occupational Safety and Health Administration (OSHA) requires many employers with ten or more employees to keep a record of serious work related injuries and illnesses (certain low risk industries are exempted). Employers must report any worker fatality within 8 hours and any amputation, loss of an eye, or hospitalization of any worker within 24…
The Colorado Department of Health Care Policy and Financing, through its Medicaid program, is responsible for collection of outstanding liens for the state. This department is in charge of disbursement of state funds to indigent citizens in need of medical benefits. Oftentimes, a claimant will pursue medical benefits through the department if they qualify. This…
The growing epidemic of chronic opioid use and addiction, and its consequences, permeates the American medical and legal landscape. Since the spike in the use of ubiquitous pain medications in the late 1990s, there has been little actual oversight in the health care industry to regulate the prescription of these highly addicting drugs. In March…