How company doctors can terminate your Colorado workers’ compensation benefits

  • February 4, 2015

By Your Denver Personal Injury Attorney

(DISCLAIMER: Colorado workers’ compensation cases are complex.  The following blog post is neither exhaustive nor is it intended as legal advice. You should never act on matters of importance to yourself based on the blog posts of an attorney.)
"Trust me. I work for them."

“Trust me. I work for them.”

When you’ve been hurt on the job, Colorado workers’ compensation law makes employers pay you 66.66% of your average weekly wage (up to the statutory limit) and all of your injury-related medical bills.  These benefits are sometimes referred to as “temporary partial disability” benefits.

There is no limit on the time that an employee can receive these benefits, but there are a couple of ways that company doctors can terminate those benefits.  Therefore, it’s important that, when dealing with company doctors, you are your own best advocate.

One way for a company doctor to terminate a worker’s benefits is to find that the employee has reached maximum medical improvement.  The Colorado Workers’ Compensation Act defines “maximum medical improvement” as the “point in time when any medically determinable physical or mental impairment as a result of injury has become stable and when no further treatment is reasonably expected to improve the condition.”

In other words, MMI means that the employee has gotten as good as she gonna get.  What’s tricky about this determination, however, is that once it has been made, the employee’s benefits are cut off.

Now, you can challenge the company doctor’s MMI finding through an independent medical examination (“IME”), but what happens in the meantime while the employee’s benefits are cut off?  An independent medical examination is going to take at least another 75-90 days on average just to complete.  Then you have to request a hearing.  And even then, there’s no guarantee that the new IME doctor is going to disagree with  the previous doctor’s findings.

(Not to get too complicated here, but an MMI determination is usually accompanied by an impairment rating which determines the amount of your settlement.  But usually, as a matter of course, your Colorado workers’ compensation lawyer is going to challenge that initial impairment rating which means that you’re left without benefits while the appeals process is underway.)

A second way that company doctors can terminate your benefits under Colorado’s workers’ compensation law is to release the employee back to modified employment.

Basically, this occurs when the employer sends a checklist of modified duties to the doctor for him to sign off on.  Once the doctor signs off on the restricted duties and the employer makes a formal modified job offer, you either accept the offer and work at the offered pay rate or you reject the offer.  Either way, your benefits are terminated once a modified job offer has been made.

For example, think about a window washer who injured his back on the job and has been off work for a while.  In the past, he used to climb scaffolding all day as a part of his duties, but now doctor won’t authorize him to climb a ladder or bend or reach above the shoulder on account of his back.

Instead, the doctor says that the window washer can mix cleaning solution and clean first floor windows only and checks off on the employer’s list as such.

In theory, this makes sense.  The window washer isn’t quite ready to go back to full duty (and he might not ever be), but he can do some light duty work in the meantime.

But the reality is different from the theory.  In reality, what company doctors are doing in Colorado workers’ compensation cases are signing off on work restrictions without involving the employees in the process.  They get the letter from the employer, check ‘yes’ on every work restriction, and send the letter back in, hardly glancing at their patient’s file.

By the time the employer has made the modified job offer and the employee and her lawyer is notified, it’s too late.  The employee is either going to go back to work under these restrictions or not.  If she can’t work based on these current restrictions, she’ll need the doctor to amend the restrictions at her next appointment.  If he will.  In the meantime, she has to decide whether or not to accept the modified job offer.

The point here is that, as an employee, you have to be your best advocate.  Sure, your Denver workers’ compensation attorney is going to fight tooth-and-nail to get you every last bit of compensation you deserve, but once your treating physician has made a determination that you are MMI or he has released you back to work under bogus and unrealistic work restrictions, your benefits are cut off.  And as much as your lawyer may scream and yell about it, the administrative law judge charged with hearing your case is going to defer to the doctor’s findings at least until your lawyer has had enough time to schedule and independent medical examination and build a defense on your behalf.

If it sounds like I’m cynical when it comes to workers’ compensation company doctors, it’s because I am.  Like everything else, I’m sure that there are good company doctors and bad ones.  But they are still doctors chosen by and working for the employers and insurance companies.  Sure, you can change doctors one time provided that you give written notice within ninety days after the date of the injury, but before you reach maximum medical improvement (and in other limited circumstances).  However, you’ll still be dealing with a company doctor.

In the end, you are your own best advocate.  Don’t let company doctors push you around.  And hire a workers’ compensation lawyer that’s going to fight for you.  Call Your Denver Personal Injury Attorney Jeffry Dougan today at 303-704-1222 and set up your FREE initial consultation. Don’t wait.  This is too important.

Related: Denver Workers’ Compensation Attorney

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