Colorado Workmans Comp Benefits: How to Apply, Qualify, and Amounts

You got hurt at work, and now you have no idea what to do. Should you go to your doctor and get checked out, or report the accident to your supervisor first? How do you even know if you have Colorado workmans comp insurance through your employer? And if you’re undocumented, can the doctor report your immigration status when you go for treatment? (Answer: No, that’s illegal.)

Our guide below explains how to apply, qualify, and what types of Colorado workers’ compensation benefits you may receive.

Guide to Colorado Workmans Comp if You’re Injured on the Job: Key Takeaways

• You must notify your employer within 10 days of your work-related injury or illness to get workers’ compensation benefits in CO. Every day you’re late submitting this notification costs you one paid day off work under Colorado law.
• Unless your life is in danger, always report your injury to your supervisor before you get medical care. You must choose an authorized treating physician from the list your employer provides before you seek treatment, in most cases.
• Most Colorado businesses must carry workers’ compensation insurance, but not every employee has this type of coverage. Check the list of Colorado employees automatically exempt from filing a workers’ comp claim under existing state law below.
• If you don’t need at least 4 days off after your workplace accident, then Colorado workers’ comp insurance only pays for medical benefits. You must miss at least 4 work shifts before you qualify for biweekly payments that cover partial lost wages.

Workers’ Compensation Insurance Coverage Exceptions for Certain Employees Under Colorado Law

Any employer in this state with one or more employees must carry Colorado workers’ compensation coverage. The law applies equally to part-time and full-time employees, starting on day one of their employment. However, any injured employee that fits the descriptions listed below is automatically exempt from this coverage requirement:

• Commission-only Realtors and real estate brokers
• Domestic servants working less than 40 hours per week in a private home or household
• Drivers that work on a contract basis for app-based rideshare services, such as Uber or Lyft
• Federal workers, including railroad employees and USPS postal delivery carriers
• Independent contractors (however, contractors working for construction industry businesses must have insurance coverage)
• Prison inmates
• Residential support employees working for host-home service providers
• Sole proprietors and limited liability company business partners
• Volunteer ski operators

Every Step in the Colorado Workers’ Compensation Claims Process

If you’re an injured employee, follow the steps below to apply for workers’ compensation benefits in CO:

1. Unless your life is in danger, give your supervisor written notice about your workplace injury before you seek medical treatment.

For a life-threatening injury or occupational disease, always go to the nearest hospital or clinic for urgent medical care. Otherwise, ask your supervisor for a list of 4 authorized doctors so you can choose your treating physician. If you wait too long to notify your employer, you may lose your right to claim Colorado workmans comp benefits.

Important: Colorado Department of Labor and Employment policy states you must submit notice within 10 business days. Every day you delay doing so costs you one paid day off covered under Colorado workers’ compensation law.

2. Once you see a doctor, file Form WC-15 with the Colorado Division of Workers’ Compensation to start the claims process.

Be sure to make at least 3 copies of this form:

• One copy for your own records
• Another copy for your employer’s insurance company
• A third copy to file with the Colorado Division office in Denver in case your employer fails to notify them in a timely manner

Pro Tip: If you fail to file this form within CO’s two-year statute of limitations, then you may lose your chance to claim workers’ compensation.

3. Don’t like the treating physician you chose? You can change doctors within the first 90 days without approval from the insurance company.

However, you will need to fill out Form WC-3, One-Time Change of Physician to make this switch. If you wait until after this 90-day period ends, you must use Form WC-197, Request for Change of Physician, instead. Then, the insurance carrier has 20 days to approve or deny your request to switch providers.

4. Your employer’s insurer has 20 days to approve or deny your Colorado workmans comp claim.

You should receive your claim decision notice by mail, along with instructions on how to appeal if you’re denied benefits.

5. If approved, you must miss at least 4 work shifts before workers’ compensation coverage pays for any lost wages.

In cases where you can go back to work within a few hours or days, workers’ comp insurance will only pay your medical bills. However, if the doctor says you need ongoing treatment before you can go back to work again, you’ll qualify for wage-loss benefits. Keep reading to learn more about these benefits and how they work below.

6. Denied workers’ comp benefits? Appeal within 45 days by filing an Application for Hearing Form with the Office of Administrative Courts (OAC).

You must submit this form within 45 days after receiving the insurance company’s Notice of Contest denial letter in the mail. Generally, the OAC schedules appeals hearings within 120 days after receiving your completed application form.

What Workers’ Compensation Benefits are Available in CO?

Colorado workers’ compensation law provides some or all of the benefits listed below for an eligible injured employee. If you can go back to work right away, you’ll only then workers’ compensation insurance only pays your medical expenses. You may receive temporary disability benefits if your doctor says you need ongoing medical care as a form of wage replacement.

Medical Benefits

These benefits cover all expenses from authorized medical providers and last for up to 6 years from your filing date. Some standard costs typically covered after a workplace accident include:

• Medical appointments with any approved provider who treats your job injury or illness
• Prescription drugs and over-the-counter medications required to manage your symptoms
• Physical therapy, vocational rehabilitation, and any necessary medical supplies
• Reimbursement for your mileage, travel expenses, parking, or other costs associated with required care for your injury or illness

Pro Tip: Write down every expense related to your ongoing medical treatment and submit it to your claims adjuster within 120 days.

Temporary Total Disability Benefits

Once the required 3-day waiting period ends, you may become eligible for temporary total disability (TTD) benefits. These biweekly payments equal 66 2/3% of your average weekly wage (AWW), subject to Colorado’s minimum and maximum amounts. You can receive TTD payments every other week until you reach Maximum Medical Improvement (MMI) or return to work.

Important: Once you miss 15 days of work, Colorado workmans comp will pay you for those first 3 unpaid days off.

Temporary Partial Disability Benefits

If you can go back to work but earn less money or work fewer hours than you did before, you may receive Temporary Partial Disability (TPD) benefits. These payments usually cover 2/3 of the difference between your pre-injury wage and current paycheck.

Once the doctor clears you to go back to work full time and at your usual pay amount, your TPD benefits will end.

Permanent Partial Disability Benefits

Once you reach Maximum Medical Improvement, your treating physician determines if you have any permanent impairment that limits your ability to work and earn a living. If so, Colorado workmans comp may calculate a lump-sum payment based on your percentage of loss. Permanent partial disability benefits (PPD payments) equal 4-208 weeks of TTD payments, depending on your permanent impairment rating.

Permanent Total Disability Benefits

If you can’t go back to work at all after reaching MMI, you may then qualify for permanent disability benefits. These are known as permanent total disability benefits (PTD payments). Permanent disability payments are the same amount as TTD benefits, paid biweekly.

However, you should know that certain offsets could reduce the amount of PTD payments you get over time. Examples of things that could reduce your biweekly PTD income may include:

• Unemployment benefits
• Social Security disability insurance benefits
• Long-term or short-term disability benefits paid through an insurance policy under your employer’s benefits package
• Social Security retirement benefits

Death Benefits for Family Members of a Deceased Worker Killed on the Job

If an injured worker dies on the job, Colorado workmans comp offers death benefits to certain eligible dependents. Death benefits for families of a deceased worker can include some or all of the following:

• At least $7,000 for funeral and burial expenses (the Division director adjusts this reimbursement amount annually).
• Biweekly workers’ comp benefits for an eligible surviving spouse and any minor children until they turn 18. Surviving spouses can receive benefits for life until they remarry; children who are full-time students can receive payments until age 21.
• Colorado workers’ compensation insurance also pays TTD payments to surviving parents if the deceased worker was younger than 21.

How to Get Free Professional Colorado Workers’ Comp Claim Help

Not sure whether your work-related injury qualifies for workers’ comp in CO? If you’re injured on the job, get a free claim review from an attorney who specializes in Colorado workers’ compensation law. Not sure where to find someone who can help answer your questions?

We can connect you with a workers’ comp lawyer today for a free consultation. This free consultation is the best way to learn how to get the maximum compensation the insurance company may owe you.

If an attorney cannot help you win your case, then you owe $0 for legal representation. But if you’re successful, then you only owe one small fee afterwards.

LegalASAP can help you get a free, no-obligation consultation about your case. Our nationwide network includes hundreds of law firms located across the United States.

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