Category: Uncategorized

All Authorized Treating Physicians Must Refuse to Treat in Order for the Right of Selection to Pass to the Injured Worker

Under §8-43-404(5)(a), C.R.S., the respondent is afforded the right in the first instance to select a physician to attend the claimant. However, the statute implicitly contemplates that the respondent will designate a physician who is willing to provide treatment. Therefore, if the physician selected by the respondent refuses to treat the claimant for non-medical reasons,… Continue reading All Authorized Treating Physicians Must Refuse to Treat in Order for the Right of Selection to Pass to the Injured Worker

Updated CMS Regional Contacts

The Centers for Medicare and Medicaid Services has updated its list of regional contacts for Workers’ Compensation Medicare Set-aside Accounts. The regional contacts for Colorado are listed as: Tom Bosserman (415) 744-4907 Ian Fraser (415) 744-3665 Tina Lim (415) 744-3673 Irene Cheng (415) 744-3582 The full list of regional contacts for each state can be… Continue reading Updated CMS Regional Contacts

New Social Security Administration Release of Information Form

In July 2013, the Social Security Administration revised the Consent for Release of Information form, used to obtain information regarding an individual’s receipt of Social Security disability income benefits, Supplemental Security Income benefits, or Medicare benefits.  The fillable form can be found here. Please note that this form is not the authorization required by the… Continue reading New Social Security Administration Release of Information Form

Updated CMS Regional Contacts – Revised

The blog post dated July 22, 2013, published the updated Centers for Medicare and Medicaid Services regional contact list for Workers’ Compensation Medicare Set-aside Accounts. CMS recently revised the regional contact information. The regional contacts for Colorado now are listed as Ian Fraser, Annie Lam, and Sandee Olson, who can be reaced at (415) 744-4907. The revised list… Continue reading Updated CMS Regional Contacts – Revised

Workers’ Compensation Fraud (Part 1)

While fraud generally refers to the criminal act of intentionally deceiving some entity in order to further one’s personal financial gain, workers’ compensation fraud is specifically defined as the act of intentionally making false statements or representations to the Division of Workers’ Compensation in Colorado in order to secure payments or any type of benefit… Continue reading Workers’ Compensation Fraud (Part 1)

An Order Denying “Compensability” Only is Not an Appealable Order

In a decision that stretches the bounds of legal reasoning, the Industrial Claim Appeals Office recently issued an opinion holding an Administrative Law Judge’s order finding a claim not compensable did not deny the claimant a benefit. Abenth v. Northside Christian Church, W. C. No. 4-893-024 (September 12, 2013). The court recognized that the statute… Continue reading An Order Denying “Compensability” Only is Not an Appealable Order

An Administrative Law Judge May Deny a Penalty on the Merits for Failure to Plead Specific Grounds for Penalty

In Lovett v. Stroup Insurance Services, Inc., W. C. No. 4-808-092 (August 30, 2013), the Industrial Claim Appeals Office recently held that an Administrative Law Judge’s denial of a penalty for failure to plead the specific grounds for the penalty allegation in the merits was a denial of the penalty on the merits, rather than… Continue reading An Administrative Law Judge May Deny a Penalty on the Merits for Failure to Plead Specific Grounds for Penalty

Workers’ Compensation Fraud (Part 2)

As a continuation of Workers’ Compensation Fraud (Part 1), the following provides some further information regarding illegal workers’ compensation claims. While Part 1 of this blog provided a comprehensive definition of what constitutes workers’ compensation fraud, here in Part 2, we will focus on the criminal penalties for those who are charged with and convicted… Continue reading Workers’ Compensation Fraud (Part 2)

DIME Physician’s Opinion on Causal Relationship May Have No Presumptive Weight in Hearing on Permanent Total Disability Benefits

It long has been settled law that the Division IME physician’s opinion concerning the cause of a particular component of a claimant’s overall impairment must be overcome by clear and convincing evidence. The Industrial Claim Appeals Office appears to have departed from that rule of law in a recent decision which stated that the determination… Continue reading DIME Physician’s Opinion on Causal Relationship May Have No Presumptive Weight in Hearing on Permanent Total Disability Benefits

An Order Denying an Attempt to Overcome a Division IME Physician’s Findings on MMI Only is not an Appealable Order

As documented in a previous post, the Industrial Claim Appeals Office again dismissed an appeal for lack of a final order where the Administrative Law Judge made found that the respondents failed to overcome the Division IME physician’s opinion on Maximum Medical Improvement but did not enter an order requiring the respondents to pay a… Continue reading An Order Denying an Attempt to Overcome a Division IME Physician’s Findings on MMI Only is not an Appealable Order

The Respondents May Bear the Burden of Proving Previously-Admitted Maintenance Medical Treatment No Longer Reasonable and Necessary

It long has been settled law that where the respondents file a final admission admitting for maintenance medical benefits, the respondents are not precluded from later contesting their liability for a particular treatment. Snyder v. Industrial Claim Appeals Office, 942 P.2d 1337 (Colo. App. 1997). Moreover, when the respondents contest liability for a particular medical… Continue reading The Respondents May Bear the Burden of Proving Previously-Admitted Maintenance Medical Treatment No Longer Reasonable and Necessary