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Re-Opening a Closed Case/Denied Workers Compensation Claims/Appeals

Article 41 of the Colorado code establishes a system called Workers’ Compensation that is intended to ensure that all workers get payment for medical costs and lost wages after an injury occurs. The workers’ compensation system also provides for disability benefits for injured workers. These benefits are supposed to provide comprehensive coverage after a work-related injury.

Unfortunately, sometimes an employer or workers’ compensation insurer does not pay the full amount of benefits that the law says an injured worker is entitled to. The insurer may deny a workers’ compensation claim, or may close a case and stop paying benefits before a worker is truly recovered. If you find yourself with a denied workers’ compensation claim, or in an appeals situation, or if you are in need of help re-opening a closed case, you should contact an experienced workers’ compensation lawyer.  The Boulder workers’ compensation attorneys at The Dominick Law Firm can help injured employees throughout Boulder, Longmont, Louisville, Lafayette, Erie, Broomfield, Greeley, Ft. Collins, Superior, Denver and the entire Colorado front range. If you live in this area and need assistance with Re-Opening a Closed Case, a Denied Workers Compensation Claims or an Appeal, contact us today at (303) 447-2644 or using our online form for a free consultation to learn how we can help.

Boulder Workers’ Compensation and Denied Workers Comp Claims

Workers, compensation covers all injuries that occur as a direct result of work-duties, regardless of who is at fault for the injuries or whether there is any negligence on the part of the worker or employer. When your injury happens at work or while performing work tasks, this means that there is little reason for a workers’ compensation claim to ever be denied. Further, the benefits provided are supposed to be comprehensive and you should receive not just payment for medical costs but also temporary or permanent disability benefits.

If an employer denies a claim or tries to end your benefits before you have fully recovered, this can present a significant problem since workers’ compensation is your only remedy against your employer for a work-related injury. You are not permitted to sue your employer.

Fortunately, the workers’ compensation system provides the opportunity for appeals of denied workers’ compensation claims and you can have your case reviewed by an administrative law judge (ALJ) in the event of a denial of benefits.

Once benefits have been awarded, you also have legal recourse if the insurer tries to stop those benefits or close your case too early.  In many instances, insurance companies will try to do this once you have reached maximum medical improvement (MMI). At this time, your treating physician can assign a disability rating that will be used to determine your compensation.

Once your disability rating has been assigned, the insurance company will typically file something called a “Final Admission of Liability.”  If you do not respond to this, then your case will be closed automatically. This means that if you disagree either with the assigned disability rating or if you disagree that you have reached maximum medical improvement, you must take action and file an Objection to Final Admission within 30 days from the date when the Final Admission of Liability was mailed. Your options when objecting will include a request for a hearing before an Administrative Law judge or will include a review by an independent medical examiner.

If you wish for a medical review by an independent medical examiner, you’ll need to file a Notice and Proposal to Select an Independent Medical Examiner. This examiner, referred to as a Division Independent Medical Examiner (DIME), will  make a decision on maximum medical improvement or on your disability rating. This decision will be binding, unless there is clear and convincing evidence that the examiner made an error. As such, it is extremely important to be careful in selecting your DIME and it is also important to make sure that requesting this independent medical review instead of a hearing is the right choice.  An experienced workers’ compensation lawyer can assist you.

Once your case has been closed, this doesn’t necessarily mean that you will never have any legal opportunity to receive workers’ compensation benefits again. According to  8-43-303, it is possible to re-open a case as long as it has been less than six years from the date you were injured or less than two years since the date your last benefits were paid.  Cases may be re-opened on the basis of overpayment, errors or mistakes, or a change in your condition such as if you become worse and need additional benefits.

Because insurance companies generally don’t want to re-open a case, you will typically need to have a hearing before an administrative law judge in order to have your case re-opened successfully. You should fight for your right to reopen a case when you need it, since the law allows for re-opening under the right circumstances, unless you have entered into a settlement pursuant to section 8-43-204 and waived your rights to reopen an award.  As such, if the insurer refuses to reopen your case, you will need to speak with a lawyer.

The Dominick Law Firm can help you in cases of a workers’ compensation denial, in cases when your insurer is trying to close your case, or in situations where you need to reopen your case. Our Boulder workers’ compensation firm has assisted clients throughout Boulder, Thornton, Longmont, Louisville, Lafayette, Erie, Broomfield, Lyons, Mead, Loveland, Wheatridge, Greeley, Ft. Collins, Superior, Denver and the entire Colorado front range with re-opening a closed case, denied workers’ compensation claims, or appeal issues. If you live in this area and need assistance with your workers’ comp claim, contact us today at (303) 447-2644 or using our online form for a free consultation to learn how we can help.

Michael P. Dominick Workers Compensation Attorney
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Dominick Law Office
(303) 447-2644
250 Arapahoe Ave #301, Boulder, CO 80302

Call Us Today for a FREE case evaluation (303) 447-2644