Going it alone: are risks of losing a workers’ comp appeal worth it?

Mar 25 2015

Going it alone: are the risks of losing a workers’ comp appeal worth it?
The Colorado Department of Labor’s website is filled with information useful to workers injured on the job and who are filing for workers’ compensation benefits. On the site, you can find information on how the claim-filing process works and how the appeals process works, too.

You’ll also learn that both processes can be tackled alone, without legal representation. But before you try to tackle an appeal of a comp decision that didn’t go your way, read through the rules of procedure. The rules are not optional; everyone appealing a workers’ comp decision must know them and adhere to them or risk losing their appeal and all benefits.

There are no do-overs because a person doesn’t know procedure. The system is unforgiving and many of the staffers in it are overworked. So an appeal must be done right the first time.

If you’re going to try an appeal on your own, read through the definitions and provisions, the claims adjusting requirements and rules regarding modification, termination and suspension of temporary disability benefits, as well as Rule 7 (it governs the closure of claims approval of settlement agreements and petitions to reopen). Rule 8 is about authorized treating physicians and independent medical exams, while Rule 9 is about the Division of Workers’ Compensation Dispute Resolution.

Rule 10? It’s about the medical utilization review and Rule 11? Its 6,500-words-plus apply “to parties and physicians participating in the workers’ compensation IME program pursuant to the authority of the Workers’ Compensation Act.” Daunting? Sure.

But don’t misunderstand us: laypeople can make their way through the appeals process. Yes, it is complicated and yes, it takes a real commitment of time and effort to be successful, but it can be done. In minor matters, it might not be a big deal to appeal a workers’ comp denial on your own.

But when a major injury is involved — one requiring surgery and extensive care and time away from your job — the risk of losing an appeal might be too great to try it on your own. It’s entirely up to you, of course, but if you would like to discuss the pros and cons of going with an attorney, Denver-area workers’ comp lawyers will talk to you about the decision.