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Are workers’ compensation programs getting a bad rap?

Prompted by deficit concerns and certain highly publicized fraud investigations, conservative commentators have attacked various benefits programs in recent years. Workers’ compensation programs are not immune from such posturing. Indeed, a recent article characterized this perception as the “myth” of workers’ compensation fraud.

Studies affirm the integrity of workers’ compensation programs

For the record, studies estimate that fraud affects 2 percent (or fewer) of workers’ compensation claims nationwide. Nevertheless, the Colorado Department of Labor and Employment takes the integrity of the workers’ compensation program very seriously, and for good reason: state law mandates employers to carry this type of insurance. State law also classifies material false statements in a claim as a class 5 felony offense. Accordingly, the CDLE’s website provides a mechanism for reporting fraud, and state officials may launch an investigation into a credible report.

Misperceptions may negatively impact the claims process 

Unfortunately, public misperceptions about workers’ compensation fraud may negatively impact injured workers. The Colorado Workers’ Compensation Act provides certain statutory rights to workers injured while performing their duties at work, regardless of fault, including medical treatment, wage loss replacement, and/or financial help after permanent impairment. Notably, these rights continue regardless of job status.

Yet when workers’ compensation benefits get a bad rad, an injured worker may hesitate to stand up for these statutory rights. A worker may delay in reporting an on-the-job injury, downplay any injuries suffered, accept inadequate medical treatment, and/or return to work before reaching maximum medical improvement.

Any of these responses could jeopardize a worker’s claim. As a practical matter, an injured worker who waits too long may not get the appropriate medical treatment needed to make a full recovery. There may also be procedural consequences under the law. We recommend reporting a workplace accident immediately to your supervisor to create a written record. You only have one body, so you need to take care of it for your future.

Injured workers should not fear for their job security

Injured workers should also not fear that filing a claim will jeopardize their job security. The claim is really against the insurance company, not the employer, who has already paid the insurance premiums. Thus, utilizing your workers’ compensation benefits will not cause your employer financial strain. 

The law is designed to provide the benefits an injured worker requires to be able to return to work.  If there is temporary disability or permanent impairment, a worker may be entitled to additional benefits and/or require additional accommodations. State law defines each of these terms; so make sure you consult with an attorney if you are unsure of your status or whether a specific condition might qualify, such as chronic regional pain syndrome.

Be open to alternative work assignments

If your doctor has prescribed certain restrictions, your employer may offer you reasonable accommodations or an alternative work assignment. If that new assignment pays less, the statute provides a formula to compensate some of the difference.

Stand up for your workers’ compensation rights 

As this discussion illustrates, workers’ compensation law can be procedurally complex. In addition, your employer’s insurance carrier may not consent to every treatment you need. If disputes do arise, state law also provides a mechanism for resolving disputes before an administrative law judge. Don’t rely on current misconceptions about fraud or waste. Workers’ compensation is a vital program that protects our state industry by making injured workers whole again.

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