Simple form is start of complex process

Apr 24 2015

The Colorado Department of Labor and Employment’s Division of Workers’ Compensation has a pretty simple form with a pretty innocuous name: Notice of Contest. Denver Broncos’ fans might hope that the form relates to a match-up against the Patriots, but unfortunately, it is the form sent to workers’ compensation claimants when an insurer or employer has decided to dispute (contest) your claim.

The form has some basic information: your name, Social Security number, workers’ comp claim number and the like. The section that will immediately draw your attention is the one in which it says your “claim is contested/denied for the following reason…”

Underneath that line are five boxes, each with a reason for denying or contesting a claim typed out next to it. In order, they are:

  • “Further investigation”: this box means the insurer or employer wants to investigate your claim some more.
  • “Injury/Illness not work-related”: if this box is checked, it means the insurance company or your employer believes you were not injured while on the job. Or it can mean that the illness you have filed a claim for is not related to your work.
  • “No insurance coverage”: if this box is checked, it can mean your employer has no workers’ comp coverage or that you are not covered (independent contractors, for instance, are not typically covered).
  • “Third-Party involvement”: this box means that your injury was caused by a third party — someone not connected to you or your employer. Example: you’re a delivery driver who is in a traffic accident during the course of your work. The accident is the fault of the other driver, who is in this situation, the third party.
  • “Other/please describe”: this box simply means that the insurer or your employer has another reason — one not listed above — for denying or contesting your claim.

When you get a notice of contest, the form itself is simple enough, but the process of appealing a denial of your claim can be complex. This is when a Colorado workers’ compensation attorney will often get involved in the fight for needed medical care and replacement of wages.