Glossary of Colorado Workers Compensation Terms
The world of Colorado Workers Compensation has its own vocabulary. Sometimes there may be terms used on this website which have the same meaning as other terms, and that may cause you to wonder why different terms or phrases are used, instead of consistently using the same term. Just to make sure we are on the same page, I have prepared a glossary of terms used by attorneys who practice Colorado Workers Compensation law.
As a precaution, let me again remind the reader that this website should not be relied upon as legal advice. The reader should consult an attorney face to face for that. The circumstances of every case are different.
Accident: An unforeseen event occurring without the will or design of the person whose mere act causes it. An unexpected or undesigned occurrence.
AMA Guides: Colorado has adopted the AMA Guides to the Evaluation of Permanent Impairment, 3rd Ed. (Rev.) as the standard for determining permanent partial disability following a workers compensation injury. The book is often referred to by Colorado workers compensation attorneys as simply "the guides." The "impairment rating" which you end up with is used to calculate the extent of your entitlement to permanent partial disability benefits. When evaluating permanent impairment, physicians in Colorado must comply with "the guides" or their rating will likely be overturned at a hearing.
Attorney: This word may be used interchangeably with the word "lawyer." The Colorado Workers Compensation Act uses the term "attorney" exclusively. Don't ask me why.
Average Weekly Wage: The average weekly wage is the monthly, weekly, daily, or hourly compensation that an injured worker was receiving at the time of the injury, averaged out over a period of one week. It may be adjusted by an Administrative Law Judge at hearing if the criteria above do not result in a fair computation under the Colorado Workers' Compensation Act.
Average weekly wage is an extremely important component to the computation of your Colorado workers compensation benefits. It determines your rate of compensation for temporary benefits, and is one of the four components utilized to calculate your permanent partial disability benefits under the Workers' Compensation Act. I have found that it is understated by the workers compensation insurance carrier in about 50% of the workers compensation cases I have reviewed, sometimes slightly, and sometimes substantially. You should always make sure that the average weekly wage stated in any admission of liability truly represents your gross earnings (the amount you earn before deductions). If it is understated, you should consult a workers compensation attorney on how to handle this. Don't ignore it.
Contingent Fee Agreement: A contingent fee is an arrangement which permits the injured worker to obtain legal representation from a Colorado workers compensation attorney without having to pay the attorney a retainer, and without having to advance court costs. The work comp attorney advances the court costs, and the attorney's fee is deferred until you begin to receive monetary benefits for your workers compensation claim. When the case is concluded, court costs and the remainder of workers compensation attorney's fee are taken out of the workers compensation settlement money you receive for your work injury. This makes it possible for a person with little or no means to hire a Colorado workers compensation attorney to secure representation for a valid workers compensation injury claim which needs to be pursued.
Death Benefits. Formerly known as "widow benefits." When a work injury results in the death of the injured worker, "death benefits" are work comp benefits paid to a dependent in the amount of 2/3 the deceased worker's average weekly wage. The surviving spouse and minor children are presumed to be wholly dependent upon the deceased worker.
Employer's First Report of Injury: Every employer has the obligation to report injuries to their employees to the Colorado Division of Workers' Compensation if the injured worker sustains an injury causing loss of work for more than three shifts or three calendar days, or permanent impairment, or if the injury results in a fatality. This report must be on a form utilized by the Colorado Division of Workers' Compensation, which is captioned "Employer's First Report of Injury."
Final Admission of Liability: This is the ticking bomb. When your treating physician places you at maximum medical improvement, whether you agree with them or not, the insurance carrier is required to file a Final Admission of Liability with the Colorado Division of Workers' Compensation. They are required to mail it to you as well.
If you have a whole person rating, you have 30 days from the date of mailing, and not from the date of receipt, to file an objection to the Final Admission of Liability, along with a Notice and Proposal of Independent Medical Examination, should you want to challenge the rating, or the authorized treating physician's finding of maximum medical improvement. If you fail to accomplish both of these things, your workers compensation claim will be closed pursuant to the terms of the Final Admission, even if those terms are incorrect.
If you have a scheduled rating, you have 30 days from mailing to file an objection to the Final Admission and an Application for Hearing to contest your rating. Whether your injury is scheduled, or whole person, you must file an objection to the Final Admission and a Notice and Proposal of IME to contest the authorized treating physician's finding of maximum medical improvement.
If your workers compensation claim has been closed as a consequence of your failure to do these things, consult a Colorado workers compensation attorney to see if there is any way to have the Final Admission set aside or stricken. However, you're better off consulting an attorney immediately after an injury so this does not happen to you.
Impairment rating: When the injured worker is placed at maximum medical improvement, the authorized treating physician will "rate" the loss of function of the injured body part. Your permanent workers compensation disability benefits will be influenced by, and may depend exclusively on, the rating assigned by the authorized treating physician. Note: a workers compensation attorney can help you challenge this rating to recover a greater disability award. The rating must be consistent with the AMA Guides.
Independent Medical Examination: There are basically three kinds of independent medical examinations under the Colorado Workers Compensation Act. The first is your right to be examined by a physician other than the physician appointed by your employer (which is how your "authorized treating physician" was chosen). There are times when this is not only recommended, but actually critical to your case to have this done.
The second is the so-called "RIME" - the respondents' independent medical examination. In Colorado work comp lingo, the respondents are the employer and the workers compensation insurance carrier. The injured worker is the claimant. It's somewhat paradoxical that not only do they get to choose the physician to treat you, they also get to send you to their independent medical examiner if the physician they chose gives them an opinion they don't like. That's the world of Colorado workers compensation.
The third independent medical examination is the Division Independent Medical Examination (a "DIME"). That's the examination that usually (not always) occurs after you have been placed at maximum medical improvement following your work injuries. It is normally utilized by the claimant to challenge the authorized treating physician's finding of maximum medical improvement or the impairment rating. It is also used by insurance companies to challenge the rating assigned by the doctor they picked in the first place if they don't like their own physician's rating.
Industrial accident: An accident which happens on the job. This has a broad interpretation under the Colorado Workers' Compensation Act. For example, if you slip and fall on ice located on stairs adjacent to your work station, you are generally covered even if you haven't "clocked in" yet.
Industrial injury. This is the same thing as a "work injury," a "work comp injury," a "workers compensation injury," or a "workmans comp injury." Different terms are used around the country to express the same concept. All of these phrases are acceptable. An industrial injury is an injury caused by an industrial accident.
Maximum medical improvement: A point in time when any medically determinable physical or mental impairment, as a result of a workers compensation injury, has become stable and when no further treatment is reasonably expected to improve the condition.
Occupational Injury: An injury which arises out of and within the course of your employment. Under the Colorado Workers Compensation Act, an occupational injury may be the result of a single incident, or an overuse injury caused by prolonged exposure to a hazardous activity, which causes premature "wear and tear" of the body. A Colorado occupational injury attorney is the same thing as a Colorado workers compensation attorney.
On the job injury: A workers compensation injury which arises out of and within the course of an injured worker's employment. This is the same as an "industrial injury," "occupational injury," or simply a "work injury."
Permanent Partial Disability Benefits: Following your arrival at maximum medical improvement, a determination will be made whether you have any permanent effects from your occupational injury. If so, the authorized treating physician is obligated to determine whether the lingering effects of your injury merit a rating under the AMA Guides. A rating is based on loss of function of the body part injured. That numerical rating will determine the amount of your permanent partial disability benefit under the Colorado Workers' Compensation Act.
Permanent Total Disability: Under the Colorado Workers' Compensation Act, an injured worker is permanently and totally disabled if the occupational injury causes the injured worker to permanently lose all wages. To qualify for permanent total disability benefits under the Colorado Workers' Compensation Act, the injured worker must prove that he/she is unable to earn any wages in the same or other employment. If you feel you have a workers compensation injury that has permanently caused you to lose all wages, you will definitely need to hire a workers compensation attorney to pursue permanent total disability benefits.
Scheduled injury Under the Colorado Workers Compensation Act a scheduled injury is usually an injury to an arm or leg, or actually any part of the body other than the back, torso, neck or head. Eye and ear injuries are considered scheduled workers compensation injuries.
Statute of Limitations: A Colorado workers compensation claim should be initiated no more than two years from the date of the injury. The time period may be extended an additional year for a reasonable excuse. If your workers compensation claim is not timely filed, it is barred. If you feel this has happened to you, contact a workers compensation attorney immediately. There are occasionally things that can be done to preserve the workers compensation claim if not timely initiated.
TPD: Temporary Partial Disability Benefits. Like TTD, these are workers compensation benefits paid to an injured worker for lost wages, except they are paid to an injured worker who has returned to modified employment, is not earning the same wage as his preinjury wage, and has not yet arrived at maximum medical improvement. TPD benefits are paid out in the amount of 2/3 the lost wages, per the Colorado Workers Compensation Act.
TTD: Temporary Total Disability Benefits. These are work comp benefits received following a work injury while the injured worker is losing wages and receiving ongoing medical treatment. TTD benefits are paid out to compensate the injured worker for lost wages caused by the industrial injury. These benefits are paid out in the amount of 2/3 the injured worker's average weekly wage. TTD benefits terminate when the injured worker reaches MMI (maximum medical improvement), or returns to work, or is released to return to full duty by the authorized treating physician.
Whole Person Rating: This is a rating the injured worker receives for permanent effects to the head, neck, or spine. Not all injuries are rateable. The authorized treating physician (who is picked by the insurance carrier) will determine if your injury falls within the parameters of the AMA Guides. The rating will be contained in the Final Admission of Liability ("the ticking bomb"). Remember, you can challenge the rating assigned by the authorized treating physician by requesting a Division Independent Medical Examination (DIME). I suggest you contact a Colorado workers compensation attorney for this.
Workers' Claim for Compensation: Any person who sustains an occupational injury (this is the same as a work injury) may file a "claim for compensation" with the Colorado Division of Workers' Compensation. This formally initiates your workers' compensation claim. The claim is filed on a form that is prescribed by the Division. You can't formally initiate the claim by just sending a personal letter. The Division of Workers' Compensation will then send a copy of your claim form to the employer, and if insured, their workers compensation insurance carrier. They will then have 20 days from the date of receipt to file either an Admission of Liability or a Notice of Contest. I would strongly encourage an injured worker to take advantage of a free initial consultation before filing a Worker's Claim for Compensation. It can be done without a workers compensation attorney, but an attorney can help you avoid the pitfalls.
Workers Compensation Attorney: The same as a work comp attorney, or a work injury attorney, or a "workmans comp" attorney. Do not confuse the term with "personal injury attorney." Not all personal injury attorneys handle workers compensation law. In fact, most of them do not. Workers compensation is a very distinct, specialized area of the law requiring the expertise of an attorney who has a practice dedicated to workers compensation law.
Work Injury Benefits: This is the same thing as workers compensation benefits.
Workman's Compensation: The term utilized today in Colorado is actually "Workers' Compensation." However, up until the mid-1980s the term workman's compensation was still used in the Colorado courts. Today, the term workman's compensation is considered obsolete. There is actually no difference in the meaning between the terms "workmans compensation benefits" and "workers compensation benefits." Colorado and most other states have adopted the phrase "workers compensation" because it is gender neutral.
Workmen's Compensation: The same as Workman's Compensation.