Colorado workers’ comp change tightens review deadlines

The end of a legislative term is when many bills are finally ready for the governor’s desk. In the last weeks of May, Governor Hickenlooper signed 104 bills into law.

Of the bills signed into law, SB 13-249 changes some of the deadlines in Colorado workers’ compensation cases. Senator Lois Tochtrop and Representative Angela Williams sponsored the legislation. The bill will require that the state Division of Workers’ Compensation review Division Independent Medical Examiner’s (DIME) Reports within five days. Then the agency must notify the parties of any deficiencies or corrections.

When deficiencies exist in the report, the agency sends an Incomplete Notice to the parties and the physician. The physician then has 20 days to make revisions. When a response is not received, the agency issues another Incomplete Notice, but it triggers the period when an insurer can take action.

Shorter timeframe for insurer action

Workers’ compensation insurers used to have 30 days to admit the finding in the DIME or appeal by filing an Application for Hearing. After August 7, 2013, the insurer will only have 20 days to admit or contest the findings.

The 20-day timeframe commences on the date the DIME Report Receipt issues. If the finding is “not at MMI” or medical maximum improvement the insurer might file an admission and authorize the injured worker to return for more treatment from the treating physician or seek an administrative hearing to contest the findings.

The changes mean an injured worker will find out the insurer’s decision sooner and likely receive faster treatment.

Other changes effective in 2013

Another piece of legislation, Senate Bill 13-285, will also lead to some workers’ compensation changes in 2013. For instance, an insurer will need to reimburse an injured worker for the full amount he or she paid for treatment. If this amount is above the fee schedule, the insurer will need to seek reimbursement from the medical provider.

Some of the other changes relate to the payment of benefits amount of timing of certain requests and, including:

• Temporary partial benefits must be paid at least once every two weeks similar to the payment of temporary total benefits
• An insurer must provide a copy of a claim file within 15 days after an injured worker mails a written request
• Insurers must now wait 24 months rather than 18 months from the date of the injury before requesting a DIME to review whether an injured worker has reached MMI

Changes such as the deadline for sending a complete claim file should help to streamline the workers’ compensation process. The extension of time for the DIME reports will mean injured workers will not have to worry about another medical examination that might overrule the opinion of the treating physician regarding MMI as soon.

Following a workplace injury, consult an experienced Colorado workers’ compensation attorney who can advise of procedural requirements and ensure you receive all benefits to which you are entitled.