2019 Colorado Workers' Compensation Act

2019

Colorado

Workers’ Compensation Act

Division of Workers’ Compensation

Jared Polis, Governor

Joe Barela, Executive Director

Paul Tauriello, Director

The Rules of Procedure

can be purchased from:

LexisNexis Matthew Bender & Co., Inc.

1275 Broadway

Albany, NY 12204

Phone: (800) 223-1940

Fax: (800) 544-6572

customer.support@lexisnexis.com

Copies of the Workers’ Compensation Act

can be obtained from:

Division of Workers’ Compensation

633 17th Street

Denver, CO 80202-3660

303.318.8700

http://colorado.gov/cdle/dwc/

This portion of the Colorado Revised Statutes, reprinted with the permission of the Committee on Legal Services in

accordance with section 2-5-118, C.R.S., is an unofficial publication of Colorado Revised Statutes.

Reference should always be made to the official set of statutes published and enacted pursuant to article 5 of title 2,

Colorado Revised Statutes, on questions involving legal interpretations or when litigation is involved.

An index to the Act prepared by the Division of Workers’ Compensation can be found at the end of this

cument.

Table of Contents

ARTICLE 14.5 - Cost Containment .............................................................................................................................. 1

ARTICLE 40 - General Provisions ................................................................................................................................ 3

ARTICLE 41 - Coverage and Liability ......................................................................................................................... 9

ARTICLE 42 – Benefits .............................................................................................................................................. 18

ARTICLE 43 - Procedure ............................................................................................................................................ 34

ARTICLE 44 - Insurance............................................................................................................................................. 58

ARTICLE 45 - Pinnacol Assurance............................................................................................................................. 66

ARTICLE 46 - Specific Insurance Funds .................................................................................................................... 72

ARTICLE 47 - Administration .................................................................................................................................... 77

ARTICLE 55 - Workers' Compensation Classification Appeals Board ...................................................................... 81

ARTICLE 67 – Colorado Uninsured Employer Act .................................................................................................... 83

TITLE 8

LABOR AND INDUSTRY

ARTICLE 14.5

Cost Containment

8-14.5-101. Short title. This article shall be known

d may be cited as the "Workers' Compensation Cost

Containment Act".

8-14.5-102. Legislative declaration. The general

assembly hereby finds and declares that any adjustments to

premiums for workers' compensation insurance be granted on

the basis of equity, rate adequacy, fairness, and insurer

compliance with Colorado insurance rating laws. The general

assembly further finds and declares that notwithstanding the

granting of different rates to insureds for their experience

modification, participation in return-to-work programs, and

premium volume discounts not exceeding fifteen percent, any

other premium adjustments should be principally weighted in

a manner primarily encouraging the adoption and successful

implementation by insureds of effective workplace safety

programs mainly encompassing risk management and medical

cost containment procedures.

8-14.5-103. Definitions. As used in this article,

unless the context otherwise requires:

(1) "Approved program" means a cost containment

or risk management program approved by the board.

(2) "Board" means the workers' compensation cost

containment board established pursuant to section 8-14.5-104.

(3) "Certified program" means a cost containment or

risk management program which has been implemented for a

period of at least one year and certified by the board.

(3.5) "Commissioner" means the insurance

commissioner, appointed pursuant to section 10-1-104, C.R.S.

(4) "Department" means the department of labor and

employment.

(5) "Director" means the director of the division.

(6) "Division" means the division of workers'

compensation in the department of labor and employment.

(7) "High risk employer" means any employer

classified in the upper ten percent of the insurance rate

schedule in the Colorado workers' compensation insurance

system.

(8) "Managed care" shall have the meaning set forth

in section 8-42-101 (3.6)(p)(I)(B).

(9) "Workplace safety program" means those

programs offered by insurance carriers authorized to do

business in this state for purposes of workers' compensation

insurance policies and implemented by employers to promote

cost containment and risk management of workplace safety

hazards.

8-14.5-104. Creation of board. (1) There is hereby

created in the division the workers' compensation cost

containment board, to be composed of seven members: The

commissioner of insurance, the chief executive officer of

Pinnacol Assurance, and five members appointed by the

governor and confirmed by the senate. Appointed members of

the board shall be chosen among the following: Employers or

their designated representatives engaged in businesses having

workers' compensation insurance rates in the upper five

percent of the rate schedule, actuaries or executives with risk

management experience in the insurance industry, or

employers who have demonstrated good risk management

experience with respect to their workers' compensation

insurance.

(2) The board shall exercise its powers and perform

its functions under the department and the director of the

division as if the same were transferred to the department by a

type 2 transfer, as such transfer is defined in the

"Administrative Organization Act of 1968", article 1 of title

24, C.R.S.

(3) The appointed members of the board shall serv

for

terms of three years and may be reappointed; except that,

of the members first appointed, two shall serve for terms of

three years; two shall serve for terms of two years, and one

shall serve for a term of one year. The chief executive officer

of Pinnacol Assurance and the commissioner of insurance shall

serve continuously.

(4) Members of the board shall receive no

compensation but shall be reimbursed for actual and necessary

traveling and subsistence expenses incurred in the

performance of their official duties as members of the board.

8-14.5-105. Powers and duties of board -

rules. (1) The board shall have the following powers and

duties:

(a) To establish model cost containment and ris

anagement programs for selected classifications in the upper

ten percent of the insurance rate schedule under the Colorado

workers' compensation insurance program;

(b) To adopt standards for the approval of particular

cost containment and risk management programs submitted by

community, technical, or local district colleges or by

employers in those selected high risk classifications;

and risk management programs implemented by community,

technical, or local district colleges or by employers in those

selected high risk classifications for a period of at least one

year;

(d) To promote cost containment and ris

management training by community, technical, or local district

colleges, employers, groups of employers, or trade

associations;

(e) To review annually the classifications in the

upper ten percent of the insurance rate schedule under the

Colorado workers' compensation insurance program for

inclusion in the cost containment program;

(f) To set the qualifications for technical personnel to

assist community, technical, and local district colleges and

employers in establishing risk management and cost

containment programs;

(g) To disseminate information regarding the types

of workers' compensation insurance policies available;

(h) To adopt such rules and regulations as may be

necessary to carry out the purposes of this article.

8-14.5-106. Duties of director. (1) The director

shall have the following powers and duties:

(

a) To provide technical advice to the board;

(b) To provide technical advice and assistance to

community, technical, or local district colleges, employers,

groups of employers, or trade associations with respect to the

To Index

development and implementation of cost containment and risk

management programs;

relating to the development and implementation of cost

containment and risk management programs;

(d) To maintain records of all proceedings of the

board, including the evaluation of proposals for cost

containment and risk management programs submitted by

employers and by community, technical, or local district

colleges;

(e) To maintain records of all employers and

community, technical, or local district colleges with certified

programs.

8-14.5-107. Cost containment certification. Any

employer complying with an approved program for at least one

year may present evidence of such compliance to the board and

petition the board to certify its program. The names of such

certified employers shall be made available on a periodic basis

to bona fide insurance carriers on file with the division.

8-14.5-107.5. Workplace safety programs - study

by commissioner. (1) The commissioner shall undertake a

full study of current workplace safety, risk management, and

cost containment programs offered by insurers, including

Pinnacol Assurance, a review and analysis of the various

incentives used by insurers to obtain policyholder

participation, including any premium adjustment programs in

use, and shall evaluate other possible programs and incentives

that could be used by insurers to expand workplace safety

programs and reward policyholder participation. The

commissioner shall consult with the Colorado department of

labor and employment in conducting the study. Such study,

review and analysis, and evaluation shall include but not be

limited to the following:

(a) Whether or not by a date certain, all insurers

including Pinnacol Assurance issuing workers' compensation

insurance policies in this state shall offer all insureds in the ten

most populous counties a managed care plan featuring a

designated medical provider;

(b) Whether or not by a date certain, if it is in the best

interest of employers and employees, all insurers including

Pinnacol Assurance issuing workers' compensation insurance

policies in this state shall offer to all or some selected classes

of insureds some type of basic workplace safety program;

should continue providing certification of workplace safety

programs or whether such certification should be provided by

insurers for insureds;

(d) Whether or not by July 1, 1995, the commissioner

should promulgate regulations concerning the granting of

premium adjustments for an insured's participation and

implementation of a basic workplace safety program or

managed care program;

(e) The participation by insureds in existing

workplace safety programs offered by insurers and the

methods by which insurers offer such programs;

(f) Insurer compliance with deductible provisions;

(g) Insurer compliance with the provisions of part 4

of article 4 of title 10, C.R.S., regarding the current design and

use of any premium adjustment, rate deviation, premium

discount, retro-rate, scheduled adjustment, or other type of

financial plan and their effect on the fairness and

reasonableness of rates for those insureds not qualifying for

experience or schedule rating;

(h) The efficacy of reducing the premium dollar

volume needed for an insured to become experience rated;

(i) A cost benefit analysis of implementation of

workplace safety programs.

(2) (a) Repealed.

(b) Insurers shall make all necessary information and

records pertaining to workplace safety programs of such

insurers available to the commissioner in carrying out the

study required by subsection (1) of this section. The reasonable

costs of such study shall be borne by insurers, including

Pinnacol Assurance, as determined by the commissioner based

on the total cost of such study.

8-14.5-108. Cost containment fund - creation. All

moneys collected for cost containment pursuant to section 8-

14.5-109 or 8-44-112 (1)(b)(III) shall be transmitted to the

state treasurer who shall credit the same to the cost

containment fund, which fund is hereby created. All moneys

credited to said fund and all interest earned thereon shall be

subject to appropriation by the general assembly to pay the

direct and indirect costs of the cost containment program, and

said moneys shall remain in such fund for such purposes and

shall not revert to the general fund or any other fund.

8-14.5-109. Grants-in-aid - cooperative

agreements. The division may receive grants-in-aid from any

agency of the United States and may cooperate and enter into

agreements with any agency of the United States, any agency

of any other state, and any other agency of this state or its

political subdivisions, for the purpose of carrying out the

provisions of this article.

8-14.5-110. Repeal of article. (Repealed)

To Index

ARTICLE 40

General Provisions

PART 1

SHORT TITLE - LEGISLATIVE DECLARATION

8-40-101. Short title. Articles 40 to 47 of this title

shall be known and may be cited as the "Workers'

Compensation Act of Colorado".

8-40-102. Legislative declaration. (1) It is the

intent of the general assembly that the "Workers'

Compensation Act of Colorado" be interpreted so as to assure

the quick and efficient delivery of disability and medical

benefits to injured workers at a reasonable cost to employers,

without the necessity of any litigation, recognizing that the

workers' compensation system in Colorado is based on a

mutual renunciation of common law rights and defenses by

employers and employees alike.

(2) The general assembly hereby finds that the

determination of whether an individual is an employee for

purposes of the "Workers' Compensation Act of Colorado" is

subject to a great deal of speculation and litigation. It is the

intent of the general assembly to provide an easily

ascertainable standard for determining whether an individual

is an employee. In order to further this objective, the test for

determining whether an individual is an employee for the

purposes of the "Workers' Compensation Act of Colorado"

shall be based on the nine criteria found in section 8-40-202

(2)(b)(II) which shall supersede the common law. The fact that

an individual performs services exclusively or primarily for

another shall not be conclusive evidence that the individual is

an employee.

PART 2

DEFINITIONS

8-40-201. Definitions. As used in articles 40 to 47 of

this title, unless the context otherwise requires:

(1) "Accident" means an unforeseen event occurring

without the will or design of the person whose mere act causes

it; an unexpected, unusual, or undesigned occurrence; or the

effect of an unknown cause or, the cause, being known, an

unprecedented consequence of it.

(2) "Accident", "injury", or "injuries" includes

disability or death resulting from accident or occupational

disease as defined in subsection (14) of this section.

(2.5) Repealed.

(3) "Board" means the board of directors of Pinnacol

Assurance.

(3.4) "Chief executive officer" means the chief

executive officer of Pinnacol Assurance.

(3.5) Repealed.

(3.6) "Claimant" means a person who either:

(a) Receives benefits under articles 40 to 47 of this

title; or

(b) Has or asserts, in any administrative or judicia

orum or in any communication with the director, the division,

or an employer, insurer, or self-insured employer, a right to

receive such benefits.

(4) "Division" means the division of workers'

compensation in the department of labor and employment.

(5) "Director" means the director of the division of

workers' compensation.

(6) "Employee" has the meaning set forth in section

8-40-202 and the scope of such term is set forth in section 8-

40-301.

(7) "Employer" has the meaning set forth in section

8-40-203 and the scope of such term is set forth in section 8-

40-302.

(8) "Employment" means any trade, occupation, job,

position, or process of manufacture or any method of carrying

on any trade, occupation, job, position, or process of

manufacture in which any person may be engaged; except that

it shall not include participation in a ridesharing arrangement,

as defined in section 39-22-509 (1)(a)(II), C.R.S., and

participation in such a ridesharing arrangement shall not affect

the wages paid to or hours or conditions of employment of an

employee; nor shall it include the employee's participation in a

voluntary recreational activity or program, regardless of

whether the employer promoted, sponsored, or supported the

recreational activity or program.

(9) "Examiner" means one of the industrial claim

appeals examiners appointed to the industrial claim appeals

panel in the industrial claim appeals office.

(10) "Executive director" means the executiv

rector of the department of labor and employment.

(11) (Deleted by amendment, L. 2002, p. 1882, § 27,

effective July 1, 2002.)

(11.5) "Maximum medical improvement" means a

point in time when any medically determinable physical or

mental impairment as a result of injury has become stable and

when no further treatment is reasonably expected to improve

the condition. The requirement for future medical maintenance

which will not significantly improve the condition or the

possibility of improvement or deterioration resulting from the

passage of time shall not affect a finding of maximum medical

improvement. The possibility of improvement or deterioration

resulting from the passage of time alone shall not affect a

finding of maximum medical improvement.

(12) "Mediation" means a process through which

arties involved in a dispute concerning matters arising under

articles 40 to 47 of this title meet with a mediator to discuss

such matter or matters, defining and articulating the issues and

their positions on such issues, with a goal of resolving such

dispute or disputes.

(13) "Mediator" means an individual who is trained

to assist disputants in reaching a mutually acceptable

resolution of their disputes through the identification and

evaluation of alternatives.

(13.5) Repealed.

(14) "Occupational disease" means a disease which

results directly from the employment or the conditions under

which work was performed, which can be seen to have

followed as a natural incident of the work and as a result of the

exposure occasioned by the nature of the employment, and

which can be fairly traced to the employment as a proximate

cause and which does not come from a hazard to which the

worker would have been equally exposed outside of the

employment.

To Index

(15) "Order" means and includes any decision,

finding and award, direction, rule, regulation, or other

determination arrived at by the director or an administrative

law judge.

(15.5) "Overpayment" means money received by a

claimant that exceeds the amount that should have been paid,

or which the claimant was not entitled to receive, or which

results in duplicate benefits because of offsets that reduce

disability or death benefits payable under said articles. For an

overpayment to result, it is not necessary that the overpayment

exist at the time the claimant received disability or death

benefits under said articles.

(16) "Panel" means the industrial claim appeals

panel that conducts administrative appellate review pursuant

to articles 40 to 47 of this title.

(16.5) (a) "Permanent total disability" means the

employee is unable to earn any wages in the same or other

employment. Except as provided in paragraph (b) of this

subsection (16.5), the burden of proof shall be on the employee

to prove that the employee is unable to earn any wages in the

same or other employment.

(b) Total loss of or total loss of use of both hands, or

both arms, or both feet, or both legs, or both eyes, or any two

thereof shall create a rebuttable presumption of permanent

total disability. "Total loss of use" shall be a medical

determination, based upon objective findings, made by an

independent medical examiner who is a level II accredited

physician in the appropriate field.

(17) "Place of employment" means every place

whether indoors, outdoors, or underground and the premises,

workplaces, works, and plants appertaining thereto or used in

connection therewith where either temporarily or permanently

any industry, trade, or business is carried on; or where any

process or operation directly or indirectly relating to any

industry, trade, or business is carried on; or where any person

is directly or indirectly employed by another for direct or

indirect gain or profit.

(18) "State" includes any state or territory of the

United States, the District of Columbia, and any province of

Canada.

(18.5) "Temporary help contracting firm" means any

person who is in the business of employing individuals and,

for compensation from a third party, providing those

individuals to perform work for the third party, under the

supervision of the third party.

(19) (a) "Wages" shall be construed to mean the

money rate at which the services rendered are recompensed

under the contract of hire in force at the time of the injury,

either express or implied.

(b) The term "wages" includes the amount of the

employee's cost of continuing the employer's group health

insurance plan and, upon termination of the continuation, the

employee's cost of conversion to a similar or lesser insurance

plan, and gratuities reported to the federal internal revenue

service by or for the worker for purposes of filing federal

income tax returns and the reasonable value of board, rent,

housing, and lodging received from the employer, the

reasonable value of which shall be fixed and determined from

the facts by the division in each particular case, but does not

include any similar advantage or fringe benefit not specifically

enumerated in this subsection (19). If, after the injury, the

employer continues to pay any advantage or fringe benefit

specifically enumerated in this subsection (19), including the

cost of health insurance coverage or the cost of the conversion

of health insurance coverage, that advantage or benefit shall

not be included in the determination of the employee's wages

so long as the employer continues to make payment. Medicaid

and other indigent health care programs are not health

insurance plans for the purposes of this section.

under this subsection (19) unless it is also considered wages

for federal income tax purposes.

8-40-202. Employee. (1) "Employee" means:

(a) (I) (A) Every person in the service of the state, or

of any county, city, town, or irrigation, drainage, or school

district or any other taxing district therein, or of any public

institution or administrative board thereof under any

appointment or contract of hire, express or implied; and every

elective official of the state, or of any county, city, town, or

irrigation, drainage, or school district or any other taxing

district therein, or of any public institution or administrative

board thereof; and every member of the military forces of the

state of Colorado while engaged in active service on behalf of

the state under orders from competent authority. Police

officers and firefighters who are regularly employed shall be

deemed employees within the meaning of this paragraph (a),

as shall also sheriffs and deputy sheriffs, regularly employed,

and all persons called to serve upon any posse in pursuance of

the provisions of section 30-10-516, C.R.S., during the period

of their service upon such posse, and all members of volunteer

fire departments, including any person receiving a retirement

pension under section 31-30-1122, C.R.S., who serves as an

active volunteer firefighter of a fire department subsequent to

retirement pursuant to section 31-30-1132, C.R.S., or any

person ordered by the chief or a designee of the chief's at the

scene of an emergency or during the period of an emergency

to become a member of that department for the duration of an

emergency, and to perform the duties of a firefighter, and only

if the person who is so ordered reports any claim within ten

days of the cessation of the emergency, volunteer rescue teams

or groups, volunteer disaster teams, volunteer ambulance

teams or groups, and volunteer search teams in any county,

city, town, municipality, or legally organized fire protection

district or ambulance district in the state of Colorado, and all

members of the civil air patrol, Colorado wing, while said

persons are actually performing duties as volunteer firefighters

or as members of such volunteer rescue teams or groups,

volunteer disaster teams, volunteer ambulance teams or

groups, or volunteer search teams or as members of the civil

air patrol, Colorado wing, and while engaged in organized

drills, practice, or training necessary or proper for the

performance of such duties. Members of volunteer police

departments, volunteer police reserves, and volunteer police

teams or groups in any county, city, town, or municipality,

while actually performing duties as volunteer police officers,

may be deemed employees within the meaning of this

paragraph (a) at the option of the governing body of such

county or municipality.

(B) Notwithstanding the provisions of sub-

subparagraph (A) of this subparagraph (I), any elected or

To Index

appointed official of any county, city, town, or irrigation,

drainage, or school district or taxing district who receives no

compensation for service rendered as such an official, other

than reimbursement of actual expenses, may be deemed not to

be an employee within the meaning of this paragraph (a) at the

option of the governing body of such county, city, town, or

district. The option to exclude such officials as employees

within the meaning of this paragraph (a) may be exercised as

to any category of officials or as to any combination of

categories of officials. Any such option may be exercised for

any policy year by the filing of a statement with the division

not less than forty-five days before the start of the policy year

for which the option is to be exercised. If such a statement is

in effect as to any category of such uncompensated officials,

no official in said category shall be deemed an employee

within the meaning of this paragraph (a). The governing body

shall notify each official of such action promptly at the time

such election to exclude is exercised.

(II) The rate of compensation of such persons

accidentally injured, or, if killed, the rate of compensation for

their dependents, while serving upon such posse or as

volunteer firefighters or as members of such volunteer police

departments, volunteer police reserves, or volunteer police

teams or groups or as members of such volunteer rescue teams

or groups, volunteer disaster teams, volunteer ambulance

teams or groups, or volunteer search teams or as members of

the civil air patrol, Colorado wing, and of every nonsalaried

person in the service of the state, or of any county, city, town,

or irrigation, drainage, or school district therein, or of any

public institution or administrative board thereof under any

appointment or contract of hire, express or implied, including

nonsalaried elective officials of the state, and of all members

of the military forces of the state of Colorado shall be at the

maximum rate provided by articles 40 to 47 of this title; except

that this subparagraph (II) shall apply to an official described

in sub-subparagraph (B) of subparagraph (I) of this paragraph

(a) only if no statement exercising the option to exclude such

official as an employee within the meaning of this paragraph

(a) is in effect.

(III) Any person who, as part of a rehabilitation

program of the department of human or social services of any

county or city and county, is placed with a private employer

for the purpose of training or learning trades or occupations is

deemed while so engaged to be an employee of such private

employer. Any person who receives a work experience

assignment to a position in any department or agency of any

county or municipality, in any school district, in the office of

any state agency or political subdivision thereof, or in any

private for profit or any nonprofit agency pursuant to the

provisions of part 7 of article 2 of title 26, is deemed while so

assigned to be an employee of the respective department,

agency, office, political subdivision, private for profit or

nonprofit agency, or school district to which said person is

assigned or, if so negotiated between the county and the entity

to which the person is assigned, of the county arranging the

work experience assignment. Any person who receives a work

experience assignment to a position in any federal office or

agency pursuant to part 7 of article 2 of title 26, is deemed

while so assigned to be an employee of the county arranging

the work experience assignment. The rate of compensation for

such persons if accidentally injured or, if killed, for their

dependents is based upon the wages normally paid in the

community in which they reside for the type of work in which

they are engaged at the time of such injury or death; except

that, if any such person is a minor, compensation to such minor

for permanent disability, if any, or death benefits to such

minor's dependents must be paid at the maximum rate of

compensation payable under articles 40 to 47 of this title 8 at

the time of the determination of such disability or of such

death.

(IV) Except as provided in section 8-40-301 (3) and

section 8-40-302 (7)(a), any person who may at any time be

receiving training under any work or job training or

rehabilitation program sponsored by any department, board,

commission, or institution of the state of Colorado or of any

county, city and county, city, town, school district, or private

or parochial school or college and who, as part of any such

work or job training or rehabilitation program of any

department, board, commission, or institution of the state of

Colorado or of any county, city and county, city, town, school

district, or private or parochial school or college, is placed with

any employer for the purpose of training or learning trades or

occupations shall be deemed while so engaged to be an

employee of the respective department, board, commission, or

institution of the state of Colorado or of the county, city and

county, city, town, school district, or private or parochial

school or college sponsoring such training or rehabilitation

program unless the following conditions are met, in which case

the placed person shall be deemed an employee of the

employer with whom he or she is placed:

(A) The sponsoring entity and the employer agree

that the employer shall cover the placed person under the

employer's workers' compensation insurance;

(B) The employer does in fact insure and keep

insured its liability for workers' compensation as provided in

articles 40 to 47 of this title and does in fact cover the placed

person under such insurance; and

entities and employers entered into after April 1, 1991, the

employer has been provided with notice of the provisions of

this subparagraph (IV) and of subparagraphs (V) and (VI) of

this paragraph (a).

(V) In the event a person placed with an employer is

deemed an employee of the employer pursuant to

subparagraph (IV) of this paragraph (a), the sponsoring entity

shall not be subject to any liability for or on account of the

death of or personal injury to the person so placed. In the event

such person is deemed an employee of the sponsoring entity

pursuant to the said subparagraph (IV), the employer shall not

be subject to any liability for or on account of the death of or

personal injury to the person and shall not be required to carry

workers' compensation insurance or to pay premiums for

workers' compensation insurance with respect to the person.

(VI) The rate of compensation for a person placed

pursuant to subparagraph (IV) of this paragraph (a) if

accidentally injured or, if killed, for dependents of such person

shall be based upon the wages normally paid in the community

in which such person resides or in the community where said

work or job training or rehabilitation program is being

conducted for the type of work in which the person is engaged

To Index

at the time of such injury or death, as determined by the

director; except that, if any such person is a minor,

compensation for such minor for permanent disability, if any,

or death benefits to such minor's dependents shall be paid at

the maximum rate of compensation payable under articles 40

to 47 of this title at the time of the determination of such

disability or death.

(b) Every person in the service of any person,

association of persons, firm, or private corporation, including

any public service corporation, personal representative,

assignee, trustee, or receiver, under any contract of hire,

express or implied, including aliens and also including minors,

whether lawfully or unlawfully employed, who for the purpose

of articles 40 to 47 of this title are considered the same and

have the same power of contracting with respect to their

employment as adult employees, but not including any persons

who are expressly excluded from articles 40 to 47 of this title

or whose employment is but casual and not in the usual course

of the trade, business, profession, or occupation of the

employer. The following persons shall also be deemed

employees and entitled to benefits at the maximum rate

provided by said articles, and, in the event of injury or death,

their dependents shall likewise be entitled to such maximum

benefits, if and when the association, team, group, or

organization to which they belong has elected to become

subject to articles 40 to 47 of this title and has insured its

liability under said articles: All members of privately

organized volunteer fire departments, volunteer rescue teams

or groups, volunteer disaster teams, volunteer ambulance

teams or groups, and volunteer search teams and organizations

while performing their respective duties as members of such

privately organized volunteer fire departments, volunteer

rescue teams or groups, volunteer disaster teams, volunteer

ambulance teams or groups, and volunteer search teams and

organizations and while engaged in organized drills, practice,

or training necessary or proper for the performance of their

respective duties.

(2) (a) Notwithstanding any other provision of this

section, any individual who performs services for pay for

another shall be deemed to be an employee, irrespective of

whether the common-law relationship of master and servant

exists, unless such individual is free from control and direction

in the performance of the service, both under the contract for

performance of service and in fact and such individual is

customarily engaged in an independent trade, occupation,

profession, or business related to the service performed. For

purposes of this section, the degree of control exercised by the

person for whom the service is performed over the

performance of the service or over the individual performing

the service shall not be considered if such control is exercised

pursuant to the requirements of any state or federal statute or

regulation.

(b) (I) To prove that an individual is engaged in an

independent trade, occupation, profession, or business and is

free from control and direction in the performance of the

service, the individual and the person for whom services are

performed may show by a preponderance of the evidence that

the conditions set forth in paragraph (a) of this subsection (2)

have been satisfied. The parties may also prove independence

through a written document.

(II) To prove independence it must be shown that the

person for whom services are performed does not:

(A) Require the individual to work exclusively for

the person for whom services are performed; except that the

individual may choose to work exclusively for such person for

a finite period of time specified in the document;

(B) Establish a quality standard for the individual;

except that the person may provide plans and specifications

regarding the work but cannot oversee the actual work or

instruct the individual as to how the work will be performed;

fixed or contract rate;

(D) Terminate the work of the service provider

during the contract period unless such service provider violates

the terms of the contract or fails to produce a result that meets

the specifications of the contract;

(E) Provide more than minimal training for the

individual;

(F) Provide tools or benefits to the individual; except

that materials and equipment may be supplied;

(G) Dictate the time of performance; except that a

completion schedule and a range of negotiated and mutually

agreeable work hours may be established;

(H) Pay the service provider personally instead of

making checks payable to the trade or business name of such

service provider; and

(I) Combine the business operations of the person for

whom service is provided in any way with the business

operations of the service provider instead of maintaining all

such operations separately and distinctly.

(III) A document may satisfy the requirements of this

paragraph (b) if such document demonstrates by a

preponderance of the evidence the existence of the factors

listed in subparagraph (II) of this paragraph (b) as are

appropriate to the parties' situation. The existence of any one

of these factors is not conclusive evidence that the individual

is an employee.

(IV) If the parties use a written document pursuant to

this paragraph (b), such document must be signed by both

parties and may be the contract for performance of service or

a separate document. Such document shall create a rebuttable

presumption of an independent contractor relationship

between the parties where such document contains a

disclosure, in type which is larger than the other provisions in

the document or in bold-faced or underlined type, that the

independent contractor is not entitled to workers'

compensation benefits and that the independent contractor is

obligated to pay federal and state income tax on any moneys

earned pursuant to the contract relationship. All signatures on

any such document must be duly notarized.

(V) If the parties use a written document pursuant to

this paragraph (b) and one of the parties is a professional whose

license to practice a particular occupation under the laws of the

state of Colorado requires such professional to exercise a

supervisory function with regard to an entire project such

supervisory role shall not affect such professional's status as

part of the independent contractor relationship.

conflict with section 8-40-301 or to relieve any obligations

imposed pursuant thereto.

To Index

(d) Nothing in this section shall be construed to

remove the claimant's burden of proving the existence of an

employer-employee relationship for purposes of receiving

benefits pursuant to articles 40 to 47 of this title.

(e) (I) Notwithstanding any other provision of this

section, a written agreement between a nonprofit youth sports

organization and a coach, specifying that the coach is an

independent contractor and not an employee of the nonprofit

youth sports organization and otherwise satisfying the

requirements of this paragraph (e), shall be conclusive

evidence that the relationship between the nonprofit youth

sports organization and the coach is an independent contractor

relationship rather than an employment relationship and that

the nonprofit youth sports organization is not obligated to

secure compensation for the coach in accordance with the

"Workers' Compensation Act of Colorado".

(II) The written agreement shall contain a disclosure,

in bold-faced, underlined, or large type, in a conspicuous

location, and acknowledged by the parties by signature,

initials, or other means demonstrating that the parties have read

and understand the disclosure, indicating that the coach:

(A) Is an independent contractor and not an

employee of the nonprofit youth sports organization;

(B) Is not entitled to workers' compensation benefits

in connection with his or her contract with the nonprofit youth

sports organization; and

on any moneys paid pursuant to the contract for coaching

services and that the nonprofit youth sports organization will

not withhold any amounts from the coach for purposes of

satisfying the coach's income tax liability.

(III) A written agreement between a nonprofit youth

sports organization and a coach in accordance with this

paragraph (e) shall not be conclusive evidence of an

independent contractor relationship for purposes of any civil

action instituted by a third party.

(IV) As used in this paragraph (e), "nonprofit youth

sports organization" means an organization that is exempt

from federal taxation under section 501 (c)(3) of the federal

"Internal Revenue Code of 1986", as amended, and is primarily

engaged in conducting organized sports programs for persons

under twenty-one years of age.

(3) Notwithstanding any other provision of this

section, "employee" includes a person who participates in a

property tax work-off program established pursuant to article

3.7 of title 39, C.R.S.

8-40-203. Employer. (1) "Employer" means:

(a) The state, and every county, city, town, and

irrigation, drainage, and school district and all other taxing

districts therein, and all public institutions and administrative

boards thereof without regard to the number of persons in the

service of any such public employer. All such public

employers shall be at all times subject to the compensation

provisions of articles 40 to 47 of this title.

(b) Every person, association of persons, firm, and

private corporation, including any public service corporation,

personal representative, assignee, trustee, or receiver, who has

one or more persons engaged in the same business or

employment, except as otherwise expressly provided in

articles 40 to 47 of this title, in service under any contract of

hire, express or implied.

PART 3

SCOPE AND APPLICABILITY

8-40-301. Scope of term "employee" -

definition. (1) (a) "Employee" excludes any person employed

by a passenger tramway area operator, as defined in section

12-150-103 (1), or other employer, while participating in

recreational activity, who at such time is relieved of and is not

performing any duties of employment, regardless of whether

such person is utilizing, by discount or otherwise, a pass,

ticket, license, permit, or other device as an emolument of

employment.

(b) (I) "Employee" excludes any person employed

by an out-of-state employer performing incidental work in

Colorado where the employee is covered at the time of injury

under the workers' compensation act of another state regardless

of where the contract for employment was created.

(II) For purposes of this section, "incidental work"

means work that is randomly or fortuitously in Colorado.

(III) This section only applies to a workers'

compensation act of another state that includes a reciprocal

provision exempting Colorado employers from liability under

the other state's act for incidental work.

(2) "Employee" excludes any person who is a

licensed real estate sales agent or a licensed real estate broker

associated with another real estate broker if:

(a) Substantially all of the sales agent's or associated

broker's remuneration from real estate brokerage is derived

from real estate commissions; and

(b) The services of the sales agent or associated

broker are performed under a written contract specifying that

the sales agent or associated broker is an independent

contractor; and

associated broker shall not be treated as an employee for

federal income tax purposes.

(3) (a) Notwithstanding the provisions of section 8-

40-202 (1)(a)(IV), "employee" excludes any person who is

confined to a city or county jail or any department of

corrections facility as an inmate and who, as a part of such

confinement, is working, performing services, or participating

in a training or rehabilitation or work release program; except

that "employee" includes an inmate of a department of

corrections facility or a city, county, or city and county jail who

is working, performing services, or participating in a training,

rehabilitation, or work release program that has been certified

by the federal prison industry enhancement certification

program pursuant to the federal "Justice System Improvement

Act of 1979", 18 U.S.C. sec. 1761 (c). For the purposes of

articles 40 to 47 of this title, an inmate participating in a

program certified by the federal prison industry enhancement

certification program is an employee of that certified program,

which certified program shall carry workers' compensation

insurance pursuant to articles 40 to 47 of this title. No inmate

participating in a certified program shall be deemed to be an

employee of the state, city, county, or city and county that

To Index

owns, operates, or contracts for the operation of the facility or

jail in which the inmate is incarcerated.

(b) The provisions of paragraph (a) of this subsection

(3) do not apply to an inmate who is working for a private

employer under a contract of hire wherein the private employer

is required to maintain workers' compensation insurance for its

employees pursuant to articles 40 to 47 of this title. Such

inmate shall be an employee of such private employer for

purposes of articles 40 to 47 of this title.

(3) do not apply to an inmate working for a joint venture

established pursuant to the provisions of section 17-24-119 or

17-24-121, C.R.S. Such inmate shall be an employee of such

joint venture for purposes of articles 40 to 47 of this title.

(d) The provisions of paragraph (a) of this subsection

(3) do not apply to an inmate working for a private person or

entity pursuant to the provisions of section 17-24-122, C.R.S.

Such inmate shall be an employee of such private person or

entity for purposes of articles 40 to 47 of this title.

(4) "Employee" excludes any person who volunteers

time or services for a ski area operator, as defined in section

33-44-103 (7), C.R.S., or for a ski area sponsored program or

activity, notwithstanding the fact that such person may receive

noncash remuneration for such person or such person's

designee in conjunction with such person's status as a

volunteer. No contract of hire, express or implied, is created

between any volunteer pursuant to this section and a ski area

operator. Notice shall be given to such volunteer in writing that

the volunteering of time or services under this subsection (4)

does not constitute employment for purposes of the "Workers'

Compensation Act of Colorado" and that such person is not

entitled to benefits pursuant to said act.

(5) "Employee" excludes any person who is working

as a driver under a lease agreement pursuant to section 40-

11.5-102, C.R.S., with a common carrier or contract carrier.

(6) Any person working as a driver with a common

carrier or contract carrier as described in this section shall be

eligible for and shall be offered workers' compensation

insurance coverage by Pinnacol Assurance or similar coverage

consistent with the requirements set forth in section 40-11.5-

102 (5), C.R.S.

(7) Persons who provide host home services as part

of residential services and supports, as described in section

25.5-10-206 (1)(e), C.R.S., for an eligible person, as defined

in section 25.5-6-403 (2)(a), C.R.S., pursuant to the "Home-

and Community-based Services for Persons with

Developmental Disabilities Act", part 4 of article 6 of title

25.5, C.R.S., and pursuant to a contract with a community-

centered board designated pursuant to section 25.5-10-209,

C.R.S., or a contract with a service agency as defined in section

25.5-10-202, C.R.S., shall not be considered employees of the

community-centered board or the service agency.

(8) For the purposes of articles 40 to 47 of this title

8, "employee" excludes any person who performs services for

more than one employer at a race meet as defined by section

44-32-102 (20), or at a horse track as defined by section 44-

32-102 (8).

(9) Notwithstanding any other provision of this

section, "employee" includes a person who participates in a

property tax work-off program established pursuant to article

3.7 of title 39, C.R.S.

8-40-302. Scope of term "employer".

(1) Repealed.

(2) Articles 40 to 47 of this title are not intended to

apply to employees of eleemosynary, charitable, fraternal,

religious, or social employers who are elected or appointed to

serve in an advisory capacity and receive an annual salary or

an amount not in excess of seven hundred fifty dollars and are

not otherwise subject to the "Workers' Compensation Act of

Colorado".

(3) Articles 40 to 47 of this title are not intended to

apply to employers of casual farm and ranch labor or

employers of persons who do casual maintenance, repair,

remodeling, yard, lawn, tree, or shrub planting or trimming, or

similar work about the place of business, trade, or profession

of the employer if such employers have no other employees

subject to said articles 40 to 47, if such employments are casual

and are not within the course of the trade, business, or

profession of said employers, if the amounts expended for

wages paid by the employers to casual persons employed to do

maintenance, repair, remodeling, yard, lawn, tree, or shrub

planting or trimming, or similar work about the place of

business, trade, or profession of the employer do not exceed

the sum of two thousand dollars for any calendar year, and if

the amounts expended for wages by the employer of casual

farm and ranch labor do not exceed the sum of two thousand

dollars for any calendar year.

(4) Articles 40 to 47 of this title are not intended to

apply to employers of persons who do domestic work or

maintenance, repair, remodeling, yard, lawn, tree, or shrub

planting or trimming, or similar work about the private home

of the employer if such employers have no other employees

subject to said articles 40 to 47 and if such employments are

not within the course of the trade, business, or profession of

said employers. This exemption shall not apply to such

employers if the persons who perform the work are regularly

employed by such employers on a full-time basis. For purposes

of this subsection (4), "full-time" means work performed for

forty hours or more a week or on five days or more a week.

(5) (a) Any employer excluded under this section

may elect to accept the provisions of articles 40 to 47 of this

title by purchasing and keeping in force a policy of workers'

compensation insurance covering said employees.

(b) Notwithstanding any other provision of articles

40 to 47 of this title, any working general partner or sole

proprietor actively engaged in the business may elect to be

included by endorsement as an employee of the insured and

shall be entitled to elect coverage regardless of whether such

working general partner or sole proprietor employs any other

person under any contract of hire.

(6) Articles 40 to 47 of this title are intended to apply

to officers of agricultural corporations; but effective July 1,

1977, any such agricultural corporation may elect to reject the

provisions of articles 40 to 47 of this title for any or all of said

officers.

(7) (a) Any employer, as defined in section 8-40-

203, who enters into a bona fide cooperative education or

student internship program sponsored by an educational

institution for the purpose of providing on-the-job training for

To Index

students shall be deemed an employer of such students for the

purposes of workers' compensation and liability insurance

pursuant to articles 40 to 47 of this title.

(b) If the student placed in an on-the-job training

program does not receive any pay or remuneration from the

employer, the educational institution sponsoring the student in

the cooperative education or student internship program shall

insure the student through the institution's workers'

compensation and liability insurance or enter into negotiations

with the employer for the purpose of arriving at a reasonable

level of compensation to the employer for the employer's

expense of providing workers' compensation and liability

insurance while such student is participating in on-the-job

training with said employer. This paragraph (b) shall not apply

to a student teacher participating in a program authorized

pursuant to article 62 of title 22, C.R.S.

education or student internship program" means a program

sponsored by an educational institution in which a student is

taught through a coordinated combination of specialized in-

the-school instruction provided through an educational

institution by qualified teachers and on-the-job training

provided through a local business, agency, or organization or

any governmental agency in cooperation with the educational

institution.

ARTICLE 41

Coverage and Liability

PART 1

ABROGATION OF DEFENSE

8-41-101. Assumption of risk - negligence of employee or

fellow servant. (1) In an action to recover damages for a

personal injury sustained by an employee while engaged in the

line of duty, or for death resulting from personal injuries so

sustained, in which recovery is sought upon the ground of want

of ordinary care of the employer, or of the officer, agent, or

servant of the employer, it shall not be a defense:

(a) That the employee, either expressly or impliedly,

assumed the risk of the hazard complained of as due to the

employer's negligence;

(b) That the injury or death was caused, in whole or

in part, by the want of ordinary care of a fellow servant;

in part, by the want of ordinary care of the injured employee

where such want of care was not willful.

8-41-102. Liability of employer complying. An

employer who has complied with the provisions of articles 40

to 47 of this title, including the provisions relating to insurance,

shall not be subject to the provisions of section 8-41-101; nor

shall such employer or the insurance carrier, if any, insuring

the employer's liability under said articles be subject to any

other liability for the death of or personal injury to any

employee, except as provided in said articles; and all causes of

action, actions at law, suits in equity, proceedings, and

statutory and common law rights and remedies for and on

account of such death of or personal injury to any such

employee and accruing to any person are abolished except as

provided in said articles.

8-41-103. Availability of common-law defenses. If

an employer has complied with the provisions of articles 40 to

47 of this title, including the provisions thereof relating to

insurance, and an action is brought against such employer or

such employer's insurance carrier to recover damages for

personal injuries or death sustained by an employee who has

elected not to come under said articles, such employer and such

employer's insurance carrier shall have all the defenses to the

action which they would have had if said articles and part 2 of

article 2 of this title had not been enacted.

8-41-104. Acceptance as surrender of other

remedies. An election under the provisions of section 8-40-

302 (5) and in compliance with the provisions of articles 40 to

47 of this title, including the provisions for insurance, shall be

construed to be a surrender by the employer, such employer's

insurance carrier, and the employee of their rights to any

method, form, or amount of compensation or determination

thereof or to any cause of action, action at law, suit in equity,

or statutory or common-law right, remedy, or proceeding for

or on account of such personal injuries or death of such

employee other than as provided in said articles, and shall be

an acceptance of all the provisions of said articles, and shall

bind the employee personally, and, for compensation for such

employee's death, the employee's personal representatives,

surviving spouse, and next of kin, as well as the employer, such

To Index

employer's insurance carrier, and those conducting their

business during bankruptcy or insolvency.

PART 2

COVERAGE

8-41-201. Not applicable to common carriers. The

provisions of articles 40 to 47 of this title shall not apply to

common carriers by railroad but shall apply to all other

employers as defined in said articles engaged in intrastate or

interstate commerce, or both, except those employers, other

than the Colorado division of civil air patrol, for whom a rule

of liability is established by the laws of the United States.

8-41-202. Rejection of coverage by corporate

officers and others. (1) Notwithstanding any provisions of

articles 40 to 47 of this title to the contrary, a corporate officer

of a corporation or a member of a limited liability company

may elect to reject the provisions of articles 40 to 47 of this

title. If so elected, said corporate officer or member shall

provide written notice on a form approved by the division

through a rule promulgated by the director of such election to

the worker's compensation insurer of the employing

corporation or company, if any, by certified mail. If there is no

workers' compensation insurance company, the notice shall be

provided to the division by certified mail. Such notice shall

become effective the day following receipt of said notice by

the insurer or the division.

(2) A corporate officer's or member's election to

reject the provisions of articles 40 to 47 of this title shall

continue in effect so long as the corporation's or company's

insurance policy is in effect or until said officer or member, by

written notice to the insurer, revokes the election to reject said

provisions.

(3) Nothing in this section shall be construed to limit

the responsibility of corporations or limited liability

companies to provide coverage for their employees as required

under articles 40 to 47 of this title. An election to reject

coverage pursuant to this section may not be made a condition

of employment.

(4) For the purposes of this section:

(a) "Corporate officer" means the chairperson of the

board, president, vice-president, secretary, or treasurer who is

an owner of at least ten percent of the stock of the corporation

and who controls, supervises, or manages the business affairs

of the corporation, as attested to by the secretary of the

corporation at the time of the election.

(b) "Member" means an owner of at least ten percent

of the membership interest of the limited liability company at

all times and who controls, supervises, or manages the

business affairs of the limited liability company.

8-41-203. Negligence of stranger - remedies -

subrogation - actions - compromise. (1) (a) If any employee

entitled to compensation under articles 40 to 47 of this title is

injured or killed by the negligence or wrong of another not in

the same employ, such injured employee or, in case of death,

such employee's dependents, may take compensation under

said articles and may also pursue a remedy against the other

person to recover any damages in excess of the compensation

available under said articles.

(b) The payment of compensation pursuant to

articles 40 to 47 of this title shall operate as and be an

assignment of the cause of action against such other person to

Pinnacol Assurance, the medical disaster insurance fund, the

major medical insurance fund, or the subsequent injury fund,

if compensation is payable from said funds, and otherwise to

the person, association, corporation, or insurance carrier liable

for the payment of such compensation. Said insurance carrier

shall not be entitled to recover any sum in excess of the amount

of compensation for which said carrier is liable under said

articles to the injured employee, but to that extent said carrier

shall be subrogated to the rights of the injured employee

against said third party causing the injury. If the injured

employee proceeds against such other person, then Pinnacol

Assurance, the medical disaster insurance fund, the major

medical insurance fund, the subsequent injury fund, or such

other person, association, corporation, or insurance carrier, as

the case may be, shall contribute only the deficiency, if any,

between the amount of the recovery against such other person

actually collected and the compensation provided by said

articles in such case.

shall apply to and include all compensation and all medical,

hospital, dental, funeral, and other benefits and expenses to

which the employee or, if the employee is deceased, the

employee's dependents are entitled under the provisions of said

articles, including parts 2 and 3 of article 46 of this title, or for

which the employee's employer or insurance carrier is liable or

has assumed liability.

(d) The assigned and subrogated cause of action

provided by this section, together with the right to recover

future benefits:

(I) Shall extend to all moneys collected from the

third party causing the injury for all:

(A) Economic damages; and

(B) Physical impairment and disfigurement

damages; except that, to the extent the trier of fact makes a

separate award for disfigurement damages, the right of the

beneficiary of the assigned interest to recover from such

disfigurement damages shall be limited to the amount the

beneficiary of the assigned interest paid, or is obligated to pay,

in disfigurement damages pursuant to articles 40 to 47 of this

title; and

(II) Shall not extend to moneys collected for

noneconomic damages awarded for pain and suffering,

inconvenience, emotional stress, or impairment of quality of

life.

(e) (I) Except as otherwise provided in subparagraph

(II) of this paragraph (e), the amount of the assigned and

subrogated cause of action shall be reduced by an amount

equal to the reasonable attorney fees and costs paid by the

injured employee or, if the employee is deceased, the

employee's dependents, in pursuing the recovery of the

assigned and subrogated cause of action and the collection of

such recovery.

(II) If the beneficiary of the assigned and subrogated

cause of action elects to independently pursue such assigned

cause of action, any recovery by such beneficiary shall not be

reduced by any attorney fees and costs incurred by the

employee. If the beneficiary of the assigned and subrogated

To Index

cause of action elects to intervene within ninety days after

receiving the notice required by paragraph (c) of subsection (4)

of this section, any recovery by such beneficiary shall not be

reduced by any attorney fees and costs incurred by the

employee. If such beneficiary elects to intervene after the

expiration of such ninety-day period, the court may reduce the

beneficiary's recovery by a reasonable amount for any attorney

fees and costs incurred by the employee after the end of such

ninety-day period and before receiving notice that the

beneficiary intends to intervene.

(f) Nothing in this section shall be construed as

limiting in any way the right of the injured employee to take

compensation under articles 40 to 47 of this title and also

proceed against the third party causing the injury to recover

any damages in excess of the subrogation rights described in

this section.

(2) Such a cause of action assigned to Pinnacol

Assurance may be prosecuted or compromised by it. A

compromise of any such cause of action by the employee or, if

the employee is deceased, the employee's dependents at an

amount less than the compensation provided for by articles 40

to 47 of this title shall be made only with the written approval

of the chief executive officer of Pinnacol Assurance, if the

deficiency of compensation would be payable from the

Pinnacol Assurance fund, and otherwise with the written

approval of the person, association, corporation, or insurance

carrier liable to pay the same. Such written approval shall not

be unreasonably withheld. Failure to obtain such written

approval shall entitle the party responsible for paying workers'

compensation benefits to be reimbursed for all benefits paid

from, and offset any future liability under articles 40 to 47 of

this title against, the entire proceeds recovered without any

credit for reasonable attorney fees and costs as provided in

paragraph (e) of subsection (1) of this section. If such approval

is not obtained, the employee or, if the employee is deceased,

the employee's dependents shall not be liable for any plaintiff's

attorney fees for the third-party recovery on that portion of any

recovery equal to the assigned and subrogated interest and are

not subject to any action for refusal to pay such plaintiff's

attorney fees resulting from the third-party case.

(3) If an employee is killed by the negligence or

wrong of another not in the same employ and the dependents

of such employee who are entitled to compensation under

articles 40 to 47 of this title are minors, the decision to pursue

or compromise any claim against a third party shall be made

by such minor or shall be made on the minor's behalf by a

parent of such minor or by the minor's next friend or duly

appointed guardian, as the director of the division of workers'

compensation may determine by rule in each case. Once such

decision is made, the person who made the decision shall also

bear the responsibility to provide all notices required by this

section.

(4) (a) (I) If the employee or, if the employee is

deceased, the employee's dependents make a demand upon or

a request of a person or entity not in the same employ as the

employee to seek recovery for damages arising from actions of

such other person or entity, the employee or dependents shall

also give written notice, within ten days, to the division of

workers' compensation and to all parties who may be

responsible for paying benefits to the employee or dependents

under articles 40 to 47 of this title.

(II) If the party responsible for paying workers'

compensation benefits under articles 40 to 47 of this title to the

employee or, if the employee is deceased, the employee's

dependents, makes a demand upon or a request of a person or

entity not in the same employ as the employee to seek recovery

for damages arising from actions of the other person or entity,

the party responsible for paying the workers' compensation

benefits shall also give written notice, within ten days, to the

division of workers' compensation and to the employee or, if

the employee is deceased, to the employee's dependents.

(III) The notice requirements of this paragraph (a)

shall not apply to demands or requests seeking the recovery of

medical payments only, and not seeking the recovery of any

other type of damage or loss.

(b) The notice required by this subsection (4) shall

contain the following:

(I) A description of the claim;

(II) The names and addresses of any and all other

persons believed to be negligent;

(III) The name and address of any attorney

representing the employee or dependents;

(IV) The name and address of any attorney

representing other persons believed to be negligent; and

(V) The name, address, and telephone number of the

insurance company or third-party administrator.

paragraph (c), at least twenty days before commencing a

lawsuit or arbitration proceeding to recover damages arising

from actions of another person or entity, the party initiating

such lawsuit or arbitration shall give written notice to all

parties who may be responsible for paying benefits to the

employee or dependents under articles 40 to 47 of this title and

to the employee or, if the employee is deceased, the employee's

dependents. Such notice shall contain all of the information set

out in paragraph (b) of this subsection (4) and shall be

accompanied by a draft copy of the complaint.

(II) If any applicable statutory limitation period

would expire before such twenty days have passed, the party

initiating such lawsuit or arbitration may file or serve the

complaint, or otherwise act to toll the running of such

limitation period, before such twenty days have passed. The

party initiating the lawsuit or arbitration shall provide the

notice required by subparagraph (I) of this paragraph (c) within

twenty days after commencing such action.

(d) If the employee or dependents fail to provide the

written notice required pursuant to subparagraph (I) of

paragraph (a) of this subsection (4):

(I) The party responsible for paying workers'

compensation benefits shall be entitled to reimbursement from

all moneys collected from the third party for all economic

damages and for all physical impairment and disfigurement

damages, without any credit for reasonable attorney fees as

provided in paragraph (e) of subsection (1) of this section. If

the trier of fact makes a separate award for disfigurement

damages, reimbursement from such disfigurement damage

award shall be limited to the amount the party paying workers'

compensation benefits paid, or is obligated to pay, in

disfigurement damages pursuant to articles 40 to 47 of this

To Index

title. Such rights shall not extend to moneys collected for

noneconomic damages awarded for pain and suffering,

inconvenience, emotional stress, or impairment of quality of

life.

(II) The employee or dependents shall not be liable

for any plaintiff's attorney fees for the third-party recovery on

that portion of any recovery equal to the assigned and

subrogated interest and are not subject to any action for refusal

to pay such plaintiff's attorney fees resulting from the third-

party case.

(e) If the party responsible for paying workers'

compensation benefits under articles 40 to 47 of this title fails

to provide the written notice required pursuant to subparagraph

(II) of paragraph (a) of this subsection (4), the amount of the

claim shall be reduced by fifty dollars for each day such notice

was not given to the employee or, if the employee is deceased,

the employee's dependents, in an amount not to exceed twenty

percent of the amount of the total assigned interest at the time

such notice should have been given. The failure to provide

such notice shall be a reassignment of a portion of the claim to

the employee or, if the employee is deceased, the employee's

dependents, in an amount equal to the penalty.

8-41-204. Injury outside of state - benefits in

accordance with state law. If an employee who has been

hired or is regularly employed in this state receives personal

injuries in an accident or an occupational disease arising out of

and in the course of such employment outside of this state, the

employee, or such employee's dependents in case of death,

shall be entitled to compensation according to the law of this

state. This provision shall apply only to those injuries received

by the employee within six months after leaving this state,

unless, prior to the expiration of such six-month period, the

employer has filed with the division notice that the employer

has elected to extend such coverage for a greater period of

time.

8-41-205. Waiver of compensation by employee -

approval required - exception. No waiver of compensation

or medical benefits by an employee for aggravation of any

preexisting condition or disease shall be allowed under articles

40 to 47 of this title. This section, however, shall not invalidate

any such waiver so filed and approved prior to March 1, 1977,

under the provisions of the "Colorado Occupational Disease

Disability Act", which was repealed effective September 1,

1975.

8-41-206. Disability beginning five years after

injury. Any disability beginning more than five years after the

date of injury shall be conclusively presumed not to be due to

the injury, except in cases of disability or death resulting from

exposure to radioactive materials, substances, or machines or

to fissionable materials, or any type of malignancy caused

thereby, or from poisoning by uranium or its compounds, or

from asbestosis, silicosis, or anthracosis.

8-41-207. Death after two years. In case death

occurs more than two years after the date of receiving any

injury, such death shall be prima facie presumed not to be due

to such injury; such presumption shall not apply in cases of

silicosis, asbestosis, anthracosis, or disability or death resulting

from exposure to radioactive materials, substances, or

machines or to fissionable materials, or any type of malignancy

caused thereby, or from poisoning by uranium or its

compounds. In all other cases, such presumption may be

rebutted by competent evidence.

8-41-208. Coverage for job-related exposure to or

contraction of hepatitis C. (1) The exposure to or

contraction of hepatitis C by a firefighter, emergency services

provider, or peace officer, as described in section 16-2.5-101,

C.R.S., shall be presumed to be within the course and scope of

employment if the following conditions are satisfied:

(a) A baseline test shall be provided by the employer,

or if insured, by the insurer, to be performed within five days

after the employee reports the on-the-job exposure. The

employee must report the exposure within two days after the

employee knew or reasonably should have known of the

exposure;

(b) The baseline test establishes that the employee

was not infected with hepatitis C at the time of the on-the-job

exposure;

necessary medical procedures set forth in section 8-42-101

(1)(c);

(d) The employee is determined to have hepatitis C

within twenty-four months after the on-the-job exposure to the

known or possible source.

(2) The exposure to or contraction of hepatitis C by

a firefighter, emergency services provider, or peace officer, as

described in section 16-2.5-101, C.R.S., shall not be deemed

to be within the course and scope of employment if an

employer or insurer shows by a preponderance of the evidence

that such exposure or contraction did not occur on the job.

8-41-209. Coverage for occupational diseases

contracted by firefighters. (1) Death, disability, or

impairment of health of a firefighter of any political

subdivision who has completed five or more years of

employment as a firefighter, caused by cancer of the brain,

skin, digestive system, hematological system, or genitourinary

system and resulting from his or her employment as a

firefighter, shall be considered an occupational disease.

(2) Any condition or impairment of health described

in subsection (1) of this section:

(a) Shall be presumed to result from a firefighter's

employment if, at the time of becoming a firefighter or

thereafter, the firefighter underwent a physical examination

that failed to reveal substantial evidence of such condition or

impairment of health that preexisted his or her employment as

a firefighter; and

(b) Shall not be deemed to result from the

firefighter's employment if the firefighter's employer or insurer

shows by a preponderance of the medical evidence that such

condition or impairment did not occur on the job.

(3) Repealed.

(4) An employer who participates in the voluntary

firefighter cancer benefits program created in part 4 of article

5 of title 29 is not subject to this section unless the employer

ends participation in that program.

8-41-210. Coverage for property tax work-off

program participants. Notwithstanding any provision of law

to the contrary, a governmental entity or private nonprofit or

for-profit entity that has a contract with a governmental entity

that is self-insured under articles 40 to 47 of this title may

purchase workers' compensation insurance from any insurer

To Index

authorized to transact the business of workers' compensation

insurance in this state for the express purpose of covering

participants in the property tax work-off program established

pursuant to article 3.7 of title 39, C.R.S.

8-41-211. Transportation network company

drivers - rules. On June 5, 2014, the director, upon

consideration of existing Colorado statutory and case law, may

by rule determine whether or not transportation network

companies have an obligation under existing Colorado law to

provide or offer for purchase workers' compensation insurance

coverage to transportation network company drivers.

8-41-212. Exemptions - laws of other state

furnish exclusive remedy - definitions. (1) An employee

who was hired or is regularly employed outside of Colorado

by an out-of-state employer and the out-of-state employer of

the employee are exempt from articles 40 to 47 of this title 8

while the employee is temporarily working for the out-of-state

employer within Colorado if:

(a) The out-of-state employer has furnished

coverage pursuant to the workers' compensation laws of the

state in which the employee was hired or is regularly

employed, which coverage applies to the employee while

temporarily working in Colorado; and

(b) The state in which the employee is furnished

coverage:

(I) Is contiguous to Colorado; and

(II) Recognizes this section and provides the same

exemption from the application of its workers' compensation

laws for Colorado employers whose employees are

temporarily working in the contiguous state.

(2) For an out-of-state employee and out-of-state

employer to which this section applies, the benefits provided

under the workers' compensation laws of the state in which the

employee is furnished coverage are the exclusive remedy

against the out-of-state employer for any injury, whether

resulting in death or not, that the employee incurs while

working for the out-of-state employer in Colorado.

(3) The division may enter into an agreement with

any workers' compensation division or similar agency of a

contiguous state to promulgate rules consistent with this

section to carry out the extraterritorial application of the

workers' compensation or similar law of the agreeing state.

(4) Nothing in this section contravenes the legal

obligations of Colorado employers to provide workers'

compensation to their employees in compliance with articles

40 to 47 of this title 8.

(5) As used in this section:

(a) "Out-of-state employer" means an employer that

is domiciled in another state.

(b) "Temporarily" or "temporarily working" means:

(I) A period of sustained work that does not exceed

six months; or

(II) Engaging in the interstate movement of goods

or commodities.

PART 3

LIABILITY

8-41-301. Conditions of recovery - definitions -

repeal. (1) The right to the compensation provided for in

articles 40 to 47 of this title, in lieu of any other liability to any

person for any personal injury or death resulting therefrom,

shall obtain in all cases where the following conditions occur:

(a) Where, at the time of the injury, both employer

and employee are subject to the provisions of said articles and

where the employer has complied with the provisions thereof

regarding insurance;

(b) Where, at the time of the injury, the employee is

performing service arising out of and in the course of the

employee's employment;

by an injury or occupational disease arising out of and in the

course of the employee's employment and is not intentionally

self-inflicted.

(2) (a) [Editor's note: This version of paragraph

(a) is effective until July 1, 2018.] A claim of mental

impairment must be proven by evidence supported by the

testimony of a licensed physician or psychologist. For

purposes of this subsection (2), "mental impairment" means a

recognized, permanent disability arising from an accidental

injury arising out of and in the course of employment when the

accidental injury involves no physical injury and consists of a

psychologically traumatic event that is generally outside of a

worker's usual experience and would evoke significant

symptoms of distress in a worker in similar circumstances. A

mental impairment shall not be considered to arise out of and

in the course of employment if it results from a disciplinary

action, work evaluation, job transfer, lay-off, demotion,

promotion, termination, retirement, or similar action taken in

good faith by the employer. The mental impairment that is the

basis of the claim shall have arisen primarily from the

claimant's then occupation and place of employment in order

to be compensable.

(2) (a) [Editor's note: This version of paragraph

(a) is effective July 1, 2018.] A claim of mental impairment

must be proven by evidence supported by the testimony of a

licensed psychiatrist or psychologist. A mental impairment

shall not be considered to arise out of and in the course of

employment if it results from a disciplinary action, work

evaluation, job transfer, lay-off, demotion, promotion,

termination, retirement, or similar action taken in good faith

by the employer. The mental impairment that is the basis of the

claim must have arisen primarily from the claimant's then

occupation and place of employment in order to be

compensable.

(a.5) (I) For purposes of this subsection (2), "mental

impairment" also includes a disability arising from an

accidental physical injury that leads to a recognized permanent

psychological disability.

(II) This subsection (2)(a.5) is repealed, effective

July 1, 2018.

(b) Notwithstanding any other provision of articles

40 to 47 of this title, where a claim is by reason of mental

impairment, the claimant shall be limited to twelve weeks of

medical impairment benefits, which shall be in an amount not

less than one hundred fifty dollars per week and not more than

fifty percent of the state average weekly wage, inclusive of any

temporary disability benefits; except that this limitation shall

not apply to any victim of a crime of violence, without regard

to the intent of the perpetrator of the crime, nor to the victim

To Index

of a physical injury or occupational disease that causes

neurological brain damage; and nothing in this section shall

limit the determination of the percentage of impairment

pursuant to section 8-42-107 (8) for the purposes of

establishing the applicable cap on benefits pursuant to section

8-42-107.5.

in whole or in part, upon facts and circumstances that are

common to all fields of employment.

(d) The mental impairment which is the basis of the

claim must be, in and of itself, either sufficient to render the

employee temporarily or permanently disabled from pursuing

the occupation from which the claim arose or to require

medical or psychological treatment.

(3) [Editor's note: Subsection (3) is effective July

1, 2018.] For the purposes of this section:

(a) "Mental impairment" means a recognized,

permanent disability arising from an accidental injury arising

out of and in the course of employment when the accidental

injury involves no physical injury and consists of a

psychologically traumatic event. "Mental impairment" also

includes a disability arising from an accidental physical injury

that leads to a recognized permanent psychological disability.

(b) (I) "Psychologically traumatic event" means an

event that is generally outside of a worker's usual experience

and would evoke significant symptoms of distress in a worker

in similar circumstances.

(II) "Psychologically traumatic event" also includes

an event that is within a worker's usual experience only when

the worker is diagnosed with post-traumatic stress disorder by

a licensed psychiatrist or psychologist after the worker

experienced exposure to one or more of the following events:

(A) The worker is the subject of an attempt by

another person to cause the worker serious bodily injury or

death through the use of deadly force, and the worker

reasonably believes the worker is the subject of the attempt;

(B) The worker visually witnesses a death, or the

immediate aftermath of the death, of one or more people as the

result of a violent event; or

serious bodily injury, or the immediate aftermath of the serious

bodily injury, of one or more people as the result of the

intentional act of another person or an accident.

either at the time of the actual injury or a later time, involves a

substantial risk of death, a substantial risk of serious permanent

disfigurement, or a substantial risk of protracted loss or

impairment of the function of any part or organ of the body.

8-41-302. Scope of terms - "accident" - "injury" -

"occupational disease". (1) "Accident", "injury", and

"occupational disease" shall not be construed to include

disability or death caused by or resulting from mental or

emotional stress unless it is shown by competent evidence that

such mental or emotional stress is proximately caused solely

by hazards to which the worker would not have been equally

exposed outside the employment.

(2) "Accident", "injury", and "occupational disease"

shall not be construed to include disability or death caused by

heart attack unless it is shown by competent evidence that such

heart attack was proximately caused by an unusual exertion

arising out of and within the course of the employment.

8-41-303. Loaning employer liable for

compensation. Where an employer, who has accepted the

provisions of articles 40 to 47 of this title and has complied

therewith, loans the service of any of the employer's employees

who have accepted the provisions of said articles to any third

person, the employer shall be liable for any compensation

thereafter for any injuries or death of said employee as

provided in said articles, unless it appears from the evidence in

said case that said loaning constitutes a new contract of hire,

express or implied, between the employee whose services were

loaned and the person to whom the employee was loaned.

8-41-304. Last employer liable -

exception. (1) Where compensation is payable for an

occupational disease, the employer in whose employment the

employee was last injuriously exposed to the hazards of such

disease and suffered a substantial permanent aggravation

thereof and the insurance carrier, if any, on the risk when such

employee was last so exposed under such employer shall alone

be liable therefor, without right to contribution from any prior

employer or insurance carrier. In the case of silicosis,

asbestosis, or anthracosis, the only employer and insurance

carrier liable shall be the last employer in whose employment

the employee was last exposed to harmful quantities of silicon

dioxide (SiO

) dust, asbestos dust, or coal dust on each of at

least sixty days or more and the insurance carrier, if any, on

the risk when the employee was last so exposed under such

employer.

(2) In any case where an employee of an employer

becomes disabled from silicosis, asbestosis, anthracosis, or

poisoning or disease caused by exposure to radioactive

materials, substances, or machines or to fissionable materials,

or any type of malignancy caused thereby, or in the event death

results from silicosis, asbestosis, anthracosis, or poisoning or

disease caused by exposure to radioactive materials,

substances, or machines or to fissionable materials, or any type

of malignancy caused thereby, and, if such employee has been

injuriously exposed to such diseases while in the employ of

another employer during the employee's lifetime, the last

employer or that employer's insurance carrier, if any, shall be

liable for compensation and medical benefits as provided by

articles 40 to 47 of this title, including funeral expenses and

death benefits.

PART 4

CONTRACTORS AND LESSEES

8-41-401. Lessor contractor-out deemed

employer - liability - recovery. (1) (a) (I) Any person,

company, or corporation operating or engaged in or

conducting any business by leasing or contracting out any part

or all of the work thereof to any lessee, sublessee, contractor,

or subcontractor, irrespective of the number of employees

engaged in such work, shall be construed to be an employer as

defined in articles 40 to 47 of this title and shall be liable as

provided in said articles to pay compensation for injury or

death resulting therefrom to said lessees, sublessees,

contractors, and subcontractors and their employees or

To Index

employees' dependents, except as otherwise provided in

subsection (3) of this section.

(II) Notwithstanding subparagraph (I) of this

paragraph (a) and any other provision of law to the contrary, it

is presumed that a buyer of goods is not liable as a statutory

employer when a lessee, sublessee, contractor, or

subcontractor, or their employee who is delivering the goods

to the buyer injures himself or herself while not on the buyer's

premises. The presumption may be overcome by a showing

that the lessee, sublessee, contractor, or subcontractor, or their

employee was performing a job function that would normally

be performed by an employee of the buyer of the goods being

delivered. Nothing in this subparagraph (II) creates a

presumption of a statutory employer-employee relationship

when an injury occurs on the buyer's premises.

(III) For the purposes of this section, a "statutory

employer" is an employer who is responsible to pay workers'

compensation benefits pursuant to subparagraph (I) of this

paragraph (a).

(a.5) The general assembly hereby finds and

determines that the decision of the Colorado court of appeals

in the case of Newsom v. Frank M. Hall & Co., No. 02CA1375

(February 26, 2004), in which the court held that an

independent contractor may be an entity other than a natural

person, did not accurately reflect the intent of the general

assembly when it passed Senate Bill 93-132 and Senate Bill

95-072. The general assembly hereby declares that the term

"individual", as used in this section and in section 8-40-202,

means a natural person.

(b) The employer, before commencing said work,

shall insure and keep insured against all liability as provided

in said articles, and such lessee, sublessee, contractor, or

subcontractor, as well as any employee thereof, shall be

deemed employees as defined in said articles. The employer

shall be entitled to recover the cost of such insurance from said

lessee, sublessee, contractor, or subcontractor and may

withhold and deduct the same from the contract price or any

royalties or other money due, owing, or to become due said

lessee, sublessee, contractor, or subcontractor.

(2) If said lessee, sublessee, contractor, or

subcontractor is also an employer in the doing of such work

and, before commencing such work, insures and keeps insured

its liability for compensation as provided in articles 40 to 47 of

this title, neither said lessee, sublessee, contractor, or

subcontractor, its employees, or its insurer shall have any right

of contribution or action of any kind, including actions under

section 8-41-203, against the person, company, or corporation

operating or engaged in or conducting any business by leasing

or contracting out any part or all of the work thereof, or against

its employees, servants, or agents.

(3) Notwithstanding any provision of this section or

section 8-41-402 to the contrary, any individual who is

excluded from the definition of employee pursuant to section

8-40-202 (2), or a working general partner or sole proprietor

who is not covered under a policy of workers' compensation

insurance, or a corporate officer or member of a limited

liability company who executes and files an election to reject

coverage under section 8-41-202 (1) shall not have any cause

of action of any kind under articles 40 to 47 of this title.

Nothing in this section shall be construed to restrict the right

of any such individual to elect to proceed against a third party

in accordance with the provisions of section 8-41-203. The

total amount of damages recoverable pursuant to any cause of

action resulting from a work-related injury brought by such

individual that would otherwise have been compensable under

articles 40 to 47 of this title shall not exceed fifteen thousand

dollars, except in any cause of action brought against another

not in the same employ.

(4) (a) Notwithstanding any provision of this section

to the contrary, any person, company, or corporation who

contracts with a landowner or lessee of a farm or ranch to

perform a specified farming or ranching operation shall, prior

to entering into such contract, provide for and maintain, for the

period of such contract, workers' compensation coverage

pursuant to articles 40 to 47 of this title covering all the

employees and laborers to be utilized under such contract.

Proof of such coverage on forms or certificates issued by the

insurer shall be provided to the person, company, or

corporation contracting for the labor prior to performing such

contract.

(b) Any person, company, or corporation contracting

with a landowner or lessee of a farm or ranch to provide a

specified farming or ranching operation who fails to provide

coverage pursuant to subsection (1) of this section or who fails

to maintain such coverage for the term of the contract is guilty

of a misdemeanor and, upon conviction thereof, shall be

punished by imprisonment in the county jail for not more than

sixty days, or by a fine of not more than five hundred dollars,

or by both such fine and imprisonment.

the contrary, no person, company, or corporation contracting

with a landowner or lessee of a farm or ranch operation to

perform a specified farming or ranching operation nor any

employee of such person, company, or corporation required to

be covered by workers' compensation pursuant to this

subsection (4) shall have any right of contribution from, or any

action of any kind, including actions under section 8-41-203,

against, the person, company, or corporation contracting to

have such agricultural labor performed.

(d) (I) If any person, company, or corporation

contracting to provide labor to perform specified farming or

ranching operations and required to provide workers'

compensation coverage pursuant to articles 40 to 47 of this title

fails to provide such coverage and the person, company, or

corporation for whom the labor is provided incurs any liability

thereby, the person, company, or corporation providing the

labor shall be subject to a cause of action for said liability and

for reasonable attorney fees.

(II) If the person, company, or corporation for whom

the labor for the performance of a specified farming or

ranching operation is provided is sued by the injured

employee, said person, company, or corporation may join the

person, company, or corporation providing the labor as a third-

party defendant in lieu of filing an independent action.

(5) The provisions of this section shall not apply to

licensed real estate brokers and licensed real estate sales

agents, as regulated in article 10 of title 12, who are excluded

from the definition of employee pursuant to section 8-40-301

(2).

To Index

(6) Notwithstanding any provision of this section to

the contrary, any person, company, or corporation operating a

commercial vehicle as defined in section 42-4-235 (1)(a),

C.R.S., who holds oneself or itself out as an independent

contractor only to perform for-hire transportation, including

loading and unloading, and who contracts to perform a specific

transportation job, transportation task, or transportation

delivery for another person, company, or corporation is not

entering into an employee and employer relationship for

purposes of workers' compensation coverage pursuant to

articles 40 to 47 of this title. Nothing in this subsection (6) shall

be construed to prohibit a determination that an individual is

excluded from the definition of employee pursuant to section

8-40-202 (2) if such individual is operating a commercial

vehicle as defined in section 42-4-235 (1)(a), C.R.S.

(7) This section shall not apply to any person

excluded from the definition of "employee" pursuant to section

8-40-301 (5) or (7).

8-41-402. Repairs to real property - exception for

liability of occupant of residential real property. (1) Every

person, company, or corporation owning any real property or

improvements thereon and contracting out any work done on

and to said property to any contractor, subcontractor, or person

who hires or uses employees in the doing of such work shall

be deemed to be an employer under the terms of articles 40 to

47 of this title. Every such contractor, subcontractor, or person,

as well as such contractor's, subcontractor's, and person's

employees, shall be deemed to be an employee, and such

employer shall be liable as provided in said articles to pay

compensation for injury or death resulting therefrom to said

contractor, subcontractor, or person and said employees or

employees' dependents and, before commencing said work,

shall insure and keep insured all liability as provided in said

articles. Such employer shall be entitled to recover the cost of

such insurance from said contractor, subcontractor, or person

and may withhold and deduct the same from the contract price

or any royalties or other money due, owing, or to become due

to said contractor, subcontractor, or person. Articles 40 to 47

of this title shall not apply to the owner or occupant, or both,

of residential real property which meets the definition of a

"qualified residence" under section 163 (h)(4)(A) of the federal

"Internal Revenue Code of 1986", as amended, who contracts

out any work done to the property, unless the person

performing the work is otherwise an employee of the owner or

occupant, or both, of the property.

(2) If said contractor, subcontractor, or person doing

or undertaking to do any work for an owner of property, as

provided in subsection (1) of this section, is also an employer

in the doing of such work and, before commencing such work,

insures and keeps insured all liability for compensation as

provided in articles 40 to 47 of this title, neither said contractor,

subcontractor, or person nor any employees or insurers thereof

shall have any right of contribution or action of any kind,

including actions under section 8-41-203, against the person,

company, or corporation owning real property and

improvements thereon which contracts out work done on said

property, or against its employees, servants, or agents.

(3) (Deleted by amendment, L. 91, p. 1295, § 9,

effective July 1, 1991.)

8-41-403. Exemption of certain lessors of real

property. (1) The provisions of this part 4 shall not apply to

any lessor or sublessor of real property who rents or leases real

property to any lessee or sublessee for the purpose of

conducting the business of such lessee or sublessee, whether

as a franchise holder, independent agent, or consignee or in any

other separate capacity and whether or not such person is an

employer, as defined in section 8-40-203, but in no event

where such lessee or sublessee is an employee, as defined in

section 8-40-202.

(2) No such lessee or sublessee, or any employee or

insurer thereof, shall have any right of contribution from or

action against such lessor or sublessor under articles 40 to 47

of this title.

(3) The provisions of this part 4 shall not apply to any

lessor or sublessor of real property who leases or rents real

property to any lessee or sublessee for the purpose of

conducting any agricultural production business of such lessee

or sublessee, and no such lessee or sublessee, or any employee

or insurer thereof, shall have any right of contribution from or

action against such lessor or sublessor under articles 40 to 47

of this title.

8-41-404. Construction work - proof of coverage

required - violation - penalty - definitions. (1) (a) Except as

otherwise provided in subsection (4) of this section, every

person performing construction work on a construction site

shall be covered by workers' compensation insurance, and a

person who contracts for the performance of construction work

on a construction site shall either provide, pursuant to articles

40 to 47 of this title, workers' compensation coverage for, or

require proof of workers' compensation coverage from, every

person with whom he or she has a direct contract to perform

construction work on the construction site.

(b) A site owner, general contractor, or other person

who is not a direct party to a contract for construction work

shall not be held liable under subsection (3) of this section

solely as a result of the person's ownership interest or general

supervisory role in a construction project.

construction work on a construction site and who exercises due

diligence by either providing workers' compensation coverage

as required by this section or requiring proof of workers'

compensation coverage as required by this section from every

person with whom he or she has a direct contract to perform

construction work on the construction site shall not be liable

under subsection (3) of this section.

(2) If the parties to a contract that includes

construction work agree that part of the contract price shall be

withheld to cover workers' compensation premiums for

coverage required under this section, the premiums shall be

calculated based only on that portion of the contract price that

represents the labor portion of the contract.

(3) A violation of subsection (1) of this section is

punishable by an administrative fine imposed pursuant to

section 8-43-409 (1)(b). The division shall transmit revenues

collected through the imposition of fines pursuant to this

section to the state treasurer, who shall credit them to the

Colorado uninsured employer fund created in section 8-67-

105.

(4) (a) This section shall not apply to:

To Index

(I) An owner or occupant, or both, of residential real

property that meets the definition of a "qualified residence"

under section 163 (h)(4)(A) of the federal "Internal Revenue

Code of 1986", as amended, who contracts out any work done

to the real property, unless the person performing the work is

otherwise an employee of the owner or occupant, or both, of

the real property;

(II) An owner or occupant of real property who hires

a person or persons specifically to do routine repair and

maintenance on the real property of such owner or occupant;

(III) An independent contractor, who is a natural

person, who has formed a corporation pursuant to section 7-

102-103, C.R.S., or a limited liability company pursuant to

section 7-80-203, C.R.S., and who has rejected workers'

compensation coverage pursuant to section 8-41-202;

(IV) Corporate officers and members of a limited

liability company who have rejected workers' compensation

coverage pursuant to section 8-41-202;

(V) A partner in a partnership who has filed a

certificate of limited partnership pursuant to section 7-62-201,

C.R.S., a partnership registration statement pursuant to section

7-60-144 or 7-64-1002, C.R.S., or a statement of trade name

pursuant to section 7-71-103, C.R.S., and has filed with the

division a form, approved by the director, rejecting workers'

compensation; or

(VI) A sole proprietor who has filed a statement of

trade name pursuant to section 7-71-103, C.R.S., and has filed

with the division a form, approved by the director, rejecting

workers' compensation.

(b) Nothing in this section shall be construed to limit

the responsibility of corporations, limited liability companies,

partnerships, or sole proprietorships to provide coverage for

their employees as required under articles 40 to 47 of this title.

(5) As used in this section:

(a) "Construction site" means a location where a

structure that is attached or will be attached to real property is

constructed, altered, or remodeled.

(b) "Construction work" includes all or any part of

the construction, alteration, or remodeling of a structure.

"Construction work" does not include surveying, engineering,

examination, or inspection of a construction site or the delivery

of materials to a construction site.

includes a certificate or other written confirmation, issued by

the insurer or authorized agent of the insurer, of the existence

of workers' compensation coverage in force during the period

of the performance of construction work on the construction

site.

PART 5

DEPENDENCY

8-41-501. Persons presumed wholly

dependent. (1) For the purposes of articles 40 to 47 of this

title, the following described persons shall be presumed to be

wholly dependent (however, such presumption may be

rebutted by competent evidence):

(a) Widow or widower, unless it is shown that she or

he was voluntarily separated and living apart from the spouse

at the time of the injury or death or was not dependent in whole

or in part on the deceased for support;

(a.5) A person who is designated in a designated

beneficiary agreement for purposes of receiving workers'

compensation benefits in accordance with the provisions of

article 22 of title 15, C.R.S., unless it is shown that the

designated beneficiary was voluntarily separated and living

apart from the other designated beneficiary at the time of the

injury or death or was not dependent in whole or in part on the

deceased for support;

(b) Minor children of the deceased under the age of

eighteen years, including posthumous or legally adopted

children;

years or over and under the age of twenty-one years if it is

shown that:

(I) At the time of the decedent's death they were

actually dependent upon the deceased for support; and

(II) Either at the time of the decedent's death or at the

time they attained the age of eighteen years they were engaged

in courses of study as full-time students at any accredited

school. The period of presumed dependency of such persons

shall continue until they attain the age of twenty-one years or

until they cease to be engaged in courses of study as full-time

students at an accredited school, whichever occurs first.

8-41-502. Other dependents - temporary

dependency. Except as otherwise provided in section 8-41-

501 (1)(c), a child eighteen years of age or over and a mother,

father, grandmother, grandfather, sister, brother, or grandchild

who was wholly or partially supported by the deceased

employee at the time of death and for a reasonable period of

time immediately prior thereto is considered an actual

dependent. To be entitled to compensation, such dependents,

except as provided in section 8-41-501 (1)(c), must prove that

they were incapable of or actually disabled from earning their

own living. If said incapacity or disability is temporary only,

compensation shall be paid only during the period of such

temporary incapacity or disability.

8-41-503. Dependency and extent determined -

how. (1) Dependents and the extent of their dependency shall

be determined as of the date of the injury to the injured

employee, and the right to death benefits shall become fixed as

of said date irrespective of any subsequent change in

conditions except as provided in section 8-41-501 (1)(c).

Death benefits shall be directly payable to the dependents

entitled thereto or to such person legally entitled thereto as the

director may designate.

(2) In case an employee or claimant entitled to

compensation dies leaving dependents, any accrued and

unpaid portion of the compensation or benefits up to the time

of the death of such employee or claimant shall be paid to such

dependents as may be ordered by the director and not to the

legal representative as such of said decedent. In case the

injured employee or claimant leaves no dependents, the

director may order the application of any accrued and unpaid

benefits up to the time of the death of such employee or

claimant paid upon the expenses of the last sickness or funeral

of such decedent, the preference in such payment to be to

funeral expenses.

To Index

(3) In case an injured employee or dependent of a

deceased employee entitled to benefits under articles 40 to 47

of this title is declared incompetent or insane, any benefits

accrued or to accrue may be paid to the conservator of the

estate, if any, or to any dependents, or to the party or institution

having custody of the person of such injured employee or

dependent of a deceased employee as may be ordered by the

director in the director's discretion.

8-41-504. Action by injured employee -

dependents not parties in interest. No dependent of an

injured employee, during the life of the employee, shall be

deemed a party in interest to any proceeding by said employee

for the enforcement of any claim for compensation nor with

respect to any settlement thereof by said employee.

8-41-505. Minor children. A minor child of a

deceased putative father is entitled to compensation when it is

proved to the satisfaction of the director that the father, during

his lifetime, has acknowledged the child as his and has

regularly contributed to his or her support and maintenance for

a reasonable period of time prior to his death.

ARTICLE 42

Benefits

8-42-101. Employer must furnish medical aid -

approval of plan - fee schedule - contracting for treatment

- no recovery from employee - medical treatment

guidelines - accreditation of physicians and other medical

providers - rules - repeal. (1) (a) Every employer, regardless

of said employer's method of insurance, shall furnish such

medical, surgical, dental, nursing, and hospital treatment,

medical, hospital, and surgical supplies, crutches, and

apparatus as may reasonably be needed at the time of the injury

or occupational disease and thereafter during the disability to

cure and relieve the employee from the effects of the injury.

(b) In all cases where the injury results in the loss of

a member or part of the employee's body, loss of teeth, loss of

vision or hearing, or damage to an existing prosthetic device,

the employer shall furnish within the limits of the medical

benefits provided in paragraph (a) of this subsection (1)

artificial members, glasses, hearing aids, braces, and other

external prosthetic devices, including dentures, which are

reasonably required to replace or improve the function of each

member or part of the body or prosthetic device so affected or

to improve the employee's vision or hearing. The employee

may petition the division for a replacement of any artificial

member, glasses, hearing aid, brace, or other external

prosthetic device, including dentures, upon grounds that the

employee has undergone an anatomical change since the

previous device was furnished or for other good cause shown,

that the anatomical change or good cause is directly related to

and caused by the injury, and that the replacement is necessary

to improve the function of each member or part of the body so

affected or to relieve pain and discomfort. Implants or devices

necessary to regulate the operation of, or to replace, with

implantable devices, internal organs or structures of the body

may be replaced when the authorized treating physician deems

it necessary. Every employer subject to the terms and

provisions of articles 40 to 47 of this title must insure against

liability for the medical, surgical, and hospital expenses

provided for in this article, unless permission is given by the

director to such employer to operate under a medical plan, as

set forth in subsection (2) of this section.

medical services provider, or peace officer, as described in

section 16-2.5-101, C.R.S., is exposed during the course and

within the scope of employment to a known or possible source

of hepatitis C, the employer, or if insured, the insurer, shall, at

their expense, provide for baseline testing within the period of

time specified in section 8-41-208 (1)(a) to determine whether

the employee was free of hepatitis C at the time of the on-the-

job exposure. The employer, or if insured, the insurer, shall pay

for all reasonable and necessary medical procedures and

treatment for exposure to hepatitis C during the period of time

set forth in section 8-41-208 (1)(d).

(2) Every such plan, which is agreed to between the

employer and employee, for the furnishing of medical,

surgical, and hospital treatment, whether or not the employee

is to pay any part of the expense of such treatment, before

being put into effect, shall receive the approval of the director.

The director has full power to formulate the terms and

To Index

conditions under which any such plan may operate and the

essentials thereof, and at any time the director may order

modifications or changes in any such plan or withdraw prior

approval thereof. No plan shall be approved by the director

which relieves the employer from the burden of assuming and

paying for any part of the medical, surgical, and hospital

services and supplies required.

(3) (a) (I) The director shall establish a schedule

fixing the fees for which all surgical, hospital, dental, nursing,

vocational rehabilitation, and medical services, whether

related to treatment or not, pertaining to injured employees

under this section shall be compensated. It is unlawful, void,

and unenforceable as a debt for any physician, chiropractor,

hospital, person, expert witness, reviewer, evaluator, or

institution to contract with, bill, or charge any party for

services, rendered in connection with injuries coming within

the purview of this article or an applicable fee schedule, which

are or may be in excess of said fee schedule unless such

charges are approved by the director. Fee schedules shall be

reviewed on or before July 1 of each year by the director, and

appropriate health care practitioners shall be given a

reasonable opportunity to be heard as required pursuant to

section 24-4-103, C.R.S., prior to fixing the fees, impairment

rating guidelines, which shall be based on the revised third

edition of the "American Medical Association Guides to the

Evaluation of Permanent Impairment", in effect as of July 1,

1991, and medical treatment guidelines and utilization

standards. Fee schedules established pursuant to this

subparagraph (I) shall take effect on January 1. The director

shall promulgate rules concerning reporting requirements,

penalties for failure to report correctly or in a timely manner,

utilization control requirements for services provided under

this section, and the accreditation process in subsection (3.6)

of this section. The fee schedule shall apply to all surgical,

hospital, dental, nursing, vocational rehabilitation, and

medical services and to expert witness, expert reviewer, or

expert evaluator services, whether related to treatment or not,

provided after any final order, final admission, or full or partial

settlement of the claim.

(II) Notwithstanding the provisions of subparagraph

(I) of this paragraph (a) the fees set forth in the schedule

established pursuant to subparagraph (I) of this paragraph (a)

shall be those fees in effect immediately prior to July 1, 1991,

and such fees shall remain in effect until July 1, 1995.

(III) Notwithstanding the provisions of subparagraph

(I) of this paragraph (a), until the impairment rating guidelines

and medical treatment guidelines and utilization standards

required by subparagraph (I) of this paragraph (a) and

subsection (3.5) of this section are adopted and level I

accreditation is received, compensation for fees for

chiropractic treatments shall not be made more than ninety

days after the first of such treatments nor after the twelfth such

treatment, whichever first occurs, unless the chiropractor has

received level I accreditation.

(b) Medical treatment guidelines and utilization

standards, developed by the director, shall be used by health

care practitioners for compliance with this section.

(3.5) (a) (I) (A) "Physician" means, for the purposes

of the level I and level II accreditation programs, a physician

licensed under the "Colorado Medical Practice Act". For the

purposes of level I accreditation only and not level II

accreditation, "physician" means a dentist licensed under the

"Dental Practice Act", article 220 of title 12; a podiatrist

licensed under article 290 of title 12; and a chiropractor

licensed under article 215 of title 12.

(B) A physician assistant licensed under the

"Colorado Medical Practice Act", article 240 of title 12, may

receive level I accreditation. In order for a level I accredited

physician assistant to perform medical services requiring level

I accreditation, a level I accredited physician must delegate the

performance of those medical services to the level I accredited

physician assistant.

under either level I or level II solely by reason of being

licensed.

(D) An advanced practice nurse with prescriptive

authority pursuant to section 12-38-111.6 may receive level I

accreditation for purposes of receiving one hundred percent

reimbursement under the medical fee schedule created in

accordance with subsection (3) of this section.

(E) Nothing in this subsection (3.5)(a) grants any

person other than a physician licensed under the "Colorado

Medical Practice Act" the authority to determine that no

permanent medical impairment has resulted from the injury

pursuant to subsection (3.6)(b) of this section or that a claimant

has attained maximum medical improvement pursuant to

section 8-42-107 (8)(b)(I).

(II) The director shall promulgate rules establishing

a system for the determination of medical treatment guidelines

and utilization standards and medical impairment rating

guidelines for impairment ratings as a percent of the whole

person or affected body part based on the revised third edition

of the "American Medical Association Guides to the

Evaluation of Permanent Impairment", in effect as of July 1,

1991.

(b) A medical impairment rating system shall be

maintained by the director.

September 1, 2025.

(II) Prior to such repeal the accreditation process

created by this subsection (3.5) and subsection (3.6) of this

section shall be reviewed as provided for in section 24-34-104,

C.R.S.

(3.6) The two-tier accreditation system shall

comprise the following programs:

(a) (I) A program establishing the accreditation

requirements for physicians providing primary care to patients

who have, as a result of their injury, been unable to return to

work for more than three working days, referred to in this

section as "time-loss injuries", which program shall be

voluntary except in the case of chiropractors, for whom it shall

be mandatory, and which shall be known as level I

accreditation; and

(II) A program establishing the accreditation

requirements for physicians providing impairment evaluation

of injured workers, which program shall be known as level II

accreditation.

(b) A physician who provides impairment evaluation

of injured workers shall complete and must have received

accreditation under the level II accreditation program.

To Index

However, the authorized treating physician providing primary

care need not be level II accredited to determine that no

permanent medical impairment has resulted from the injury.

Specialists who do not render primary care to injured workers

and who do not perform impairment evaluations do not require

accreditation. The facility where a physician provides such

services cannot be accredited.

programs shall be implemented and available to physicians.

All physicians who are required to be accredited shall

complete the level II accreditation program or programs.

(d) The level I and level II accreditation programs

shall operate in such a manner that the costs of the program are

fully met by registration fees paid by the physicians. The

registration fee for each program must cover the cost of all

accreditation course work and materials.

(e) The accreditation system shall be established so

as to provide physicians with an understanding of the

administrative, legal, and medical roles and in such a manner

that accreditation is accessible to every licensed physician,

with consideration of specialty and geographic diversity.

(f) Initial accreditation shall be for a three-year

period and may be renewed for successive three-year periods.

The director by regulation may determine any additional

training program required prior to accreditation renewal.

(g) The director shall, upon good cause shown,

revoke the accreditation of any physician who violates the

provisions of this subsection (3.6) or any rule promulgated by

the director pursuant to this subsection (3.6), following a

hearing on the merits before an administrative law judge,

subject to review by the industrial claim appeals office and the

court of appeals, in accordance with all applicable provisions

of article 43 of this title.

(h) If a physician whose accreditation has been

revoked submits a claim for payment for services rendered

subsequent to such revocation, the physician shall be

considered in violation of section 10-1-128, C.R.S., and

neither an insurance carrier nor a self-insured employer shall

be under any obligation to pay such claim.

(i) A physician who provides treatment for nontime

loss injuries need not be accredited to be reimbursed for the

costs of such treatment pursuant to the provisions of the

"Workers' Compensation Act of Colorado".

(j) (Deleted by amendment, L. 96, p. 151, § 2,

effective July 1, 1996.)

(k) The division shall make available to insurers,

claimants, and employers a list of all accredited physicians and

a list of all physicians whose accreditation has been revoked.

Such lists shall be updated on a monthly basis.

(l) The registration fees collected pursuant to

paragraph (d) of this subsection (3.6) shall be transmitted to

the state treasurer, who shall credit the same to the physicians

accreditation program cash fund, which is hereby created in

the state treasury. Moneys in the physicians accreditation

program cash fund are hereby continuously appropriated for

the payment of the direct costs of providing the level I and

level II accreditation courses and materials.

(m) All administrative costs associated with the level

I and level II accreditation programs shall be paid out of the

workers' compensation cash fund in accordance with

appropriations made pursuant to section 8-44-112 (7).

(n) The director shall contract with the medical

school of the university of Colorado for the services of a

medical director to advise the director on issues of

accreditation, impairment rating guidelines, medical treatment

guidelines and utilization standards, and case management and

to consult with the director on peer review activities as

specified in this subsection (3.6) and section 8-43-501. The

medical director shall be a medical doctor licensed to practice

in this state with experience in occupational medicine. The

director may contract with an appropriate private organization

that meets the definition of a quality improvement organization

as set forth in 42 U.S.C. sec. 1320c-1 to conduct peer review

activities under this subsection (3.6) and section 8-43-501 and

to recommend whether or not adverse action is warranted.

(o) Except as provided in this subsection (3.6),

neither an insurance carrier nor a self-insured employer or

injured worker shall be liable for costs incurred for an

impairment evaluation rendered by a physician where there is

a determination of permanent medical impairment if such

physician is not level II accredited pursuant to the provisions

of this subsection (3.6).

(p) (I) For purposes of this paragraph (p):

(A) "Case management" means a system developed

by the insurance carrier in which the carrier shall assign a

person knowledgeable in workers' compensation health care to

communicate with the employer, employee, and treating

physician to assure that appropriate and timely medical care is

being provided.

(B) "Managed care" means the provision of medical

services through a recognized organization authorized under

the provisions of parts 1, 3, and 4 of article 16 of title 10,

C.R.S., or a network of medical providers accredited to

practice workers' compensation under this subsection (3.6).

(II) Every employer or its insurance carrier shall

offer at least managed care or medical case management in the

counties of Denver, Adams, Jefferson, Arapahoe, Douglas,

Boulder, Larimer, Weld, El Paso, Pueblo, and Mesa and shall

offer medical case management in all other counties of the

state.

(q) The division is authorized to accept moneys from

any governmental unit as well as grants, gifts, and donations

from individuals, private organizations, and foundations;

except that no grant, gift, or donation may be accepted by the

division if it is subject to conditions which are inconsistent

with this article or any other laws of this state or which require

expenditures from the workers' compensation cash fund which

have not been approved by the general assembly. All moneys

accepted by the division shall be transmitted to the state

treasurer for credit to the workers' compensation cash fund.

(r) (I) This subsection (3.6) is repealed, effective

September 1, 2025.

(II) Prior to such repeal the accreditation process

created by subsection (3.5) of this section and this subsection

(3.6) shall be reviewed as provided for in section 24-34-104,

C.R.S.

(3.7) On and after July 1, 1991, all physical

impairment ratings used under articles 40 to 47 of this title

shall be based on the revised third edition of the "American

To Index

Medical Association Guides to the Evaluation of Permanent

Impairment", in effect as of July 1, 1991. For purposes of

determining levels of medical impairment pursuant to articles

40 to 47 of this title a physician shall not render a medical

impairment rating based on chronic pain without anatomic or

physiologic correlation. Anatomic correlation must be based

on objective findings.

(4) Once there has been an admission of liability or

the entry of a final order finding that an employer or insurance

carrier is liable for the payment of an employee's medical costs

or fees, a medical provider shall under no circumstances seek

to recover such costs or fees from the employee.

(5) If any party files an application for hearing on

whether the claimant is entitled to medical maintenance

benefits recommended by an authorized treating physician that

are unpaid and contested, and any requested medical

maintenance benefit is admitted fewer than twenty days before

the hearing or ordered after application for hearing is filed, the

court shall award the claimant all reasonable costs incurred in

pursuing the medical benefit. Such costs do not include

attorney fees.

(6) (a) If an employer receives notice of injury and

the employer or, if insured, the employer's insurance carrier,

after notice of the injury, fails to furnish reasonable and

necessary medical treatment to the injured worker for a claim

that is admitted or found to be compensable, the employer or

carrier shall reimburse the claimant, or any insurer or

governmental program that pays for related medical treatment,

for the costs of reasonable and necessary treatment that was

provided. An employer, insurer, carrier, or provider may not

recover the cost of care from a claimant where the employer or

carrier has furnished medical treatment except in the case of

fraud.

(b) If a claimant has paid for medical treatment that

is admitted or found to be compensable and that costs more

than the amount specified in the workers' compensation fee

schedule, the employer or, if insured, the employer's insurance

carrier, shall reimburse the claimant for the full amount paid.

The employer or carrier is entitled to reimbursement from the

medical providers for the amount in excess of the amount

specified in the worker's compensation fee schedule.

8-42-102. Basis of compensation - "wages"

defined - average weekly wage - "at the time of injury"

clarified. (1) The average weekly wage of an injured

employee shall be taken as the basis upon which to compute

compensation payments.

(2) Average weekly wages for the purpose of

computing benefits provided in articles 40 to 47 of this title,

except as provided in this section, shall be calculated upon the

monthly, weekly, daily, hourly, or other remuneration which

the injured or deceased employee was receiving at the time of

the injury, and in the following manner; except that any portion

of such remuneration representing a per diem payment shall be

excluded from the calculation unless such payment is

considered wages for federal income tax purposes:

(a) Where the employee is being paid by the month

for services under a contract of hire, the weekly wage shall be

determined by multiplying the monthly wage or salary at the

time of the accident by twelve and dividing by fifty-two.

(b) Where the employee is being paid by the week

for services under a contract of hire, said weekly remuneration

at the time of the injury shall be deemed to be the weekly wage

for the purposes of articles 40 to 47 of this title.

diem basis, the weekly wage shall be determined by

multiplying the daily wage by the number of days and fractions

of days in the week during which the employee under a

contract of hire was working at the time of the injury or would

have worked if the injury had not intervened.

(d) Where the employee is being paid by the hour,

the weekly wage shall be determined by multiplying the hourly

rate by the number of hours in a day during which the

employee was working at the time of the injury or would have

worked if the injury had not intervened, to determine the daily

wage; then the weekly wage shall be determined from said

daily wage in the manner set forth in paragraph (c) of this

subsection (2).

(e) Where the employee is paid on a piecework,

tonnage, commission, or basis other than a monthly, weekly,

daily, or hourly wage and where the employment is but casual

and in the usual course of the trade, business, profession, or

occupation of his employer, the total amount earned by the

injured or killed employee in the twelve months preceding the

injury shall be computed, which sum shall be divided by the

number of pay periods the injured person was employed during

the twelve months immediately preceding the injury, and the

result thus ascertained shall be considered the average wage of

said employee per pay period.

(f) Where the employee is being paid by the mile, the

weekly wage shall be determined by multiplying the rate per

mile by the average number of miles per day the employee

drove in the service of the employer in the sixty working days

immediately preceding the date of the injury, to arrive at a

daily wage; then the weekly wage shall be determined from the

said daily wage in the manner set forth in paragraph (c) of this

subsection (2). If, on the date of the injury, the employee has

worked for the employer less than sixty days, the average daily

wage shall be based on the average miles driven per working

day during such period.

(3) Where the foregoing methods of computing the

average weekly wage of the employee, by reason of the nature

of the employment or the fact that the injured employee has

not worked a sufficient length of time to enable earnings to be

fairly computed thereunder or has been ill or has been self-

employed or for any other reason, will not fairly compute the

average weekly wage, the division, in each particular case,

may compute the average weekly wage of said employee in

such other manner and by such other method as will, in the

opinion of the director based upon the facts presented, fairly

determine such employee's average weekly wage.

(4) Where an employee is a minor and the disability

is temporary, the average weekly wage of such minor shall be

determined by the division as in cases of disability of adults.

Where the disability of such minor is permanent or if benefits

under articles 40 to 47 of this title accrue because of the death

of such minor, compensation to said minor or death benefits to

said minor's dependents shall be paid at the maximum rate of

compensation payable under said articles at the time of the

determination of such permanency or of such death.

To Index

(5) (a) The general assembly hereby finds that the

phrase "at the time of injury" in subsection (2) of this section

refers to the date of the employee's accident. When subsection

(2) of this section is used to determine a worker's average

weekly wage, the wage on the date of the accident shall be

used.

(b) Nothing in this subsection (5) alters the discretion

of the division or the director to fairly determine a worker's

average weekly wage in accordance with subsection (3) of this

section.

8-42-103. Disability indemnity payable as wages -

period of disability. (1) If the injury or occupational disease

causes disability, a disability indemnity shall be payable as

wages pursuant to section 8-42-105 (2)(a) subject to the

following limitations:

(a) If the period of disability does not last longer than

three days from the day the employee leaves work as a result

of the injury, no disability indemnity shall be recoverable

except the disbursement provided in articles 40 to 47 of this

title for medical, surgical, nursing, and hospital services,

apparatus, and supplies, nor in any case unless the division has

actual knowledge of the injury or is notified thereof within the

period specified in said articles.

(b) If the period of disability lasts longer than two

weeks from the day the injured employee leaves work as the

result of the injury, disability indemnity shall be recoverable

from the day the injured employee leaves work.

disability benefits granted by the federal "Old-Age, Survivors,

and Disability Insurance Amendments of 1965", Pub.L. 89-97,

are payable to an individual and the individual's dependents,

the aggregate benefits payable for temporary total disability,

temporary partial disability, and permanent total disability

pursuant to this section shall be reduced, but not below zero,

by an amount equal as nearly as practical to one-half the

federal periodic benefits; but, if the federal "Old-Age,

Survivors, and Disability Insurance Amendments of 1965",

Pub.L. 89-97, is amended to provide for a reduction of an

individual's disability benefits thereunder because of

compensation benefits payable under articles 40 to 47 of this

title, the reduction of compensation benefits provided in said

articles shall be decreased by an amount equal to the federal

reduction. Upon request of the insurer or employer, the

employee shall apply for such federal periodic disability

benefits and respond to requests from the insurer or employer

as to the status of such application. Failure to comply with this

section constitutes cause for suspension of benefits.

(II) In cases where it is determined that periodic

benefits granted by the federal old-age, survivors, and

disability insurance act or employer-paid retirement benefits

are payable to an individual and the individual's dependents,

the aggregate benefits payable for permanent total disability

pursuant to this section shall be reduced, but not below zero:

(A) By an amount equal as nearly as practical to one-

half such federal benefits; except that this reduction for the

periodic benefits granted by the federal old-age, survivors, and

disability insurance act shall not exceed the reduction specified

in subparagraph (I) of this paragraph (c) for the periodic

disability benefits payable to an individual;

(B) By an amount determined as a percentage of the

employer-paid retirement benefits, said percentage to be

determined by a weighted average of the employer's

contributions during the period of covered employment

divided by the total contributions during the period of covered

employment; except that in permanent total disability cases all

contributions made by the employer pursuant to a collective

bargaining agreement with the employee's representative shall

be considered to have been made by the employee.

(II.5) In cases where an employer does not

participate in federal old-age, survivors, and disability

insurance, and it is determined that employer-paid retirement

benefits are payable to an individual and the individual's

dependents, the aggregate benefits payable for permanent total

disability pursuant to this section shall be reduced, but not

below zero by an amount determined as a percentage of the

employer-paid retirement benefits, said percentage to be

determined by a weighted average of the employer's

contributions during the period of covered employment

divided by the total contributions during the period of covered

employment.

(III) Notwithstanding sub-subparagraph (A) of

subparagraph (II) of this paragraph (c), if the federal "Old-Age,

Survivors, and Disability Insurance Amendments of 1965",

Pub.L. 89-97, is amended to provide for a reduction of an

individual's periodic benefits thereunder because of

compensation benefits payable under articles 40 to 47 of this

title, the reduction of compensation benefits provided in said

articles shall be decreased by an amount equal to the federal

reduction.

(IV) The provisions of subparagraphs (II) and (III) of

this paragraph (c) shall apply only if the injury on which the

award for permanent total disability was based occurred after

the claimant reached forty-five years of age.

(d) (I) In cases where it is determined that periodic

disability benefits are payable to an employee under a pension

or disability plan financed in whole or in part by the employer,

hereinafter called "employer pension or disability plan", the

aggregate benefits payable for temporary total disability,

temporary partial disability, and permanent total disability

pursuant to this section shall be reduced, but not below zero,

by an amount equal as nearly as practical to the employer

pension or disability plan benefits, with the following

limitations:

(A) Where the employee has contributed to the

employer pension or disability plan, benefits shall be reduced

under this section only in an amount proportional to the

employer's percentage of total contributions to the employer

pension or disability plan.

(B) Where the employer pension or disability plan

provides by its terms that benefits are precluded thereunder in

whole or in part if benefits are awarded under articles 40 to 47

of this title, the reduction provided in this paragraph (d) shall

not be applicable to the extent of the amount so precluded.

(II) Upon request of the insurer or employer, the

employee shall apply for such periodic disability benefits and

respond to requests from the insurer or employer as to the

status of such application. Failure to comply with this section

shall be cause for suspension of benefits.

To Index

(III) The provisions of this paragraph (d) shall apply

to a disability pension paid pursuant to article 30.5 or 31 of title

31, C.R.S.; except that said reduction shall not reduce the

combined weekly disability benefits below a sum equal to one

hundred percent of the state average weekly wage as defined

in section 8-47-106 and applicable to the year in which the

weekly disability benefits are being paid.

(IV) If the disability benefits awarded pursuant to

articles 40 to 47 of this title are paid in a lump sum pursuant to

section 8-43-406, the weekly benefit attributed to such

workers' compensation benefits, for the purpose of calculating

the combined weekly disability benefit specified in

subparagraph (III) of this paragraph (d), shall be calculated by

assuming that the employee is receiving the weekly disability

benefits payments such employee would have received had

such weekly disability payments not been reduced and paid as

a lump sum.

(e) In cases where it is determined that periodic

disability benefits are payable to an individual and said

individual's dependents pursuant to a workers' compensation

act of another state or of the federal government, the aggregate

benefits payable for temporary total disability, temporary

partial disability, permanent partial disability, and permanent

total disability pursuant to this section shall be reduced, but not

below zero, by an amount equal to the benefits payable

pursuant to such other workers' compensation act.

(f) In cases where it is determined that

unemployment compensation benefits are payable to an

employee, the aggregate benefits payable for permanent total

disability pursuant to this section shall be reduced, but not

below zero, by an amount equal as nearly as practical to such

unemployment compensation benefits. In cases where it is

determined that unemployment insurance benefits are payable

to an employee, compensation for temporary disability shall be

reduced, but not below zero, by the amount of unemployment

insurance benefits received, unless the unemployment

insurance amount has already been reduced by the temporary

disability benefit amount and except that temporary total

disability shall not be reduced by unemployment insurance

benefits received pursuant to section 8-73-112.

(g) In cases where it is determined that a temporarily

disabled employee is responsible for termination of

employment, the resulting wage loss shall not be attributable

to the on-the-job injury.

(h) Unless the offset provisions of section 29-5-403

(10) have already been taken, in cases where it is determined

that a firefighter has received an award of benefits for a cancer

diagnosis pursuant to section 29-5-403 (3)(b) to (3)(k), the

aggregate benefits payable for temporary total disability,

temporary partial disability, permanent partial disability, and

permanent total disability shall be reduced, but not below zero,

by an amount equal to the total amount of such cancer

diagnosis benefits. In cases where it is determined that a

covered individual has received cosmetic disfigurement

benefits pursuant to section 29-5-403 (4)(b), benefits for

disfigurement payable pursuant to section 8-42-108 shall be

reduced, but not below zero, by an amount equal to such

cosmetic disfigurement benefits.

(2) Within fifteen days after receipt of written notice

by the employer or, if insured, the employer's workers'

compensation insurance carrier or third-party administrator of

the termination of a fringe benefit or advantage enumerated in

section 8-40-201 (19)(b), and the effective date of the

termination and cost of conversion, the employer or, if insured,

the employer's workers' compensation insurance carrier or

third-party administrator shall recalculate the applicable

average weekly wage and begin payment of benefits in

accordance with the recalculation with interest beginning on

the date the benefit was terminated.

8-42-104. Effect of previous injury or

compensation. (1) The fact that an employee has suffered a

previous disability or impairment or received compensation

therefor shall not preclude compensation for a later injury or

for death, but, in determining compensation benefits payable

for the later injury or death, the employee's average weekly

earnings at the time of the later injury shall be used in

determining the compensation payable to the employee or such

employee's dependents. Notwithstanding any other provision

of articles 40 to 47 of this title, no claimant may receive

concurrent permanent total disability awards from injuries

occurring in this state or any other state.

(2) (Deleted by amendment, L. 2008, p. 1676, § 2,

effective July 1, 2008.)

(3) An employee's temporary total disability,

temporary partial disability, or medical benefits shall not be

reduced based on a previous injury.

(4) An employee's recovery of permanent total

disability shall not be reduced when the disability is the result

of work-related injury or work-related injury combined with

genetic, congenital, or similar conditions; except that this

subsection (4) shall not apply to reductions in recovery or

apportionments allowed pursuant to the Colorado supreme

court's decision in the case denominated Anderson v.

Brinkhoff, 859 P.2d 819 (Colo. 1993).

(5) In cases of permanent medical impairment, the

employee's award or settlement shall be reduced:

(a) When an employee has suffered more than one

permanent medical impairment to the same body part and has

received an award or settlement under the "Workers'

Compensation Act of Colorado" or a similar act from another

state. The permanent medical impairment rating applicable to

the previous injury to the same body part, established by award

or settlement, shall be deducted from the permanent medical

impairment rating for the subsequent injury to the same body

part.

(b) When an employee has a nonwork-related

previous permanent medical impairment to the same body part

that has been identified, treated, and, at the time of the

subsequent compensable injury, is independently disabling.

The percentage of the nonwork-related permanent medical

impairment existing at the time of the subsequent injury to the

same body part shall be deducted from the permanent medical

impairment rating for the subsequent compensable injury.

(6) Nothing in this section shall be construed to

preclude employers or insurers from seeking contribution or

reimbursement, as permitted by law, from other employers or

insurers for benefits paid to or for an injured employee as long

as the employee's benefits are not reduced or otherwise

affected by such contribution or reimbursement.

To Index

8-42-105. Temporary total disability. (1) In case

of temporary total disability of more than three regular

working days' duration, the employee shall receive sixty-six

and two-thirds percent of said employee's average weekly

wages so long as such disability is total, not to exceed a

maximum of ninety-one percent of the state average weekly

wage per week. Except where vocational rehabilitation is

offered and accepted as provided in section 8-42-111 (3),

temporary total disability payments shall cease upon the

occurrence of any of the events enumerated in subsection (3)

of this section. If vocational rehabilitation is offered and

accepted, any party may at any time terminate vocational

rehabilitation upon fourteen days' written notice to the other

parties and the director. For purposes of this section,

termination of vocational rehabilitation shall be the same as if

vocational rehabilitation had never been offered and accepted,

and the employer or insurance carrier shall not be entitled to

recover any temporary total disability benefits paid during the

period that vocational rehabilitation was provided.

(2) (a) The first installment of compensation shall be

paid no later than the date that liability for the claim is admitted

by the insurance carrier or self-insured employer. If the

insurance carrier or self-insured employer denies liability for

the claim, the claimant may request an expedited hearing on

the issue of compensability if the application is filed within

forty-five days after the date of mailing of the notice of contest.

The director shall set any such expedited matter for hearing

within forty days after the date of the application, when the

issue is liability for the disease or injury. The time schedule for

such an expedited hearing is subject to the extensions set forth

in section 8-43-209. If a claimant elects not to request an

expedited hearing pursuant to this paragraph (a), the time

schedule for hearing the matter shall be as set forth in section

8-43-209. Compensation shall be paid at least once every two

weeks, except where the director determines that payment in

installments should be made at some other interval. The

director may by rule convert monthly benefit schedules to

weekly or other periodic schedules.

(b) Temporary disability compensation is not due

and payable for any period of time for which the insurer or self-

insured employer has requested from the employee's attending

physician verification of the employee's inability to work

resulting from the claimed injury or disease and the physician

cannot verify the employee's inability to work, unless the

employee has been unable to receive treatment for reasons

beyond the employee's control. Failure of the physician to

submit such verification, through no fault of the employee,

shall not affect the payment of temporary disability

compensation under this section.

with the employee's attending physician, the insurer or self-

insured employer shall notify the employee by certified mail

that temporary disability benefits may be suspended after the

employee fails to appear at a rescheduled appointment. If the

employee fails to appear at a rescheduled appointment, the

insurer or self-insured employer may, without a prior hearing,

suspend payment of temporary disability benefits to the

employee until the employee appears at a subsequent

rescheduled appointment.

(d) If the insurer or self-insured employer has

requested and failed to receive from the employee's attending

physician verification of the employee's inability to work

resulting from the claimed injury or disease, medical services

provided by the attending physician are not compensable until

the attending physician submits such verification.

(3) Temporary total disability benefits shall continue

until the first occurrence of any one of the following:

(a) The employee reaches maximum medical

improvement;

(b) The employee returns to regular or modified

employment;

written release to return to regular employment; or

(d) (I) The attending physician gives the employee a

written release to return to modified employment, such

employment is offered to the employee in writing, and the

employee fails to begin such employment.

(II) In the case of employment by a temporary help

contracting firm, once the employee has received one written

offer of modified employment meeting the requirements of

subparagraph (III) of this paragraph (d), the employee shall be

deemed to be on notice that modified employment is available.

Subsequent offers of modified employment need not be in

writing so long as the job requirements of such modified

employment are within the restrictions given the employee by

the employee's attending physician and the employee is

allowed a period of at least twenty-four hours, not including

any part of a Saturday, Sunday, or legal holiday, within which

to respond to any such offer.

(III) A written offer of modified employment under

subparagraph (II) of this paragraph (d) shall clearly state:

(A) That future offers of employment need not be in

writing;

(B) The policy of the temporary help contracting

firm regarding how and when employees are expected to learn

of such future offers; and

terminated if an employee fails to respond to an offer of

modified employment.

(4) (a) In cases where it is determined that a

temporarily disabled employee is responsible for termination

of employment, the resulting wage loss shall not be attributable

to the on-the-job injury.

(b) The claimant's refusal to accept an offer of

modified employment under either of the following conditions

does not constitute responsibility for termination:

(I) The offer of modified employment would require

the claimant to travel a distance of greater than fifty miles one

way more than the claimant's preinjury commute; or

(II) An administrative law judge determines that the

claimant's rejection of the offer of modified employment was

reasonable considering the totality of the claimant's

circumstances, including accounting for:

(A) The consequences of the industrial injury;

(B) The financial hardship that would be imposed on

the claimant in order to accept the offer of modified

employment; or

To Index

the administrative law judge, make it impracticable for the

claimant to accept the offer of modified employment.

this subsection (4) are not exhaustive.

8-42-106. Temporary partial disability. (1) In

case of temporary partial disability, the employee shall receive

sixty-six and two-thirds percent of the difference between the

employee's average weekly wage at the time of the injury and

the employee's average weekly wage during the continuance

of the temporary partial disability, not to exceed a maximum

of ninety-one percent of the state average weekly wage per

week. Temporary partial disability shall be paid at least once

every two weeks.

(2) Temporary partial disability payments shall

continue until the first occurrence of either one of the

following:

(a) The employee reaches maximum medical

improvement; or

(b) (I) The attending physician gives the employee a

written release to return to modified employment, such

employment is offered to the employee in writing, and the

employee fails to begin such employment.

(II) In the case of employment by a temporary help

contracting firm, once the employee has received one written

offer of modified employment meeting the requirements of

subparagraph (III) of this paragraph (b), the employee shall be

deemed to be on notice that modified employment is available.

Subsequent offers of modified employment need not be in

writing so long as the job requirements of such modified

employment are within the restrictions given the employee by

the employee's attending physician and the employee is

allowed a period of at least twenty-four hours, not including

any part of a Saturday, Sunday, or legal holiday, within which

to respond to any such offer.

(III) A written offer of modified employment under

subparagraph (II) of this paragraph (b) shall clearly state:

(A) That future offers of employment need not be in

writing;

(B) The policy of the temporary help contracting

firm regarding how and when employees are expected to learn

of such future offers; and

terminated if an employee fails to respond to an offer of

modified employment.

8-42-107. Permanent partial disability benefits -

schedule - medical impairment benefits - how

determined. (1) Benefits available. (a) When an injury

results in permanent medical impairment, and the employee

has an injury or injuries enumerated in the schedule set forth

in subsection (2) of this section, the employee shall be limited

to medical impairment benefits as specified in subsection (2)

of this section.

(b) When an injury results in permanent medical

impairment and the employee has an injury or injuries not on

the schedule specified in subsection (2) of this section, the

employee shall be limited to medical impairment benefits as

specified in subsection (8) of this section.

(2) Scheduled injuries. In case an injury results in a

loss set forth in the following schedule, the injured employee,

in addition to compensation to be paid for temporary disability,

shall receive compensation for the period as specified:

(a) The loss of an arm at the shoulder

208 weeks

(a.5) The loss of an arm above the hand

including the wrist

208 weeks

(b) (Deleted by amendment, L. 94, p. 2002, §

4, effective July 1, 1994.)

104 weeks

(d) The loss of a thumb and the metacarpal

bone thereof

50 weeks

(e) The loss of a thumb at the proximal joint

35 weeks

(f) The loss of a thumb at the second or distal

joint

18 weeks

(g) The loss of an index finger and the

metacarpal bone thereof

26 weeks

(h) The loss of an index finger at the proximal

joint

18 weeks

(i) Loss of an index finger at the second joint

13 weeks

(j) Loss of an index finger at the distal joint

9 weeks

(k) Loss of a second finger and the metacarpal

bone thereof

18 weeks

(l) Loss of a middle finger at the proximal joint

13 weeks

(m) Loss of a middle finger at the second joint

9 weeks

(n) Loss of a middle finger at the distal joint

5 weeks

(o) Loss of a third or ring finger and the

metacarpal bone thereof

11 weeks

(p) Loss of a ring finger at the proximal joint

7 weeks

(q) Loss of a ring finger at the second joint

7 weeks

(r) Loss of a ring finger at the distal joint

4 weeks

(s) Loss of a little finger and the metacarpal

bone thereof

13 weeks

(t) Loss of a little finger at the proximal joint

9 weeks

(u) Loss of a little finger at the second joint

9 weeks

(v) Loss of a little finger at the distal joint

4 weeks

(w) Loss of a leg at the hip joint or so near

thereto as to

preclude the use of an artificial limb

208 weeks

(w.5) The loss of a leg above the foot

including the ankle

208 weeks

(x) (Deleted by amendment, L. 94, p. 2002, §

4, effective July 1, 1994.)

(y) The loss of a foot below the ankle

104 weeks

(z) The loss of a great toe with the metatarsal

bone thereof

26 weeks

(aa) The loss of a great toe at the proximal

joint

18 weeks

(bb) The loss of a great toe at the second or

distal joint

9 weeks

(cc) The loss of any other toe with the

metatarsal bone thereof

11 weeks

(dd) The loss of any other toe at the proximal

joint

4 weeks

(ee) The loss of any other toe at the second or

distal joint

4 weeks

To Index

(ff) The loss of a tooth

6 weeks

(gg) Total blindness of one eye

104 weeks

(hh) Total deafness of both ears

139 weeks

(ii) Total deafness of one ear

35 weeks

(jj) Where worker prior to injury has suffered

a total loss of hearing in one ear, and as a result

of the accident loses total hearing in remaining

ear

139 weeks

(3) Temporary disability terminates as to injuries

coming under any provision of this section upon the

occurrence of any of the events enumerated in section 8-42-

105 (3).

(4) For the purpose of this schedule, permanent and

complete paralysis of any member as the proximate result of

accidental injury shall be deemed equivalent to the loss

thereof.

(5) If amputation is made between any two joints

mentioned in this schedule, except amputation between the

knee and the hip joint, the resulting loss shall be estimated as

if the amputation had been made at the joint nearest thereto. If

any portion of the bone of the distal joint of any finger, thumb,

or toe is amputated, the amount paid therefor shall be the

amount allowed for amputation at said distal joint.

(6) (a) The amounts specified in subsections (1) to

(5) of this section shall be at the compensation rate of one

hundred seventy-six dollars per week.

(b) On July 1, 2000, and on each succeeding July 1

thereafter, the compensation rate established in this subsection

(6) shall be modified for claims arising on and after such date

by the same percentage increase or decrease as the state

average weekly wage as determined by the director when the

director establishes the state average weekly wage pursuant to

section 8-47-106.

(7) (a) When an injured employee sustains two or

more injuries coming under this schedule, the disabilities

specified in subsections (1) to (5) of this section shall be added,

and the injured employee shall receive the sum total thereof;

except that, where the injury results in the loss or partial loss

of use of the index finger and thumb of the same hand or of

more than two digits of any one hand or foot, the disability, in

the discretion of the director, may be compensated on the basis

of the partial loss of use of said hand or foot, measured

respectively from the wrist or ankle.

(b) (I) The general assembly finds, determines, and

declares that the rating organization that studied the impact of

the changes in Senate Bill 91-218, enacted at the first regular

session of the fifty-eighth general assembly, assumed that

scheduled injuries would remain on the schedule and

nonscheduled injuries would be compensated as medical

impairment benefits. Therefore, the general assembly finds,

determines, and declares that the purpose of changing the

provisions of subparagraph (II) of this paragraph (b), as

amended by House Bill 99-1157, enacted at the first regular

session of the sixty-second general assembly, is to clarify that

scheduled injuries shall be compensated as provided on the

schedule and nonscheduled injuries shall be compensated as

medical impairment benefits, and that, when an injured worker

sustains both scheduled and nonscheduled injuries, the losses

shall be compensated on the schedule for scheduled injuries

and the nonscheduled injuries shall be compensated as medical

impairment benefits. The general assembly further determines

and declares that mental or emotional stress shall be

compensated pursuant to section 8-41-301 (2) and shall not be

combined with a scheduled or a nonscheduled injury.

(II) Except as provided in subsection (8) of this

section, where an injury causes the loss of, loss of use of, or

partial loss of use of any member specified in the foregoing

schedule, the amount of permanent partial disability shall be

the proportionate share of the amount stated in the above

schedule for the total loss of a member, and such amount shall

be in addition to compensation for temporary disability. Where

an injury causes a loss set forth in the schedule in subsection

(2) of this section and a loss set forth for medical impairment

benefits in subsection (8) of this section, the loss set forth in

the schedule found in said subsection (2) shall be compensated

solely on the basis of such schedule and the loss set forth in

said subsection (8) shall be compensated solely on the basis for

such medical impairment benefits specified in said subsection

(8).

(III) Mental or emotional stress shall be compensated

pursuant to section 8-41-301 (2) and shall not be combined

with a scheduled or a nonscheduled injury, except for the

purposes of calculating a claimant's impairment rating to

determine the applicable cap for benefits pursuant to section 8-

42-107.5.

(8) Medical impairment benefits - determination

of MMI for scheduled and nonscheduled injuries.

(a) When an injury results in permanent medical impairment

not set forth in the schedule in subsection (2) of this section,

the employee shall be limited to medical impairment benefits

calculated as provided in this subsection (8). The procedures

for determination of maximum medical improvement set forth

in paragraph (b) of this subsection (8) shall be available in

cases of injuries set forth in the schedule in subsection (2) of

this section and also in cases of injuries that are not set forth in

said schedule.

(b) (I) An authorized treating physician shall make a

determination as to when the injured employee reaches

maximum medical improvement as defined in section 8-40-

201 (11.5).

(II) If either party disputes a determination by an

authorized treating physician on the question of whether the

injured worker has or has not reached maximum medical

improvement, an independent medical examiner may be

selected in accordance with section 8-42-107.2; except that, if

an authorized treating physician has not determined that the

employee has reached maximum medical improvement, the

employer or insurer may only request the selection of an

independent medical examiner if all of the following

conditions are met:

(A) At least twenty-four months have passed since

the date of injury;

(B) A party has requested in writing that an

authorized treating physician determine whether the employee

has reached maximum medical improvement;

determined that the employee has reached maximum medical

improvement; and

To Index

(D) A physician other than such authorized treating

physician has determined that the employee has reached

maximum medical improvement.

(III) Notwithstanding paragraph (c) of this

subsection (8), if the independent medical examiner selected

pursuant to subparagraph (II) of this paragraph (b) finds that

the injured worker has reached maximum medical

improvement, the independent medical examiner shall also

determine the injured worker's permanent medical impairment

rating. The finding regarding maximum medical improvement

and permanent medical impairment of an independent medical

examiner in a dispute arising under subparagraph (II) of this

paragraph (b) may be overcome only by clear and convincing

evidence. A hearing on this matter shall not take place until the

finding of the independent medical examiner has been filed

with the division.

(b.5) When an authorized treating physician

providing primary care who is not accredited under the level II

accreditation program pursuant to section 8-42-101 (3.5)

makes a determination that an employee has reached

maximum medical improvement, the following procedures

shall apply:

(I) (A) If the employee is not a state resident upon

reaching maximum medical improvement, such physician

shall, within twenty days after the determination of maximum

medical improvement, determine whether the employee has

sustained any permanent impairment. If the employee has

sustained any permanent impairment, such physician shall

conduct such tests as are required by the revised third edition

of the "American Medical Association Guides to the

Evaluation of Permanent Impairment" to determine such

employee's medical impairment rating and shall transmit to the

self-insured employer or insurer all test results and all relevant

medical information.

(B) However, if the employee chooses not to have

the authorized treating physician perform such tests, or if the

information is not transmitted in a timely manner, the self-

insured employer or insurer shall arrange and pay for the

employee to return to Colorado for examination, testing, and

rating, at the expense of the self-insured employer or insurer.

If the employee refuses to return to Colorado for examination,

no permanent disability benefits shall be awarded.

within twenty days after receipt of the medical information

described in sub-subparagraph (A) of this subparagraph (I),

appoint a level II accredited physician to determine the

employee's medical impairment rating. If the employee was

treated by an authorized level II accredited physician in

Colorado for the same injury for which a medical impairment

rating is being sought, the self-insured employer or insurer

shall request such physician to determine the claimant's

medical impairment rating. At the same time as such rating is

transmitted to the self-insured employer or insurer, the level II

physician shall transmit a copy of the same to the authorized

treating physician and the employee.

(D) If the employee, insurer, or self-insured

employer disputes a medical impairment rating, including a

finding that there is no medical impairment, made pursuant to

sub-subparagraph (A) of this subparagraph (I), the parties to

the dispute may select an independent medical examiner in

accordance with section 8-42-107.2 to review the rating. The

cost of such independent medical examination shall be borne

by the requesting party. The finding of such independent

medical examiner shall be overcome only by clear and

convincing evidence. Any review by an independent medical

examiner shall be based on the employee's written medical

records only, without further examination, unless a party to the

dispute requests that such review include a physical

examination by the independent medical examiner. Except

when the provisions of section 8-42-107.2 (5)(b) apply, the

party requesting a physical examination shall pay all additional

costs, including, if applicable, the reasonable cost of returning

the employee to Colorado.

(II) If the employee is a state resident, such physician

shall, within twenty days after the determination of maximum

medical improvement, determine whether the employee has

sustained any permanent impairment. If the employee has

sustained any permanent impairment, such physician shall

refer such employee to a level II accredited physician for a

medical impairment rating, which shall be based on the revised

third edition of the "American Medical Association Guides to

the Evaluation of Permanent Impairment". If the referral is not

timely made by the authorized treating physician, the insurer

or self-insured employer shall refer the employee to a level II

accredited physician within forty days after the determination

of maximum medical improvement. If the employee, insurer,

or self-insured employer disputes the finding regarding

permanent medical impairment, including a finding that there

is no permanent medical impairment, the parties to the dispute

may select an independent medical examiner in accordance

with section 8-42-107.2. The finding of any such independent

medical examiner shall be overcome only by clear and

convincing evidence.

medical improvement has been determined pursuant to

subparagraph (I) of paragraph (b) of this subsection (8), and

there is a determination that permanent medical impairment

has resulted from the injury, the authorized treating physician

shall determine a medical impairment rating as a percentage of

the whole person based on the revised third edition of the

"American Medical Association Guides to the Evaluation of

Permanent Impairment", in effect as of July 1, 1991. Except

for a determination by the authorized treating physician

providing primary care that no permanent medical impairment

has resulted from the injury, any physician who determines a

medical impairment rating shall have received accreditation

under the level II accreditation program pursuant to section 8-

42-101. For purposes of determining levels of medical

impairment, the physician shall not render a medical

impairment rating based on chronic pain without anatomic or

physiologic correlation. Anatomic correlation must be based

on objective findings. If either party disputes the authorized

treating physician's finding of medical impairment, including

a finding that there is no permanent medical impairment, the

parties may select an independent medical examiner in

accordance with section 8-42-107.2. The finding of the

independent medical examiner may be overcome only by clear

and convincing evidence. A hearing on this matter shall not

take place until the finding of the independent medical

examiner has been filed with the division.

To Index

(c.5) When an injury results in the total loss or total

loss of use of an arm at the shoulder, a forearm at the elbow, a

hand at the wrist, a leg at the hip or so near thereto as to

preclude the use of an artificial limb, the loss of a leg at or

above the knee where the stump remains sufficient to permit

the use of an artificial limb, a foot at the ankle, an eye, or a

combination of any such losses, the benefits for such loss shall

be determined pursuant to this subsection (8).

(d) Medical impairment benefits shall be determined

by multiplying the medical impairment rating determined

pursuant to paragraph (c) of this subsection (8) by the age

factor determined pursuant to paragraph (e) of this subsection

(8) and by four hundred weeks and shall be calculated at the

temporary total disability rate specified in section 8-42-105.

Up to ten thousand dollars of the total amount of any such

award or scheduled award shall be automatically paid in a

lump sum less the discount as calculated in section 8-43-406

upon the injured employee's written request to the employer

or, if insured, to the employer's insurance carrier. The

remaining periodic payments of any such award, after

subtracting the total amount of the lump sum requested by the

employee without subtracting the discount calculated in

section 8-43-406, shall be paid at the temporary total disability

rate but not less than one hundred fifty dollars per week and

not more than fifty percent of the state average weekly wage,

beginning on the date of maximum medical improvement.

(e) The age factor for use in calculating medical

impairment benefits pursuant to this subsection (8) is as

follows:

AGE

FACTOR

AGE

FACTOR

20 or younger

1.80

1.40

1.78

1.38

1.76

1.36

1.74

1.34

1.72

1.32

1.70

1.30

1.68

1.28

1.66

1.26

1.64

1.24

1.62

1.22

1.60

1.20

1.58

1.18

1.56

1.16

1.54

1.14

1.52

1.12

1.50

1.10

1.48

1.08

1.46

1.06

1.44

1.04

1.42

1.02

60 or older

1.00

(f) In all claims in which an authorized treating

physician recommends medical benefits after maximum

medical improvement, and there is no contrary medical

opinion in the record, the employer shall, in a final admission

of liability, admit liability for related reasonable and necessary

medical benefits by an authorized treating physician.

8-42-107.2. Selection of independent medical

examiner - procedure - time - disclosures regarding

physician relationships with insurers, self-insured

employers, or claimants - rules - applicability. (1) This

section governs the selection of an independent medical

examiner, also referred to in this section as an "IME", to

resolve disputes arising under section 8-42-107.

(2) (a) (I) Except as otherwise provided in

subparagraph (II) of this paragraph (a), the time for selection

of an IME commences as follows, depending on which party

initiates the dispute:

(A) For the claimant, the time for selection of an IME

commences with the date of mailing of a final admission of

liability by the insurer or self-insured employer that includes

an impairment rating issued in accordance with section 8-42-

107.

(B) For the insurer or self-insured employer, the time

for selection of an IME commences with the date on which the

disputed finding or determination is mailed or physically

delivered to the insurer or self-insured employer.

(II) If, as of the date on which the time for selection

of an IME would otherwise commence, a medical condition is

not yet ratable because of a provision in the medical treatment

guidelines or in the revised third edition of the "American

Medical Association Guides to the Evaluation of Permanent

Impairment", the time for selection of an IME shall commence

on the date on which an impairment rating is mailed or

physically delivered.

(b) If any party disputes a finding or determination

of the authorized treating physician, such party shall request

the selection of an IME. The requesting party shall notify all

other parties in writing of the request, on a form prescribed by

the division by rule, and shall propose one or more acceptable

candidates for the purpose of entering into negotiations for the

selection of an IME. Such notice and proposal is effective upon

mailing via United States mail, first-class postage paid,

addressed to the division and to the last-known address of each

of the other parties. Unless such notice and proposal are given

within thirty days after the date of mailing of the final

admission of liability or the date of mailing or delivery of the

disputed finding or determination, as applicable pursuant to

paragraph (a) of this subsection (2), the authorized treating

physician's findings and determinations shall be binding on all

parties and on the division.

IME and the examination is conducted before the insurer or

self-insured employer admits liability pursuant to section 8-43-

203 (2)(b), the claimant may not request a second independent

medical examination on that issue but may appeal the IME's

decision, as set forth in section 8-43-203 (2)(b)(II).

(3) (a) Upon receiving the requesting party's notice

and proposal pursuant to subsection (2) of this section, the

other parties have until the end of the thirtieth day after the date

of mailing of such notice and proposal within which to

negotiate and select an IME. If the parties agree on an IME on

or before such thirtieth day, the requesting party shall promptly

notify the IME in writing that he or she has been selected. If,

within such time, the parties are unable to agree or the

requesting party receives no response to the notice and

proposal, the insurer or self-insured employer shall give

To Index

written notice of such fact to the division within thirty days via

United States mail, first-class postage paid. The division shall

then, within ten days after receiving such written notice, select

three physicians by a revolving selection process established

by the division from the list of physicians maintained by the

division. The division shall administer the list in such fashion

as to ensure that the names of candidates to serve as IME in

each pending case remain confidential until the IME is

selected. The director of the division shall promulgate rules to

implement the process of selecting a panel of three physicians

from which the parties may select a physician to conduct a

division independent medical examination. The selection of a

physician panel shall be based on various factors, including,

but not limited to, the designation by rule of the fields of

specialization authorized to perform independent medical

examinations for conditions listed under each medical

treatment guideline and measures to prevent the over-

utilization of physicians or specialists. The requesting party

shall have the opportunity to strike one of the three physicians

from the list, followed by the opposing party who shall then be

given the opportunity to strike one physician from the list. The

remaining IME physician shall be designated by the division

to conduct the IME. If one or neither party strikes a physician

from the list, the division shall select the physician to conduct

the IME from the remaining physicians on the list.

(b) Upon selection of the IME, the insurance carrier

shall provide to the IME and all other parties a complete copy

of all medical records in its possession pertaining to the subject

injury, postmarked or hand-delivered within fourteen days

prior to the independent medical examination. If the insurance

carrier or its representative fails to timely submit such medical

records, the claimant may request that the division cancel the

independent medical examination or the claimant may submit

all the medical records he or she has available within ten days

prior to the independent medical examination, or as otherwise

arranged by the division with the IME. If the claimant submits

medical records, the defaulting party may supplement such

records pursuant to rules of the division. This paragraph (b)

shall not be construed to prohibit an independent medical

examination from being rescheduled.

prepared according to the rules of the division and shall be

submitted to the IME and all other parties no later than seven

days prior to the independent medical examination.

(d) (I) The IME shall neither contact any of the

authorized treating physicians or any examining or reviewing

physician nor request a claimant to undergo repeat testing

when the testing results were valid and the IME has resolved

any disparity in testing results.

(II) Subparagraph (I) of this paragraph (d), as

enacted by Senate Bill 09-168, enacted in 2009, is declared to

be procedural and was intended to and shall apply to all

workers' compensation claims, regardless of the date the claim

was filed.

(3.5) (a) Prior to making a determination to strike a

physician from the list of IME physicians provided by the

division in accordance with paragraph (a) of subsection (3) of

this section, a party may request and shall be entitled to obtain

and review a summary disclosure pertaining to any business,

financial, employment, or advisory relationship between a

listed physician, or any entity affiliated with the physician, and

the insurer, self-insured employer, or claimant who is a party

to the claim. The party shall not be required to make its

determination to strike a physician from the list until he or she

has received and has had a reasonable opportunity to review

the summary disclosure.

(b) The director shall adopt rules as necessary to

implement this subsection (3.5). At a minimum, the rules shall:

(I) Require physicians to disclose the requested

business, financial, employment, or advisory relationship

information in a summarized format;

(II) Detail the form and manner in which the

summary disclosure is to be provided;

(III) Set parameters regarding the period within

which a requesting party is allowed to review the summary

disclosure prior to making a determination to strike a physician

from the list; and

(IV) Prohibit a physician who fails to disclose the

requested summarized information from conducting an

independent medical examination until he or she complies with

the request.

(4) (a) Upon receipt of the IME's report, the division

has five business days to review the report and either:

(I) Issue a notice to all parties that the division has

received the IME's report; or

(II) Notify the IME of any deficiencies in the report

by letter and send copies to all parties.

(b) Upon notification of any deficiencies identified

in the IME's report, the IME has twenty days to remedy the

deficiencies and resubmit the report. After the report has been

resubmitted, the division shall comply with paragraph (a) of

this subsection (4). If the IME fails to timely respond to the

notification of deficiencies, the division shall issue a notice

that it has received the IME's report and the insurer or self-

insured employer shall comply with paragraph (c) of this

subsection (4).

of the division's notice that it has received the IME's report, the

insurer or self-insured employer shall either file its admission

of liability pursuant to section 8-43-203 or request a hearing

before the division contesting one or more of the IME's

findings or determinations contained in such report.

(5) (a) Except as provided in paragraph (b) of this

subsection (5), the requesting party shall advance the full cost

of the independent medical examination to the IME at least ten

days before the appointed time for the examination.

(b) A claimant who has established that he or she is

indigent shall receive an independent medical examination

without having to advance the cost to the independent medical

examiner. The director of the division of workers'

compensation shall promulgate rules to establish a procedure

to determine indigence.

(6) This section was enacted by House Bill 98-1062,

as enacted at the second regular session of the sixty-first

general assembly, as a remedial statute and is procedural in

nature. The purpose of this section is to improve and simplify

remedies already existing for the enforcement of rights and the

redress of injuries under the workers' compensation laws of

Colorado. This section effected procedures related to the

selection of an IME and shall be applicable to all open cases

To Index

with a date of injury on or after July 1, 1991, for which a

division IME has not been requested, pursuant to section 8-42-

107.

8-42-107.5. Limits on temporary disability

payments and permanent partial disability payments. No

claimant whose impairment rating is twenty-five percent or

less may receive more than seventy-five thousand dollars from

combined temporary disability payments and permanent

partial disability payments. No claimant whose impairment

rating is greater than twenty-five percent may receive more

than one hundred fifty thousand dollars from combined

temporary disability payments and permanent partial disability

payments. For the purposes of this section, any mental

impairment rating shall be combined with the physical

impairment rating to establish a claimant's impairment rating

for determining the applicable cap. For injuries sustained on

and after January 1, 2012, the director shall adjust these limits

on the amount of compensation for combined temporary

disability payments and permanent partial disability payments

on July 1, 2011, and each July 1 thereafter, by the percentage

of adjustment made by the director to the state average weekly

wage pursuant to section 8-47-106.

8-42-107.6. Premium dividend for employing

injured employees. The commissioner of insurance shall

include within the premium dividends specified in rules and

regulations promulgated pursuant to section 10-4-408 (5),

C.R.S., a premium dividend of up to ten percent if an employer

reemploys injured employees at their preinjury wages

including any wage increases to which such employees would

have been entitled had the employee not been injured. The total

amount of the premium dividend shall be determined on a pro

rata basis, taking into account the total number of employees

injured during the period of time the insurance policy was in

effect and the total number of injured employees who have

sustained permanent partial disability as a result of their

injuries and who have been rehired by such employer.

8-42-108. Disfigurement - additional

compensation. (1) If an employee is seriously, permanently

disfigured about the head, face, or parts of the body normally

exposed to public view, in addition to all other compensation

benefits provided in this article and except as provided in

subsection (2) of this section, the director may allow

compensation not to exceed four thousand dollars to the

employee who suffers such disfigurement.

(2) If an employee sustains any of the following

disfigurements, the director may allow up to eight thousand

dollars as compensation to the employee in addition to all other

compensation benefits provided in this article other than

compensation allowed under subsection (1) of this section:

(a) Extensive facial scars or facial burn scars;

(b) Extensive body scars or burn scars; or

(3) The director shall adjust the limits on the amount

of compensation for disfigurement specified in this section on

July 1, 2008, and each July 1 thereafter by the percentage of

adjustment made by the director to the state average weekly

wage pursuant to section 8-47-106.

8-42-109. Added compensation for additional

injuries. Where an injured employee sustains an injury

covered by sections 8-42-107, 8-42-108, and 8-46-101 but in

addition thereto receives other injuries which are sufficient in

their nature to alone cause temporary total disability, said

employee shall receive, in addition to the amounts specified in

said schedule, compensation for temporary total disability as

long as said disability is found to exist as a result of said other

injuries.

8-42-110. Permanent partial disability - how

determined. (Repealed)

8-42-111. Award for permanent total

disability. (1) In cases of permanent total disability, the award

shall be sixty-six and two-thirds percent of the average weekly

wages of the injured employee and shall continue until death

of such person so totally disabled but not in excess of the

weekly maximum benefits specified in this article for injuries

causing temporary total disability.

(2) (Deleted by amendment, L. 91, p. 1313, § 19,

effective July 1, 1991.)

(3) A disabled employee capable of rehabilitation

which would enable the employee to earn any wages in the

same or other employment, who refuses an offer of

employment by the same or other employer or an offer of

vocational rehabilitation paid for by the employer shall not be

awarded permanent total disability.

(4) For injuries occurring on and after July 1, 1991,

and before July 1, 1994, the average weekly wage of injured

employees used for computing compensation paid for awards

pursuant to subsection (1) of this section shall be increased by

two percent per year effective July 1 of each year, and such

increased compensation shall be payable for the subsequent

twelve months.

(5) Repealed.

8-42-112. Acts of employees reducing

compensation. (1) The compensation provided for in articles

40 to 47 of this title shall be reduced fifty percent:

(a) Where injury is caused by the willful failure of

the employee to use safety devices provided by the employer;

(b) Where injury results from the employee's willful

failure to obey any reasonable rule adopted by the employer

for the safety of the employee; or

effective July 1, 1999.)

(d) Where the employee willfully misleads an

employer concerning the employee's physical ability to

perform the job, and the employee is subsequently injured on

the job as a result of the physical ability about which the

employee willfully misled the employer. Notwithstanding any

other provisions of articles 40 to 47 of this title, the provisions

of this paragraph (d) shall apply in addition to any other

penalty that may be imposed under section 8-43-402.

(2) In the event the claimant or dependent is

receiving periodic disability benefits for which a reduction in

Colorado workers' compensation benefits has been made

pursuant to section 8-42-103, the fifty percent reduction

provided for in subsection (1) of this section shall be computed

according to the rate of benefits received by the claimant or

dependent after, and not before, such other reduction has been

made.

(3) An admission of liability reducing compensation

under this section must include a statement by a representative

To Index

of the employer listing the specific facts on which the

reduction is based.

(4) If the insurer or self-insured employer admits

liability for the claim, any party may request an expedited

hearing on the issue of whether the employer or insurer may

reduce compensation under this section if the application for

hearing is filed within forty-five days after the date of the

admission reducing compensation under this section. The

director shall set any expedited matter for hearing within sixty

days after the date of the application. The time schedule for an

expedited hearing is subject to the extensions set forth in

section 8-43-209. If the party elects not to request an expedited

hearing under this subsection (4), the time schedule for hearing

the matter is as set forth in section 8-43-209.

(5) Nothing in this section limits the right of a party

to submit evidence at a hearing scheduled under this section or

section 8-43-209.

(6) Nothing in this section precludes a party from

requesting a hearing pursuant to the time schedule set forth in

section 8-43-209.

8-42-112.5. Limitation on payments - use of

controlled substances. (1) Nonmedical benefits otherwise

payable to an injured worker are reduced fifty percent where

the injury results from the presence in the worker's system,

during working hours, of controlled substances, as defined in

section 18-18-102 (5), C.R.S., that are not medically

prescribed or of a blood alcohol level at or above 0.10 percent,

or at or above an applicable lower level as set forth by federal

statute or regulation, as evidenced by a forensic drug or alcohol

test conducted by a medical facility or laboratory licensed or

certified to conduct such tests. A duplicate sample from any

test conducted must be preserved and made available to the

worker for purposes of a second test to be conducted at the

worker's expense. If the test indicates the presence of such

substances or of alcohol at such level, it is presumed that the

employee was intoxicated and that the injury was due to the

intoxication. This presumption may be overcome by clear and

convincing evidence.

(2) As used in this section, "nonmedical benefits"

means all benefits provided for in articles 40 to 47 of this title

other than disbursements for medical, surgical, nursing, and

hospital services, apparatus, and supplies.

8-42-113. Limitations on payments to prisoners -

incentives to sheriffs and department of

corrections. (1) Notwithstanding any other provision of law

to the contrary except as provided in subsection (4) of this

section, any individual who is otherwise entitled to benefits

under articles 40 to 47 of this title shall neither receive nor be

entitled to such benefits for any week following conviction

during which such individual is confined in a jail, prison, or

any department of corrections facility.

(1.5) (a) In the event the identifying information

transmitted to the department of labor and employment

pursuant to section 17-26-118.5 (2), C.R.S., results in the

termination of workers' compensation benefits pursuant to

subsection (1) of this section, the employer or the insurance

carrier, if any, shall pay to the sheriff a reward equal to ten

percent of one week's benefit to which the ineligible individual

would otherwise be eligible to receive.

(b) An individual who is ineligible pursuant to

subsection (1) of this section shall repay to the employer or the

insurance carrier, if any, any amounts received while not

eligible.

(2) After such individual's release from confinement,

the individual shall be restored to the same position with

respect to entitlement to benefits under articles 40 to 47 of this

title as said individual would otherwise have enjoyed at the

point in time of such release from confinement. However,

except as provided in subsection (3) of this section, said

individual shall not be able to recover, recoup, or otherwise be

retroactively entitled to any of the benefits to which the

individual would have been entitled without the limitation

specified in subsection (1) of this section.

(3) If upon appeal such conviction is overturned,

such individual shall be entitled to recover the benefits to

which such individual would have been entitled except for the

operation of subsection (1) of this section.

(4) This section shall not apply to benefits under

articles 40 to 47 of this title to which an inmate of a department

of corrections facility or a city, county, or city and county jail

is entitled for injury or occupational disease arising out of and

in the course of the inmate working, performing services, or

participating in a training, rehabilitation, or work release

program that has been certified by the federal prison industry

enhancement certification program pursuant to the federal

"Justice System Improvement Act of 1979", 18 U.S.C. sec.

1761 (c). The inmate shall be entitled to benefits in accordance

with section 8-40-301 (3)(a).

8-42-113.5. Recovery of overpayments - notice

required. (1) If a claimant has received an award for the

payment of disability benefits or a death benefit under articles

40 to 47 of this title and also receives any payment, award, or

entitlement to benefits under the federal old-age, survivors,

and disability insurance act, an employer-paid retirement

benefit plan, or any other plan, program, or source for which

the original disability benefits or death benefit is required to be

reduced pursuant to said articles, but which were not reflected

in the calculation of such disability benefits or death benefit:

(a) Within twenty calendar days after learning of

such payment, award, or entitlement, the claimant, or the legal

representative of a claimant who is a minor, shall give written

notice of the payment, award, or entitlement to the employer

or, if the employer is insured, to the employer's insurer. If the

claimant or legal representative gives such notice, any

overpayment that resulted from the failure to make the

appropriate reduction in the original calculation of such

disability benefits or death benefit shall be recovered by the

employer or insurer in installments at the same rate as, or a

lower rate than, the rate at which the overpayments were made.

Such recovery shall reduce the disability benefits or death

benefit payable after all other applicable reductions have been

made.

(b) If the claimant or legal representative of a

claimant who is a minor was receiving benefits in excess of the

amounts that should have been paid under articles 40 to 47 of

this title and failed to give the notice required by paragraph (a)

of this subsection (1), the employer or insurer is authorized to

cease all disability or death benefit payments immediately until

the overpayments have been recovered in full.

To Index

(b.5) (I) After the filing of a final admission of

liability, except in cases of fraud, any attempt to recover an

overpayment shall be asserted within one year after the time

the requester knew of the existence of the overpayment.

(II) Subparagraph (I) of this paragraph (b.5), as

enacted by Senate Bill 09-168, enacted in 2009, is declared to

be procedural and was intended to and shall apply to all

workers' compensation claims, regardless of the date the claim

was filed.

contemplated in paragraph (a) or (b) of this subsection (1) is

not practicable, the employer or insurer is authorized to seek

an order for repayment.

(d) When an overpayment is repaid to the insurer, the

insurer shall credit the losses on the claim and report the

corrected losses to the insurance rating organization on the

next scheduled report for purposes of the employer's

experience modification.

8-42-114. Death benefits. In case of death, the

dependents of the deceased entitled thereto shall receive as

compensation or death benefits sixty-six and two-thirds

percent of the deceased employee's average weekly wages, not

to exceed a maximum of ninety-one percent of the state

average weekly wage per week for accidents occurring on or

after July 1, 1989, and not less than a minimum of twenty-five

percent of the applicable maximum per week. In cases where

it is determined that periodic death benefits granted by the

federal old age, survivors, and disability insurance act or a

workers' compensation act of another state or of the federal

government are payable to an individual and the individual's

dependents, the aggregate benefits payable for death pursuant

to this section shall be reduced, but not below zero, by an

amount equal to fifty percent of such periodic benefits.

8-42-115. Death from injury - benefits. (1) In case

death proximately results from the injury, the benefits shall be

in the amount and to the persons following:

(a) If there are no dependents, compensation shall be

limited to the expenses provided for medical, hospital, and

funeral expense of the deceased, together with such sums as

may have accrued or been paid to the deceased during the

deceased's lifetime for disability, and any amount or payment

which is due under section 8-46-101.

(b) If there are wholly dependent persons at the time

of death, the payment shall be in accordance with the

provisions of section 8-42-114.

of death, the payment shall not exceed sixty-six and two-thirds

percent of the average weekly wages, subject to the limitations

of articles 40 to 47 of this title as to maximum and minimum

weekly amounts, to continue for such period after the date of

death as is required to pay, at the weekly rate, the total amount

awarded by the director to be paid to such partially dependent

persons.

8-42-116. When death not proximate result -

benefits. (1) If death occurs to an injured employee, other

than as a proximate result of any injury, before disability

indemnity ceases and the deceased leaves persons wholly

dependent upon the deceased for support, death benefits shall

be as follows:

(a) Where the injury proximately caused permanent

total disability, the death benefit shall consist of the unpaid and

unaccrued portion of the permanent total disability benefit

which the employee would have received had the employee

lived until receiving compensation at the employee's regular

rate for a period of six years.

(b) Where the injury proximately caused permanent

partial disability, the death benefit shall consist of the unpaid

and unaccrued portion of the permanent partial disability

benefit which the employee would have received had he lived.

8-42-117. Benefits to partial dependents. (1) If

death occurs to an injured employee, other than as a proximate

result of the injury, before disability indemnity ceases and the

deceased leaves persons partially dependent upon the deceased

for support, death benefits shall be as follows:

(a) Where the injury proximately caused permanent

total disability, the death benefit shall consist of that proportion

of the unpaid and unaccrued portion of the permanent total

disability benefit which the employee would have received had

the employee lived until said employee had received

compensation at the employee's regular rate for a period of six

years as the amount devoted by the deceased to the support of

such persons for the year immediately prior to the injury bears

to the total income of the persons during said year.

(b) Where the injury caused permanent partial

disability, the death benefit shall consist of that proportion of

the unpaid and unaccrued portion of the permanent partial

disability benefit which the employee would have received if

the employee had lived as the amount devoted by the deceased

to the support of such persons for the year immediately prior

to the injury bears to the total income of the persons during

said year.

8-42-118. Applicability of repeal of death benefits

to nonresident dependents. The repeal of section 8-50-114,

as said section existed prior to July 1, 1983, shall not affect the

payments of death benefits which are being paid before July 1,

1983.

8-42-119. Partial dependents -

compensation. Partial dependents shall be entitled to receive

only that portion of the benefits provided for those wholly

dependent which the average amount of the wages regularly

contributed by the deceased to such partial dependents at and

for a reasonable time immediately prior to the injury bore to

the total income of the dependents during the same time. The

director has power and discretion to determine the proper

elements to be considered as income of said dependents in each

particular case. Where there are persons both wholly

dependent and partially dependent, only those wholly

dependent shall be entitled to compensation.

8-42-120. Termination of right to benefits. Death

benefits shall be paid to a dependent widow or widower for life

or until remarriage, and, if there are no dependent children, as

defined in section 8-41-501 (1)(b) and (1)(c), at the time of

remarriage, a two-year lump-sum benefit without discount,

less any lump sums previously paid, shall be paid to such

widow or widower. Death benefits shall terminate upon the

happening of any of the following contingencies and shall

thereupon survive to the remaining dependents, if any: Upon

the death of any dependent; when a child or brother or sister of

the deceased reaches the age of eighteen years, except as

To Index

otherwise provided in sections 8-41-501 (1)(b) and (1)(c) and

8-41-502; and upon the expiration of six years from the date of

the death of the injured employee in the case of partial

dependents.

8-42-121. Director to determine and apportion

benefits. Death benefits shall be paid to such one or more of

the dependents of the decedent, for the benefit of all the

dependents entitled to such compensation, as may be

determined by the director, who may apportion the benefits

among such dependents in such manner as the director may

deem just and equitable. Payment to a dependent subsequent

in right may be made, if the director deems it proper, which

payment shall operate to discharge all other claims therefor.

The dependents or persons to whom benefits are paid shall

apply the same to the use of the several beneficiaries thereof

according to their respective claims upon the decedent for

support in compliance with the finding and direction of the

director.

8-42-122. Minor dependents - safeguarding

payments. In all cases of death where the dependents are

minor children, it shall be sufficient for the surviving spouse

or a friend to make application and claim on behalf of the

minor children. The director, for the purpose of protecting the

rights and interests of any dependents whom the director

deems incapable of fully protecting their own interests, may

deposit the payments in any type of account in state or national

banks insured by the federal deposit insurance corporation or

its successor, savings and loan associations that are insured by

the federal deposit insurance corporation or its successor, or

credit unions that are insured by the national credit union share

insurance fund and may otherwise provide for the manner and

method of safeguarding the payments due such dependents in

such manner as the director sees fit.

8-42-123. Burial expenses. When, as a proximate

result of an injury, death occurs to an injured employee, there

shall be paid in one lump sum within thirty days after death a

sum not to exceed seven thousand dollars for reasonable

funeral and burial expenses. Said sum may be paid to the

undertaker, cemetery, or any other person who has paid the

funeral and burial costs, if the director so orders. If the

employee leaves no dependents, compensation shall be limited

to said sum and the compensation, if any, which has accrued

to date of death and the medical, surgical, and hospital

expenses provided in articles 40 to 47 of this title. If the

deceased employee leaves dependents, said sum shall be paid

in addition to all other sums of compensation provided for in

this article.

8-42-124. Assignability and exemption of claims -

payment to employers - when. (1) Except for amounts due

under court-ordered support or for a judgment for a debt for

fraudulently obtained public assistance, fraudulently obtained

overpayments of public assistance, or excess public assistance

paid for which the recipient was ineligible, claims for

compensation or benefits due, or any proceeds thereof, under

articles 40 to 47 of this title shall not be assigned, released, or

commuted except as provided in said articles and shall be

exempt from all claims of creditors and from levy, execution,

and attachment or other remedy or recovery or collection of a

debt, which exemption may not be waived.

(2) The power given in any power of attorney or

other authority from any injured employee or the dependents

of any killed employee purporting to authorize any other

person to receive, be paid, or receipt for any compensation

benefits awarded any such claimant shall be wholly void and

illegal and of no force and effect; except that:

(a) Any employer who is subject to the provisions of

articles 40 to 47 of this title and who, by separate agreement,

working agreement, contract of hire, or any other procedure,

continues to pay a sum in excess of the temporary total

disability benefits prescribed by articles 40 to 47 of this title to

any employee temporarily disabled as a result of any injury

arising out of and in the course of such employee's

employment and has not charged the employee with any

earned vacation leave, sick leave, or other similar benefits shall

be reimbursed if insured by an insurance carrier or shall take

credit if self-insured to the extent of all moneys that such

employee may be eligible to receive as compensation or

benefits for temporary partial or temporary total disability

under the provisions of said articles, subject to the approval of

the director. If the employee is injured while under a fixed

duration contract of employment, all salary and wages paid

pursuant to that contract shall be prorated over the duration of

the contract in determining whether in any given week the

employer paid a sum in excess of the temporary total disability

benefit.

(b) This subsection (2) shall not apply to an attorney

licensed to practice law in this state and acting in accordance

with a power of attorney given by the claimant solely for the

purpose of distributing funds pursuant to an admission of

liability or an order of the division.

(3) Such payments shall be paid directly to the

employer during the period of time that such employer

continues to pay a sum in excess of the temporary total

disability benefits prescribed by articles 40 to 47 of this title

and has not charged any earned vacation leave, sick leave, or

other similar benefits to any employee so disabled and for so

long as such employee is eligible for temporary disability

benefits under the provisions of articles 40 to 47 of this title.

The payment of such moneys to an employer shall constitute

the payment of compensation or benefits to the employee in

accordance with the provisions of section 8-42-103.

(4) When the payment by an employer to any such

disabled employee is reduced to a sum equal to or less than the

temporary total disability benefits prescribed by articles 40 to

47 of this title, or when the employer has charged the employee

with any earned vacation leave, sick leave, or other similar

benefits for any reason, the rights of the employee to receive

direct payment of any award for temporary partial or

temporary total disability that said employee may be entitled

to on and after the effective date of such reduction shall be

reinstated in accordance with the provisions of articles 40 to

47 of this title.

(5) Any employer subject to the provisions of articles

40 to 47 of this title and otherwise qualifying for direct

payment of employee benefits as provided in this section shall

notify the division and the insurance carrier of such employer's

eligibility to receive such moneys. The director shall approve

such direct payment after the filing of such information by the

employer as the director may require.

To Index

(6) Nothing in this section shall be construed to limit

in any way the right of any employee to full payment of any

award which may be granted to said employee for permanent

partial or permanent total disability under the provisions of

articles 40 to 47 of this title; except that benefits for permanent

total disability and permanent partial disability shall be subject

to wage assignment or income assignment as wages pursuant

to section 14-14-102 (9), C.R.S., and subject to garnishment as

earnings pursuant to section 13-54.5-101 (2)(b), C.R.S., and

subject to administrative lien and attachment pursuant to

section 26-13-122, C.R.S., for purposes of enforcement of

court-ordered child support and subject to garnishment as

earnings pursuant to sections 13-54-104 (1)(b)(IV) and 13-

54.5-101 (2)(d), C.R.S., for purposes of enforcement of a

judgment for a debt for fraudulently obtained public

assistance, fraudulently obtained overpayments of public

assistance, or excess public assistance paid for which the

recipient was ineligible.

(7) Following an injury, any injured employee may

authorize in writing the continuation of any payroll deduction

which the employee had authorized or could have authorized

before the injury, which authorization shall be legal and may

be honored by the employer to the extent that proceeds of

compensation of claims are available to the employer or are

made available to the employer by the employer's insurance

carrier for this purpose until the authorization is revoked in

writing by the injured employee.

(8) If any employer who pays to an injured employee

a sum in excess of the temporary total disability benefits

prescribed by articles 40 to 47 of this title and who has not

charged the employee with any earned vacation leave, sick

leave, or other similar benefits seeks to have assigned the

compensation benefits otherwise due the injured employee as

provided in this section, the employer shall notify the

employee of said request at the same time the employer makes

the request of the director or insurance carrier or both.

8-42-125. Data gathering on workers'

compensation system. The governor and the leader of the

opposing party in the house of representatives and the leader

of the opposing party in the senate shall contract with a person

or entity for obtaining information on the workers'

compensation system. The person or entity gathering the

information shall work solely at the unanimous direction of the

governor and the opposition leadership. Issues or topics that

will be subject to the information gathering process shall be

determined by unanimous decision of the governor and the

opposition leadership. The contractor for the gathering of the

information shall have complete access to all records of and

files in the division of workers' compensation and the office of

administrative courts. Such contractor shall guarantee that any

information gathered on any individual shall be kept

confidential.

ARTICLE 43

Procedure

PART 1

NOTICES AND REPORTS

8-43-101. Record of injuries - occupational

disease - reported to division - rules. (1) Every employer

shall keep a record of all injuries that result in fatality to, or

permanent physical impairment of, or lost time from work for

the injured employee in excess of three shifts or calendar days

and the contraction by an employee of an occupational disease

that has been listed by the director by rule. Within ten days

after notice or knowledge that an employee has contracted

such an occupational disease, or the occurrence of a

permanently physically impairing injury, or lost-time injury to

an employee, or immediately in the case of a fatality, the

employer shall, upon forms prescribed by the division for that

purpose, report said occupational disease, permanently

physically impairing injury, lost-time injury, or fatality to the

division. The report shall contain such information as shall be

required by the director.

(2) Unless exempted by the director pursuant to rule

because of a small number of filings or a showing of financial

hardship, beginning July 1, 2006, reports submitted pursuant

to this section shall be submitted in an electronic format as

determined by the director. Exposure to an injurious substance

as defined by the director by rule and injuries to employees

that result in no more than three days' or three shifts' loss of

time from work, or no permanent physical impairment, or no

fatality to the employee shall be reported by the employer only

to the insurer of said employer's workers' compensation

insurance liability, which injuries and exposure the insurer

shall report only by monthly summary form to or as otherwise

requested by the division.

8-43-102. Notice to employer of injury - notice to

employees of requirement - failure to report. (1) (a) Every

employee who sustains an injury resulting from an accident

shall notify said employee's employer in writing of the injury

within four days of the occurrence of the injury. If the

employee is physically or mentally unable to provide said

notice, the employee's foreman, superintendent, manager, or

any other person in charge who has notice of said injury shall

submit such written notice to the employer. Any other person

who has notice of said injury may submit a written notice to

the said person in charge or to the employer, and in that event

the injured employee shall be relieved of the obligation to give

such notice. Otherwise, if said employee fails to report said

injury in writing, said employee may lose up to one day's

compensation for each day's failure to so report. If, at the time

of said injury, the employer has failed to display the notice

specified in paragraph (b) of this subsection (1), the time

period allotted to the employee shall be tolled for the duration

of such failure.

(b) Every employer shall display at all times in a

prominent place on the workplace premises a printed card with

a minimum height of fourteen inches and a width of eleven

inches with each letter to be a minimum of one-half inch in

height, which shall read as follows:

To Index

WARNING

IF YOU ARE INJURED ON THE JOB,

WRITTEN NOTICE OF YOUR

INJURY MUST BE GIVEN TO YOUR

EMPLOYER WITHIN FOUR

WORKING DAYS AFTER THE

ACCIDENT, PURSUANT TO SECTION

8-43-102 (1), COLORADO REVISED

STATUTES.

IF THE INJURY RESULTS FROM

YOUR USE OF ALCOHOL OR

CONTROLLED SUBSTANCES, YOUR

WORKERS' COMPENSATION

DISABILITY BENEFITS MAY BE

REDUCED BY ONE-HALF IN

ACCORDANCE WITH SECTION 8-42-

112.5, COLORADO REVISED

STATUTES.

(1.5) (a) Every employee of an employer who has

permission to be its own insurance carrier pursuant to section

8-44-201 or of an employer who participates in a public entity

self-insurance pool pursuant to section 8-44-204 who sustains

an injury resulting from an accident shall notify his employer

in writing of said injury within four working days of the

occurrence of the injury, unless the employer, or the

employee's foreman, superintendent, or manager has written

notice of said injury. If the employee is physically or mentally

unable to provide said notice, the employee's foreman,

superintendent, or manager, or any other person in charge who

has written notice of said injury, shall submit such written

notice to the employer. If said employee fails to report said

injury in writing, such employee may lose up to one day's

compensation for each day's failure to so report. Any other

person who has notice of said injury may submit a written

notice to the employer which report shall relieve the injured

employee from reporting the accident. Any employer receiving

written notice of an injury pursuant to this subsection (1.5)

shall affix thereon the date and time of receipt of such notice

and shall make a copy of such notice available to the injured

employee within two working days following receipt of such

notice.

(b) Every employer who has permission to be its own

insurance carrier pursuant to section 8-44-201 or who

participates in a public entity self-insurance pool pursuant to

section 8-44-204 shall display at all times in a prominent place

on the workplace premises a printed card with a minimum

height of fourteen inches and a width of eleven inches with

each letter to be a minimum of one-half inch in height, which

shall read as follows:

WARNING

IF YOU ARE INJURED ON THE JOB,

WRITTEN NOTICE OF YOUR

INJURY MUST BE GIVEN TO YOUR

EMPLOYER WITHIN FOUR

WORKING DAYS AFTER THE

ACCIDENT, PURSUANT TO SECTION

8-43-102 (1.5), COLORADO REVISED

STATUTES.

IF THE INJURY RESULTS FROM

YOUR USE OF ALCOHOL OR

CONTROLLED SUBSTANCES, YOUR

WORKERS' COMPENSATION

DISABILITY BENEFITS MAY BE

REDUCED BY ONE-HALF IN

ACCORDANCE WITH SECTION 8-42-

112.5, COLORADO REVISED

STATUTES.

(2) Written notice of the contraction of an

occupational disease shall be given to the employer by the

affected employee or by someone on behalf of the affected

employee within thirty days after the first distinct

manifestation thereof. In the event of death from such

occupational disease, written notice thereof shall be given to

the employer within thirty days after such death. Failure to

give either of such notices shall be deemed waived unless

objection is made at a hearing on the claim prior to any award

or decision thereon. Actual knowledge by an employer in

whose employment an employee was last injuriously exposed

to an occupational disease of the contraction of such disease

by such employee and of exposure to the conditions causing it

shall be deemed notice of its contraction. If the notice required

in this section is not given as provided and within the time

fixed, the director may reduce the compensation that would

otherwise have been payable in such manner and to such extent

as the director deems just, reasonable, and proper under the

existing circumstances.

8-43-103. Notice of injury - time limit. (1) Notice

of an injury, for which compensation and benefits are payable,

shall be given by the employer to the division and insurance

carrier, unless the employer is self-insured, within ten days

after the injury, and, in case of the death of any employee

resulting from any such injury or any accident in which three

or more employees are injured, the employer shall give

immediate notice thereof to the director. If no such notice is

given by the employer, as required by articles 40 to 47 of this

title, such notice may be given by any person. Any notice

required to be filed by an injured employee or, if deceased, by

said employee's dependents may be made and filed by anyone

on behalf of such claimant and shall be considered as done by

such claimant if not specifically disclaimed or objected to by

such claimant in writing filed with the division within a

reasonable time. Such notice shall be in writing and upon

forms prescribed by the division for that purpose and served

upon the division by delivering to, or by mailing by registered

mail two copies thereof addressed to, the division at its office

in Denver, Colorado. Upon receipt of such notice from a

To Index

claimant, the division shall immediately mail one copy thereof

to said employer or said employer's agent or insurance carrier.

(2) The director and administrative law judges

employed by the office of administrative courts shall have

jurisdiction at all times to hear and determine and make

findings and awards on all cases of injury for which

compensation or benefits are provided by articles 40 to 47 of

this title. Except in cases of disability or death resulting from

exposure to radioactive materials, substances, or machines or

to fissionable materials, or any type of malignancy caused

thereby, or from poisoning by uranium or its compounds, or

from asbestosis, silicosis, and anthracosis, the right to

compensation and benefits provided by said articles shall be

barred unless, within two years after the injury or after death

resulting therefrom, a notice claiming compensation is filed

with the division. This limitation shall not apply to any

claimant to whom compensation has been paid or if it is

established to the satisfaction of the director within three years

after the injury or death that a reasonable excuse exists for the

failure to file such notice claiming compensation and if the

employer's rights have not been prejudiced thereby, and the

furnishing of medical, surgical, or hospital treatment by the

employer shall not be considered payment of compensation or

benefits within the meaning of this section; but, in all cases in

which the employer has been given notice of an injury and

fails, neglects, or refuses to report said injury to the division as

required by the provisions of said articles, this statute of

limitations shall not begin to run against the claim of the

injured employee or said employee's dependents in the event

of death until the required report has been filed with the

division.

(3) In cases of disability or death resulting from

exposure to radioactive materials, substances, or machines or

to fissionable materials, or any type of malignancy caused

thereby, or from poisoning by uranium or its compounds, or

from asbestosis, silicosis, or anthracosis, the right to

compensation and benefits shall be barred unless, within five

years after the commencement of disability or death, a notice

claiming compensation is filed with the division.

8-43-104. Electronic filings - rules. (1) The

rejection for technical errors by the division of any document,

form, or notice that is filed electronically shall not affect the

validity of the notice to the claimant or any other party.

(2) The director may promulgate rules concerning

electronic filing of documents, forms, or notices in accordance

with article 4 of title 24, C.R.S. Such rules shall be consistent

with any policies, standards, and guidelines set forth by the

office of information technology, created in section 24-37.5-

103, C.R.S.

PART 2

SETTLEMENT AND HEARING PROCEDURES

8-43-201. Disputes arising under "Workers'

Compensation Act of Colorado". (1) The director and

administrative law judges employed by the office of

administrative courts in the department of personnel shall have

original jurisdiction to hear and decide all matters arising

under articles 40 to 47 of this title; except that the following

principles shall apply: A claimant in a workers' compensation

claim shall have the burden of proving entitlement to benefits

by a preponderance of the evidence; the facts in a workers'

compensation case shall not be interpreted liberally in favor of

either the rights of the injured worker or the rights of the

employer; a workers' compensation case shall be decided on

its merits; and a party seeking to modify an issue determined

by a general or final admission, a summary order, or a full

order shall bear the burden of proof for any such modification.

(2) The amendments made to subsection (1) of this

section by Senate Bill 09-168, enacted in 2009, are declared to

be procedural and were intended to and shall apply to all

workers' compensation claims, regardless of the date the claim

was filed.

(3) It is appropriate for the director or an

administrative law judge to consider the medical treatment

guidelines adopted under section 8-42-101 (3) in determining

whether certain medical treatment is reasonable, necessary,

and related to an industrial injury or occupational disease. The

director or administrative law judge is not required to utilize

the medical treatment guidelines as the sole basis for such

determinations.

8-43-202. Director may refer taking of evidence in

cases to appropriate officials of other states. The director,

after notice to the parties in interest, may refer the taking of

any evidence to any commission, court, or board administering

in another state the compensation laws thereof, and such

commission, court, or board of such other state, after notifying

the parties in interest of the time and place of holding such

hearing, shall hold hearings and take such evidence in the same

manner and by the officers as authorized by the laws of such

state, and all such proceedings shall be certified and return

thereof made as prescribed by the director.

8-43-203. Notice concerning liability - notice to

claimants - notice of rights and claims process -

rules. (1) (a) The employer or, if insured, the employer's

insurance carrier shall notify in writing the division and the

injured employee or, if deceased, the decedent's dependents

within twenty days after a report is, or should have been, filed

with the division pursuant to section 8-43-101, whether

liability is admitted or contested; except that, for the purpose

of this section, any knowledge on the part of the employer, if

insured, is not knowledge on the part of the insurance carrier.

The employer or the employer's insurance carrier may notify

the division electronically. Unless exempted by the director

pursuant to rule because of a small number of filings or a

showing of financial hardship, beginning July 1, 2006, all

notices of contest shall be filed electronically. The rejection of

an electronically filed notice by the division for a technical

error shall not affect the validity of the notice to the claimant.

If the insurance carrier or self-insured employer denies liability

for the claim, the claimant may request an expedited hearing

on the issue of compensability if the application therefor is

filed within forty-five days after the date of mailing of the

notice of contest. The director shall set any such expedited

matter for hearing within sixty days after the date of the

application, when the issue is liability for the disease or injury.

The time schedule for such an expedited hearing is subject to

the extensions set forth in section 8-43-209. If a claimant elects

not to request an expedited hearing pursuant to this subsection

To Index

(1), the time schedule for hearing the matter shall be as set forth

in section 8-43-209.

(b) The written notice given pursuant to this

subsection (1) shall include a specific reference to the

claimant's obligations under section 8-42-113.5.

(1.5) (Deleted by amendment, L. 92, p. 1825, § 4,

effective April 29, 1992.)

(2) (a) If such notice is not filed as provided in

subsection (1) of this section, the employer or, if insured, the

employer's insurance carrier, as the case may be, may become

liable to the claimant, if the claimant is successful on the claim

for compensation, for up to one day's compensation for each

day's failure to so notify; except that the employer or, if

insured, the employer's insurance carrier shall not be liable for

more than the aggregate amount of three hundred sixty-five

days' compensation for failure to timely admit or deny liability.

Fifty percent of any penalty paid pursuant to this subsection

(2) shall be paid to the subsequent injury fund, created in

section 8-46-101, and fifty percent to the claimant.

(b) (I) If the employer or, if insured, the employer's

insurance carrier admits liability, such notice shall specify the

amount of compensation to be paid, to whom compensation

will be paid, the period for which compensation will be paid,

and the disability for which compensation will be paid, and

payment thereon shall be made immediately.

(II) (A) An admission of liability for final payment

of compensation must include a statement that this is the final

admission by the workers' compensation insurance carrier in

the case, that the claimant may contest this admission if the

claimant feels entitled to more compensation, to whom the

claimant should provide written objection, and notice to the

claimant that the case will be automatically closed as to the

issues admitted in the final admission if the claimant does not,

within thirty days after the date of the final admission, contest

the final admission in writing and request a hearing on any

disputed issues that are ripe for hearing, including the selection

of an independent medical examiner pursuant to section 8-42-

107.2 if an independent medical examination has not already

been conducted. If an independent medical examination is

requested pursuant to section 8-42-107.2, the claimant is not

required to file a request for hearing on disputed issues that are

ripe for hearing until the division's independent medical

examination process is terminated for any reason. Any issue

for which a hearing or an application for a hearing is pending

at the time that the final admission of liability is filed shall

proceed to the hearing without the need for the applicant to

refile an application for hearing on the issue. This information

must also be included in the admission of liability for final

payment of compensation. The respondents have twenty days

after the date of mailing of the notice from the division of the

receipt of the IME's report to file an admission or to file an

application for hearing. The claimant has thirty days after the

date respondents file the admission or application for hearing

to file an application for hearing, or a response to the

respondents' application for hearing, as applicable, on any

disputed issues that are ripe for hearing. The revised final

admission, if any, must contain the statement required by this

subparagraph (II), and the provisions relating to contesting the

revised final admission apply. When the final admission is

predicated upon medical reports, the reports must accompany

the final admission.

(B) The amendments made to sub-subparagraph (A)

of this subparagraph (II) by Senate Bill 09-168, enacted in

2009, are declared to be procedural and were intended to and

shall apply to all workers' compensation claims, regardless of

the date the claim was filed.

(2) for failure to timely admit or deny liability if a request for

such penalty is filed more than seven years after the alleged

violation. The division shall retain original claim records filed

with the division for at least seven years after closure of the

case. Seven years after a case is closed, the records may only

be used for reopening a settlement on the grounds of fraud or

mutual mistake of material fact.

(d) Once a case is closed pursuant to this subsection

(2), the issues closed may only be reopened pursuant to section

8-43-303. Upon proper showing in writing made within said

times fixed therefor, the director may extend the time for filing

such admission of liability or notice of contest, but not

exceeding ten days at any one time. Hearings may be set to

determine any matter, but, if any liability is admitted,

payments shall continue according to admitted liability.

(3) In addition to any other notice required by this

section, at the time that the employer or, if insured, the

employer's insurance carrier provides the notice required by

subsection (1) of this section, the employer or insurance carrier

shall provide to the claimant a brochure written in easily

understood language, in a form developed by the director after

consultation with employers, insurance carriers, and

representatives of injured workers, describing the claims

process and informing the claimant of his or her rights. If the

claimant has previously authorized the employer or, if insured,

the employer's insurance carrier to communicate with the

claimant through electronic transmission, the brochure may be

sent to the claimant electronically. The brochure shall, at a

minimum, contain the following information:

(a) Who the claimant may contact with questions

concerning the claim, the claims process, and assistance with

the claim, including:

(I) The insurance carrier or employer;

(II) The division and the website for the division;

(III) The office of administrative courts and the

website for the office; and

(IV) An attorney hired at the expense of the claimant;

(b) The claimant's right to receive medical care for

work-related injuries or occupational diseases paid for by the

employer or the employer's insurance carrier including:

(I) That most claimants have a right to choose from

a list of at least two different doctors;

(II) That most claimants have a right to change

doctors one time within ninety days after the injury and all

claimants have the right to request a change of doctor at other

times under certain other circumstances;

(III) The claimant's doctor's right to refer the

claimant to other medical providers and specialists to provide

the reasonable and necessary medical care that the claimant's

work-related injuries or illness require;

(IV) The claimant's right to discuss with his or her

doctor who should be present during a claimant's medical

To Index

appointment, and the right to refuse to have a nurse case

manager employed on the claimant's claim present at the

claimant's medical appointment;

(V) The claimant's right to see and have copies of all

of the claimant's medical records related to the medical care

the claimant received for his or her work-related injury or

illness;

(VI) The claimant's right to seek medical care and

medical opinions about the claimant's work-related injury at

the claimant's own expense;

(VII) The claimant's right to a medical examination

by a doctor chosen by the claimant or by the division at the

claimant's expense;

(VIII) The claimant's right to a permanent

impairment evaluation after the claimant's treating doctors

determine that the claimant has reached maximum medical

improvement; and

(IX) The claimant's right to be informed whether

medical care after maximum medical improvement will be

provided and to receive reasonable continued medical care if it

is necessary to maintain maximum medical improvement;

benefit payments, including the claimant's right to receive:

(I) Wage replacement payments in the form of

temporary total disability payments or temporary partial

disability payments;

(II) Permanent impairment benefits if the claimant is

left with a permanent impairment as a result of a work-related

injury or disease;

(III) Disfigurement payments for permanent scarring

or disfigurement caused by the claimant's work-related injury

or surgery required because of the claimant's work-related

injury; and

(IV) Mileage expenses for travel to and from work-

related medical care and to and from pharmacies to obtain

medical prescriptions for work-related medical care;

(d) A description of how the claims process works,

including:

(I) The claimant's right to file a claim for workers'

compensation with the division within two years after the date

of the claimant's injury or occupational disease;

(II) The claimant's right to receive a general

admission of liability or notice of contest once the claim has

been properly reported to the division;

(III) The claimant's right to verify that the claimant's

average weekly wage payments for temporary total disability

have been properly calculated by the claimant's employer or

the employer's insurance carrier;

(IV) The claimant's right to prehearings and hearings

on disputed issues;

(V) The claimant's right to present evidence, testify,

introduce medical and other records, present witnesses, and

make arguments at any hearing;

(VI) The claimant's right to object to and request a

hearing on any final admission of liability within thirty days

after the mailing of the admission in order to retain certain

rights;

(VII) The claimant's right to challenge a finding of

an impairment rating or maximum medical improvement in a

final admission of liability within thirty days after the mailing

of the admission in order to retain certain rights;

(VIII) The claimant's right to pursue penalties for

violations of the law including late payment of benefits or

improper refusal to pay benefits;

(IX) The claimant's right, subject to certain

requirements, to reopen a claim within six years after the date

of the injury or illness or within two years after the date of the

last receipt of medical or wage benefits; and

(X) A description of other rights conferred upon a

claimant pursuant to law or rule.

(4) Within fifteen days after the mailing of a written

request for a copy of the claim file, the employer or, if insured,

the employer's insurance carrier or third-party administrator

shall provide to the claimant or his or her representative a

complete copy of the claim file that includes all medical

records, pleadings, correspondence, investigation files,

investigation reports, witness statements, information

addressing designation of the authorized treating physician,

and wage and fringe benefit information for the twelve months

leading up to the date of injury and thereafter, regardless of the

format. If a privilege or other protection is claimed for any

materials, the materials must be detailed in an accompanying

privilege log.

8-43-204. Settlements - rules. (1) An injured

employee may settle all or part of any claim for compensation,

benefits, penalties, or interest. If such settlement provides by

its terms that the employee's claim or award shall not be

reopened, such settlement shall not be subject to being

reopened under any provisions of articles 40 to 47 of this title

other than on the ground of fraud or mutual mistake of material

fact.

(2) Such a settlement shall be in writing and shall be

signed by a representative of the employer or insurer and

signed and sworn to by the injured employee. For claims that

have a settlement amount of seventy-five thousand dollars or

more, a written notice of the settlement agreement shall be

provided to the employer.

(3) The settlement shall be reviewed in person with

the injured employee and approved in writing by an

administrative law judge or the director of the division prior to

the finalization of such settlement. The settlement shall be filed

with the division as a part of the injured employee's permanent

record.

(4) If an employee owes child support and a

garnishment has been filed pursuant to section 13-54.5-101,

C.R.S., or the state child support enforcement agency has filed

a notice of administrative lien and attachment pursuant to

section 26-13-122, C.R.S., with the insurer or self-insured

employer, all proceeds of any award, lump sum settlement, and

the indemnity portion of any structured settlement shall be

subject to said garnishment or administrative lien and

attachment. Proceeds up to the amount of the garnishment or

administrative lien and attachment shall be paid as directed on

the notice to the obligee or to the state child support

enforcement agency on behalf of the obligee to whom support

is owed.

(5) If an employee owes a debt for which a writ is

issued as a result of a judgment for fraudulently obtained

public assistance, fraudulently obtained overpayments of

To Index

public assistance, or excess public assistance paid for which

the recipient was ineligible and a garnishment has been filed

pursuant to section 13-54-104 or 13-54.5-101 with the insurer

or self-insured employer, all proceeds of any award, lump sum

settlement, and the indemnity portion of any structured

settlement are subject to the garnishment. Proceeds up to the

amount of the garnishment shall be paid as directed by the

county department of human or social services responsible for

administering the state public assistance programs.

(6) To aid in settlement, the director shall review

mortality tables from the United States government and private

industry and issue rules establishing a single life expectancy

table on July 1 in every even-numbered year, commencing July

1, 2010. The director may adopt current mortality tables used

by medicare. Nothing in this subsection (6) shall be construed

to limit the use of rated ages.

(7) Any lump sum payable as a full or partial

settlement shall be paid to the claimant or the claimant's

attorney within fifteen calendar days after the date the

executed settlement order is received by the carrier or the

noninsured or self-insured employer.

(8) The director shall adopt rules as necessary to

implement the procedure to review and approve settlement

documents. At a minimum, the rules must:

(a) Allow a represented claimant to submit

settlement documents for approval by electronic mail;

(b) Provide for the approval of settlement documents

if the claimant's signature is not an original but is notarized;

and

counsel of record, or to the insurance carrier or self-insured

employer if not represented, a copy of the division's order

approving the settlement agreement of the parties.

8-43-205. Mediation. (1) Any party involved in a

claim arising under articles 40 to 47 of this title may request

mediation services by filing a request for mediation services

with the division. However, mediation shall be entirely

voluntary and shall not be conducted without the consent of all

parties to the claim. If a request for mediation services is made

after an application for a hearing has been filed, the

administrative law judge hearing the dispute shall approve, on

motion of the parties, the submission of the dispute to

mediation prior to hearing the matter. An application for

mediation services shall be filed on a form prescribed by the

director. Upon receiving the application for mediation

services, the director shall cause a mediation conference to

occur within thirty days thereafter. At a mediation conference,

the claimant may be represented by the claimant, counsel, or

any other agent of the claimant's choice. Mediators need not be

attorneys.

(2) Mediation proceedings conducted pursuant to

this section shall be considered to be settlement negotiations

and are confidential. No admission, representation, or

statement made in the course of such mediation proceedings

that is not otherwise subject to discovery or otherwise

obtainable under the procedures established in articles 40 to 47

of this title shall be admissible as evidence or subject to

discovery under said articles. No mediator who participates in

mediation proceedings conducted pursuant to this section shall

be compelled or permitted to testify about any matter discussed

or revealed during such proceedings in any other proceeding

under articles 40 to 47 of this title.

(3) The division shall develop a program to

implement the provisions of this section. Such program shall

be a simple, nonadversarial method for the mediation of

disputes arising under articles 40 to 47 of this title. Such

program shall provide for the use of neutral mediators and the

conduct of proceedings in an informal setting. The director

shall adopt rules and regulations to implement such program.

8-43-206. Settlement conference

procedures. (1) Any employee, insurer, or employer, if self-

insured, involved in a dispute arising under articles 40 to 47 of

this title may request settlement conference services from the

director or the office of administrative courts in the department

of personnel. However, such settlement procedures are

optional and entirely voluntary, and no such procedures shall

be conducted without the consent of both parties to the dispute.

(2) Settlement conferences shall be conducted by a

settlement conference officer who may be a prehearing

administrative law judge or an administrative law judge in the

office of administrative courts in the department of personnel

appointed pursuant to section 24-30-1003, C.R.S., and

assigned to hear disputes arising under articles 40 to 47 of this

title. The parties may agree on the selection of a settlement

conference officer; except that such officer shall not be the

administrative law judge who is regularly assigned to hear the

employee's case. If the parties fail to agree on the selection of

such officer, they may apply to the director or to the office of

administrative courts for the designation of a settlement

conference officer who shall not be the administrative law

judge who is regularly assigned to hear the employee's case.

(3) Settlement conference proceedings conducted

pursuant to this section shall be considered to be settlement

negotiations and are confidential. No admission,

representation, or statement made in the course of such

settlement conference proceedings that is not otherwise subject

to discovery or otherwise obtainable under the procedures

established in articles 40 to 47 of this title shall be admissible

as evidence or subject to discovery under said articles. No

settlement conference officer who participates in settlement

conference proceedings conducted pursuant to this section

shall be compelled or permitted to testify about any matter

discussed or revealed during such proceedings in any other

proceeding under articles 40 to 47 of this title.

(4) The executive director of the department of

personnel shall adopt rules and regulations to implement the

provisions of this section. Such rules and regulations shall be

consistent with the provisions of section 8-43-204.

(5) The director of the division of workers'

compensation shall adopt rules and regulations to implement

the provisions of this section. Such rules and regulations shall

be consistent with the provisions of section 8-43-204.

8-43-206.5. Right to binding arbitration for

resolution of disputes under articles 40 to 47. At any time

prior to a hearing, the parties may agree to submit any dispute

under articles 40 to 47 of this title to binding arbitration. Said

arbitration shall be by an administrative law judge of the

parties' choice or pursuant to arbitration procedures as

provided by the Colorado rules of civil procedure. Any

arbitration award pursuant to the provisions of this section

To Index

shall be binding upon the parties, and no other procedure

contained in this article shall be available to the parties for the

further review of such award.

8-43-207. Hearings. (1) Hearings shall be held to

determine any controversy concerning any issue arising under

articles 40 to 47 of this title. In connection with hearings, the

director and administrative law judges are empowered to:

(a) In the name of the division, issue subpoenas for

witnesses and documentary evidence which shall be served in

the same manner as subpoenas in the district court;

(b) Administer oaths;

(d) Limit or exclude cumulative or repetitive proof or

examination;

(e) Upon written motion and for good cause shown,

permit parties to engage in discovery; except that permission

need not be sought if each party is represented by an attorney.

The director or administrative law judge may rule on discovery

matters and impose the sanctions provided in the rules of civil

procedure in the district courts for willful failure to comply

with permitted discovery.

(f) Upon written motion and for good cause shown,

conduct prehearing conferences for the settlement or

simplification of issues;

(g) Dispose of procedural requests upon written

motion or on written briefs or oral arguments as determined

appropriate;

(h) Control the course of the hearing and the conduct

of persons in the hearing room;

(i) Upon written motion and for good cause shown,

grant reasonable extensions of time for the taking of any action

contained in this article;

(j) Upon good cause shown, adjourn any hearing to a

later date for the taking of additional evidence;

(k) Issue orders;

(l) Appoint guardians ad litem, as appropriate, in

matters involving dependents' claims, and assess the

reasonable fees and costs, therefore, from one or more of the

parties;

(m) Determine the competency of witnesses who

testify in a workers' compensation hearing or proceeding and

the competency of parties that have entered into settlement

agreements pursuant to section 8-43-204. Such competency

determinations shall only be for the purpose of the particular

workers' compensation proceeding.

(n) Dismiss all issues in the case except as to

resolved issues and except as to benefits already received,

upon thirty days notice to all the parties, for failure to prosecute

the case unless good cause is shown why such issues should

not be dismissed. For purposes of this paragraph (n), it shall be

deemed a failure to prosecute if there has been no activity by

the parties in the case for a period of at least six months.

(o) Set aside all or any part of any fee for medical

services rendered pursuant to articles 40 to 47 of this title if an

administrative law judge determines after a hearing that, based

upon a review of the medical necessity and appropriateness of

care provided pursuant to said articles, any such fee is

excessive or that the treatment rendered was not necessary or

appropriate under the circumstances. If all or part of any fee

for medical services is set aside pursuant to this paragraph (o),

the provider of any such services shall not contract with, bill,

or charge the claimant for such fees and shall not attempt in

any way to collect any such charges from the claimant. No fee

for medical services shall be set aside pursuant to this

paragraph (o) if the treatment was authorized in writing by the

insurer or employer.

(p) Impose the sanctions provided in the Colorado

rules of civil procedure, except for civil contempt pursuant to

rule 107 thereof, for willful failure to comply with any order

of an administrative law judge issued pursuant to articles 40 to

47 of this title;

(q) Require repayment of overpayments.

8-43-207.5. Prehearing

conferences. (1) Notwithstanding any provision of articles 40

to 47 of this title to the contrary, at any time not less than ten

days prior to the formal adjudication on the record of any issue

before the director or an administrative law judge in the office

of administrative courts, any party to a claim may request a

prehearing conference before a prehearing administrative law

judge in the division of workers' compensation for the speedy

resolution of or simplification of any issues and to determine

the general readiness of remaining issues for formal

adjudication on the record. The issues addressed in such

prehearing conference shall be limited to: Ripeness of legal,

but not factual, issues for formal adjudication on the record

before the director or an administrative law judge in the office

of administrative courts; discovery matters; and evidentiary

disputes. The filing of an application for hearing with the office

of administrative courts shall not be a prerequisite to a request

for a prehearing conference under this section. The director

and the administrative law judges in the office of

administrative courts may also request a prehearing conference

under this section.

(2) "Prehearing administrative law judge" means a

qualified person appointed by the director pursuant to section

8-47-101 to preside over prehearing conferences pursuant to

this section, to approve settlements pursuant to section 8-43-

204, to conduct settlement conferences pursuant to section 8-

43-206, and to conduct arbitrations pursuant to section 8-43-

206.5. Such prehearing administrative law judges shall have

authority to: Order any party to participate in a prehearing

conference; issue interlocutory orders; issue subpoenas in the

name of the division for production of documentary evidence

which shall be served in the same manner as subpoenas in the

district court; make evidentiary rulings; permit parties to cause

depositions to be taken; determine the competency of any party

to a claim to enter into a settlement agreement; and strike the

application for hearing of a party for failure to comply with

any provision of this section.

(3) An order entered by a prehearing administrative

law judge shall be an order of the director and binding on the

parties. Such an order shall be interlocutory. Prehearing

conferences need not be held on the record; however, any party

to a claim may request in advance that a record be made of the

prehearing conference, either taken verbatim by a court

reporter provided and paid for by the requesting party or

electronically recorded by the division.

(4) The director shall adopt rules and regulations as

may be necessary to implement the provisions of this section.

To Index

8-43-208. Investigations. (1) For the purpose of

making any investigation with regard to any matter

contemplated by the provisions of articles 40 to 47 of this title,

the director shall have power to appoint, with the approval of

the executive director by an order in writing, any competent

person as an agent whose duties shall be prescribed in such

order.

(2) (Deleted by amendment, L. 94, p. 1876, § 7,

effective June 1, 1994.)

(3) The director may conduct any number of such

investigations contemporaneously through different agents.

8-43-209. Time schedule for hearings -

establishment. (1) Hearings must commence within one

hundred twenty days from the date of the notice of setting by

the director pursuant to section 8-43-211 (2)(a) or of the date

shown on the certificate of service accompanying the request,

notice, or application by a party or the party's attorney pursuant

to section 8-43-211 (2)(b) or (2)(c). Upon agreement of the

parties, an administrative law judge shall grant one extension

of time, not exceeding sixty days, to commence the hearing.

(2) One extension of time to commence the hearing

of no more than sixty days may be granted by an administrative

law judge upon written request by any party to the case and for

good cause shown, in the following cases: When pulmonary

lung disease, cancer, cardiovascular disease, or stroke is

alleged as the cause of the disability; when the subsequent

injury fund is a party; when permanent total disability is

alleged; upon agreement of the parties; or when

compensability of the injury is contested. In all other cases,

extensions of time to commence the hearing of no more than

twenty days may be granted by an administrative law judge

upon written request by any party to the case and for good

cause shown.

(3) Once the hearing is commenced, the

administrative law judge may, for good cause shown, continue

the hearing to a date certain to take additional testimony, to file

an additional medical report, to file the transcript of a

deposition, or to file a position statement. Except upon the

agreement of all parties or for good cause shown, a

continuance to complete a hearing shall not exceed thirty

calendar days.

8-43-210. Evidence. Notwithstanding section 24-4-

105, C.R.S., the Colorado rules of evidence and requirements

of proof for civil nonjury cases in the district courts shall apply

in all hearings; except that medical and hospital records,

physicians' reports, vocational reports, and records of the

employer are admissible as evidence and can be filed in the

record as evidence without formal identification if relevant to

any issue in the case. Depositions may be substituted for

testimony upon good cause shown. Convictions for alcohol-

related offenses, pursuant to titles 18 and 42, C.R.S., the

transcripts of proceedings leading to such convictions, and the

court files relating to such convictions may be admissible in all

hearings conducted under the "Workers' Compensation Act of

Colorado", articles 40 to 47 of this title, where such conviction

resulted from the same occurrence, accident, or injury

occurring on the job that forms the basis for the workers'

compensation claim. All relevant medical records, vocational

reports, expert witness reports, and employer records shall be

exchanged with all other parties at least twenty days prior to

the hearing date.

8-43-211. Notice - request for hearing. (1) At least

thirty days before any hearing, the office of administrative

courts in the department of personnel shall send written notice

to all parties by regular or electronic mail or by facsimile. The

notice must:

(a) Give the time, date, and place of the hearing;

(b) Inform the parties that they must be prepared to

present their evidence concerning the issues to be heard;

represented by an attorney or other person of their choice at the

hearing.

(2) Hearings shall be set by the office of

administrative courts in the department of personnel within

eighty to one hundred twenty days after any of the following

occur:

(a) The director sets any issue for hearing. The

director may expedite the hearing for good cause shown.

(b) Any party requests a hearing on issues ripe for

adjudication by filing a written request with the office of

administrative courts in the department of personnel on forms

provided by the office. The request shall be mailed to all

parties at the time they are filed with the office of

administrative courts. After the filing of the requests, the office

of administrative courts in the department of personnel shall

set the matter for hearing insofar as is practicable in the order

in which requests are received by the office of administrative

courts.

notice to set a hearing on issues ripe for adjudication to

opposing parties or their attorneys. The director of the office

of administrative courts shall determine the place and time or

times during which settings can be made. At such setting, the

party requesting the setting shall submit a completed request

for hearing form. Any notice to set shall be mailed to opposing

parties at least ten days prior to the setting date.

(3) If an attorney requests a hearing or files a notice

to set a hearing on an issue that is not ripe for adjudication at

the time the request or filing is made, the attorney may be

assessed the reasonable attorney fees and costs of the opposing

party in preparing for the hearing or setting. The requesting

party must prove its attempt to have an unripe issue stricken

by a prehearing administrative law judge to request fees or

costs. Requested fees or costs incurred after a prehearing

conference may only be awarded if they are directly caused by

the listing of the unripe issue.

(4) Except in claims in which compensability is

contested or a hearing is requested in response to a final

admission of liability or to overcome a conclusion in a

division-sponsored independent medical examination, the

party filing an application for a hearing shall certify on the

application that the party attempted to resolve with the other

parties all issues listed in the application for a hearing.

8-43-212. Compulsion of testimony. When any

person upon whom a subpoena issued in the name of the

division has been served fails or refuses to appear, the party

who requested the subpoena may apply to the district court in

the county in which the person served resides for an order

compelling attendance before the division of the witness or the

To Index

production of the documents subpoenaed. Violation of such an

order shall be treated as contempt of the court issuing the order.

8-43-213. Transcripts. (1) All testimony and

argument of all hearings held pursuant to section 8-43-207

concerning any issue arising under articles 40 to 47 of this title

shall either be taken verbatim by a hearing reporter or shall be

electronically recorded by the division.

(2) Any party in interest may order a transcript at any

time from a hearing reporter, a court reporter provided by any

party, or, if the hearing is recorded, from the division. For

purposes of a petition to review, a transcript shall be all

testimony taken that is relevant to the issue being appealed. In

the preparation of transcripts, hearing reporters shall give

preference to transcripts as part of the record in a petition to

review; except that all transcripts shall be prepared and filed

with the office of administrative courts within twenty-five

working days after the date they were ordered. Hearing

reporters shall be paid for transcripts and copies at the rate set

by the supreme court for reporters in courts of record. If a court

reporter is unable to meet the time limit specified in this

section, any party, at its own expense, or the administrative law

judge may contract with another court reporter to ensure the

timely preparation of transcripts.

(3) Upon a satisfactory showing to the director in

writing that a party petitioning to review is indigent and unable

to pay for the preparation of the transcript, the director may

order a transcript to be prepared at the division's expense, and,

if the transcript was prepared by a hearing reporter, the division

shall pay the hearing reporter the fee therefor.

(4) When a transcript is ordered as part of the record

on a petition to review, the original of the transcript shall be

filed with the division where it shall be available to all parties

in interest.

8-43-214. Transcript certified - evidence. A

transcribed copy of the evidence and proceedings, or any

specific part thereof, of any investigation or hearing which was

prepared at the direction of the director shall be certified by the

hearing reporter, or the division if the hearing was recorded, to

be a true and correct transcript of the testimony on the

investigation or hearing of a particular witness, or a specific

part thereof, carefully compared to original notes or to the

original recording, and to be a correct statement of the

evidence and proceedings had on such investigation or

hearing. A transcribed copy which is so certified may be

received as evidence by the director, the panel, and any court

with the same effect as if the person who prepared the

transcript were present and testified to the facts so certified.

8-43-215. Orders. (1) No more than fifteen

working days after the conclusion of a hearing, the

administrative law judge or director shall issue a written order

allowing or denying the claim. The written order must either

be a summary order or a full order. A full order must contain

specific findings of fact and conclusions of law. If

compensation benefits are granted, the written order must

specify the amounts thereof, the disability for which

compensation benefits are granted, by whom and to whom

such benefits are to be paid, and the method and time of the

payments. A certificate of mailing and a copy of the written

order shall be served by regular or electronic mail or by

facsimile to each of the parties in interest or their

representatives, the original of which is a part of the records in

the case. If an administrative law judge has issued a summary

order, a party dissatisfied with the order may make a written

request for a full order within ten working days after the date

of mailing of the summary order. The request is a prerequisite

to review under section 8-43-301. If a request for a full order

is made, the administrative law judge has ten working days

after receipt of the request to issue the order. A full order shall

be entered as the final award of the administrative law judge

or director subject to review as provided in this article.

(2) Repealed.

8-43-216. Frivolous claims for compensation -

repeal. (Repealed)

8-43-217. Claims management - legislative

declaration. The general assembly hereby finds, determines,

and declares that active management of workers' compensation

claims should be practiced in order to expedite and simplify

the processing of claims, reduce litigation, and better serve the

public.

8-43-218. Authority of director. (1) The director

shall have authority to appoint claims managers to review,

audit, and close cases, to educate, inform, and assist the public

as to the workers' compensation system, to promote speedy and

uncomplicated problem resolution of workers' compensation

matters, and to otherwise manage claims.

(2) The director may require any party to a workers'

compensation claim to attend, cooperate, and comply with the

efforts of claims managers in managing claims or complaints

received by the division.

(3) Any party willfully refusing to cooperate or

comply with claims management efforts of the division shall

be subject to the penalty provisions set forth in section 8-43-

304 and to the denial or vacation of a hearing date.

(4) Any violation of any provision of this section

shall be cause for the rejection of an application for hearing or

a response thereto until such time as the violation is cured.

8-43-219. Not a limitation on rights or

privileges. Nothing in section 8-43-217 or 8-43-218 shall be

construed to limit any party's rights or privileges as provided

by law.

8-43-220. Injured worker exit survey. (1) Upon

closure of a claim, each insurer shall survey the claimant or, if

deceased, the decedent's dependents regarding the claimant's

satisfaction with the insurer for claims that are reported to the

division pursuant to section 8-43-101. The survey shall be

conducted in a form and manner as prescribed by the director.

The director shall develop the form and manner of the survey

with input from insurers that provide workers' compensation

policies pursuant to articles 40 to 55 of this title, and with the

least administrative burden as possible. The survey shall

include questions regarding courtesy, promptness of medical

care, promptness of handling the claim, promptness of

resolving the claim, and overall satisfaction with the

experience with the insurer. An employer or an insurer shall

not take disciplinary action or otherwise retaliate against a

claimant or his or her dependents for completing the survey.

(2) The insurer shall report the survey results

annually to the division. The director shall post the results of

the surveys on the division's website.

To Index

PART 3

REVIEW PROCEDURES

8-43-301. Petitions to review. (1) Any order,

corrected order, or supplemental order is final unless a petition

to review or appeal has been filed in accordance with this

article.

(2) Any party dissatisfied with an order that requires

any party to pay a penalty or benefits or denies a claimant any

benefit or penalty may file a petition to review with the

division, if the order was entered by the director, or at the

Denver office of the office of administrative courts in the

department of personnel, if the order was entered by an

administrative law judge, and serve the same by mail on all the

parties. The petition shall be filed within twenty days after the

date of the certificate of mailing of the order, and, unless so

filed, the order shall be final. The petition to review may be

filed by mail, and shall be deemed filed upon the date of

mailing, as determined by the certificate of mailing, if the

certificate of mailing indicates that the petition to review was

mailed to the division or to the Denver office of the office of

administrative courts in the department of personnel, as

appropriate. The petition to review shall be in writing and shall

set forth in detail the particular errors and objections of the

petitioner. A petitioner shall, at the same time, order any

transcript relied upon for the petition to review, arrange with

the hearing reporter to pay for the same, and notify opposing

parties of the transcript ordered. Opposing parties shall have

twenty days after the date of the certificate of mailing of the

petition to review to order any other transcript not ordered by

the petitioner and arrange with the hearing reporter to pay for

the same.

(3) If transcripts of hearings are ordered as part of the

record in a petition to review, the director or administrative law

judge cannot rule on the petition until the transcripts are lodged

with the division.

(4) When the record upon which a petition to review

has been filed is complete, the parties shall be notified in

writing. The petitioner shall have twenty days after the date of

the certificate of mailing of the notice to file a brief in support

of the petition. The opposing parties shall have twenty days

after the date of the certificate of mailing of the petitioner's

brief to file briefs in opposition thereto. After the briefs are

filed or the time for filing has run, the director or

administrative law judge shall have thirty days to enter a

supplemental order or transmit the file to the industrial claim

appeals office for review.

(5) In ruling on a petition to review, the director or

administrative law judge may issue a supplemental order

labeled as such limited to the matters raised in the petition to

review, and, as to those matters, the director or administrative

law judge may amend or alter the original order or set the

matter for further hearing. In any event, if it has not already

been done, the administrative law judge or director, following

a petition to review an order, shall make findings of fact and

conclusions of law necessary to support such order.

(6) A party dissatisfied with a supplemental order

may file a petition for review by the panel. The petition shall

be filed with the division if the supplemental order was issued

by the director or at the Denver office of the office of

administrative courts in the department of personnel if the

supplemental order was issued by an administrative law judge.

The petition shall be filed within twenty days after the date of

the certificate of mailing of the supplemental order. The

petition shall be in writing, shall set forth in detail the

particular errors and objections relied upon, and shall be

accompanied by a brief in support thereof. The petition and

brief shall be mailed by petitioner to all other parties at the time

the petition is filed. All parties, except the petitioner, shall be

deemed opposing parties and shall have twenty days after the

date of the certificate of mailing of the petition and brief to file

with the division or the Denver office of the office of

administrative courts, as appropriate, briefs in opposition to the

petition.

(7) When any petition for review by the panel is

filed, the division or the Denver office of the office of

administrative courts shall, when all briefs are submitted to the

division or the Denver office of the office of administrative

courts or within fifteen days after the date briefs were due,

certify and transmit the record to the industrial claim appeals

office along with the petitions and briefs. The division or the

Denver office of the office of administrative courts, as

appropriate, shall simultaneously send notice to the parties

including the date that the record has been transmitted to the

industrial claim appeals office.

(8) The industrial claim appeals office shall have

sixty days after receipt of the certified record to enter its order.

The panel may issue a summary order affirming the order of

the administrative law judge or director. The panel may

correct, set aside, or remand any order but only upon the

following grounds: That the findings of fact are not sufficient

to permit appellate review; that conflicts in the evidence are

not resolved in the record; that the findings of fact are not

supported by the evidence; that the findings of fact do not

support the order; or that the award or denial of benefits is not

supported by applicable law. If the findings of fact entered by

the director or administrative law judge are supported by

substantial evidence, they shall not be altered by the panel.

(9) The panel shall have the power to issue such

procedural orders as may be necessary to carry out its appellate

review under subsection (7) of this section, including but not

limited to, orders concerning completion of the record and

filing of briefs. In those cases where the parties file a stipulated

motion requesting that consideration of the appeal be deferred

pending ongoing settlement negotiations, the panel may extend

the time for entry of its order up to a maximum of thirty days.

(10) The panel's order must be mailed to all parties

of record. Any party dissatisfied with the panel's order has

twenty-one days after the date of the certificate of mailing of

such order to commence an action for judicial review in the

court of appeals.

(11) If the panel has failed to enter its order within

sixty days of the receipt of the certified record, the order of the

director or administrative law judge is deemed the order of the

panel and final unless, within thirty-five days after the end of

the sixty-day period, the petitioner commences an action for

judicial review in the court of appeals. If the panel has not

acted on the sixtieth day, the industrial claim appeals office

shall send a written notice to all parties stating that the parties

To Index

have thirty-five days after the date of the certificate of mailing

of the notice to commence such an action.

(12) If a petition to review is filed, a hearing may be

held and orders entered on any other issue in the case during

the pendency of the petition to review. If the order which is

under petition to review concerns compensability, orders

entered on these later issues are final and appealable when

entered, but not enforceable until the review of the order on

compensability is completed.

(13) If the order which is under petition to review

does not concern compensability, but concerns the respective

liability of two or more employers or insurance carriers, and

the injury or illness was found compensable in a hearing held

pursuant to section 8-43-215, the employer or insurance carrier

found liable by the director or administrative law judge shall

pay benefits in accordance with the order under review until

the review process is completed, at which time it shall be

reimbursed by the other employer or carrier if reimbursement

is necessary to comply with the final order.

(14) The signature of an attorney on a petition to

review or brief in support thereof constitutes a certificate by

the attorney that such attorney has read the petition or brief;

that, to the best of the attorney's knowledge, information, or

belief formed after reasonable inquiry, it is well grounded in

fact and is warranted by existing law or a good faith argument

for the extension, modification, or reversal of existing law, and

that it is not interposed for any improper purpose, such as to

harass, cause delay, or unnecessarily increase the cost of

litigation. If a petition or brief is signed in violation of this

subsection (14), the director, the administrative law judge, or

the panel shall award reasonable attorney fees and costs to the

party incurring the fees and costs as a result of the improper

actions.

8-43-302. Corrected orders. (1) The director, an

administrative law judge, or the panel may issue a corrected

order:

(a) At any time within thirty days after the entry of

an order, to correct any clerical errors in the order. Clerical

errors are grammatical or computational errors.

(b) At any time within thirty days of the entry of an

order, to correct any errors caused by mistake or inadvertence.

(2) Any order corrected for clerical error, mistake, or

inadvertence shall be labeled "corrected order" and mailed by

the division. Any corrected order may be appealed in the

manner provided in this article for any other order.

8-43-303. Reopening. (1) At any time within six

years after the date of injury, the director or an administrative

law judge may, after notice to all parties, review and reopen

any award on the ground of fraud, an overpayment, an error, a

mistake, or a change in condition, except for those settlements

entered into pursuant to section 8-43-204 in which the claimant

waived all right to reopen an award; but a settlement may be

reopened at any time on the ground of fraud or mutual mistake

of material fact. Upon a prima facie showing that the claimant

received overpayments, the award shall be reopened solely as

to overpayments and repayment shall be ordered. In cases

involving the circumstances described in section 8-42-113.5,

recovery of overpayments shall be ordered in accordance with

said section. If an award is reopened on grounds of an error, a

mistake, or a change in condition, compensation and medical

benefits previously ordered may be ended, diminished,

maintained, or increased. No such reopening shall affect the

earlier award as to moneys already paid except in cases of

fraud or overpayment. Any order entered under this subsection

(1) shall be subject to review in the same manner as other

orders.

(2) (a) At any time within two years after the date the

last temporary or permanent disability benefits or dependent

benefits excluding medical benefits become due or payable,

the director or an administrative law judge may, after notice to

all parties, review and reopen an award on the ground of fraud,

an overpayment, an error, a mistake, or a change in condition,

except for those settlements entered into pursuant to section 8-

43-204 in which the claimant waived all right to reopen an

award; but a settlement may be reopened at any time on the

ground of fraud or mutual mistake of material fact. Upon a

prima facie showing that the claimant received overpayments,

the award shall be reopened solely as to overpayments and

repayment shall be ordered. In cases involving the

circumstances described in section 8-42-113.5, recovery of

overpayments shall be ordered in accordance with said section.

If an award is reopened under this paragraph (a) on grounds of

an error, a mistake, or a change in condition, compensation and

medical benefits previously ordered may be ended,

diminished, maintained, or increased. No such reopening shall

affect the earlier award as to moneys already paid except in

cases of fraud or overpayment. Any order entered under this

paragraph (a) shall be subject to review in the same manner as

other orders.

(b) At any time within two years after the date the

last medical benefits become due and payable, the director or

an administrative law judge may, after notice to all parties,

review and reopen an award only as to medical benefits on the

ground of an error, a mistake, or a change in condition, except

for those settlements entered into pursuant to section 8-43-204

in which the claimant waived all right to reopen an award; but

a settlement may be reopened at any time on the ground of

fraud or mutual mistake of material fact. If an award is

reopened under this paragraph (b), medical benefits previously

ordered may be ended, diminished, maintained, or increased.

No such reopening shall affect the earlier award as to moneys

already paid. Any order entered under this paragraph (b) shall

be subject to review in the same manner as other orders.

(3) In cases where a claimant is determined to be

permanently totally disabled, any such case may be reopened

at any time to determine if the claimant has returned to

employment. If the claimant has returned to employment and

is earning in excess of four thousand dollars per year or has

participated in activities which indicate that the claimant has

the ability to return to employment, such claimant's permanent

total disability award shall cease and the claimant shall not be

entitled to further permanent total disability benefits as a result

of the injury or occupational disease which led to the original

permanent total disability award. Any subsequent permanent

partial disability benefits awarded for the same injury or

occupational disease shall be decreased by the amount of

permanent total disability benefits previously received by the

employee.

To Index

(4) The party attempting to reopen an issue or claim

shall bear the burden of proof as to any issues sought to be

reopened.

8-43-304. Violations - penalty - offset for benefits

obtained through fraud - rules. (1) Any employer or insurer,

or any officer or agent of either, or any employee, or any other

person who violates articles 40 to 47 of this title 8, or does any

act prohibited thereby, or fails or refuses to perform any duty

lawfully enjoined within the time prescribed by the director or

panel, for which no penalty has been specifically provided, or

fails, neglects, or refuses to obey any lawful order made by the

director or panel or any judgment or decree made by any court

as provided by the articles shall be subject to such order being

reduced to judgment by a court of competent jurisdiction and

shall also be punished by a fine of not more than one thousand

dollars per day for each offense, to be apportioned, in whole or

part, at the discretion of the director or administrative law

judge, between the aggrieved party and the Colorado

uninsured employer fund created in section 8-67-105; except

that the amount apportioned to the aggrieved party shall be a

minimum of twenty-five percent of any penalty assessed.

(1.5) (a) (I) An insurer who knowingly or repeatedly

violates any provision of articles 40 to 47 of this title shall be

subject to a fine as determined by the director. If necessary, the

director may conduct a hearing or may refer the matter to the

office of administrative courts for the entry of findings of fact.

The director shall promulgate rules that specify, with respect

to an insurer's willful or repeated violations that are subject to

this subsection (1.5):

(A) The circumstances pursuant to which the director

may issue an order imposing a fine; and

(B) Criteria for determining the amount of the fine.

(II) If the division determines, as part of a

compliance audit of an insurer or self-insured pool, that an

injury or occupational disease was not reported to the division

within the time specified in sections 8-43-101 and 8-43-103

because the insurer or self-insured pool did not have notice or

knowledge of the injury, occupational disease, or fatality

within a period of time that would allow the information to be

reported to the division within the time specified in sections 8-

43-101 and 8-43-103, the director shall not impose a fine for

late reporting under this subsection (1.5). The director may

impose a fine under this subsection (1.5) for late reporting

under sections 8-43-101 and 8-43-103 as part of findings from

a compliance audit if the director finds that the late reporting

constituted a knowing or repeated pattern of noncompliance

with the reporting requirements of sections 8-43-101 and 8-43-

103 and was not caused by the insurer or self-insured pool's

lack of notice or knowledge of the injury, occupational disease,

or fatality within a period of time that would allow the

information to be reported to the division within the time

specified in sections 8-43-101 and 8-43-103.

(b) Fines imposed pursuant to this subsection (1.5)

on or after July 1, 2018, shall be transmitted to the state

treasurer, who shall credit the fines to the Colorado uninsured

employer fund created in section 8-67-105.

(2) An insurer or self-insured employer may take a

credit or offset of previously paid workers' compensation

benefits or payments against any further workers'

compensation benefits or payments due a worker when the

worker admits to having obtained the previously paid benefits

or payments through fraud, or a civil judgment or criminal

conviction is entered against the worker for having obtained

the previously paid benefits through fraud. Benefits or

payments obtained through fraud by a worker shall not be

included in any data used for rate-making or individual

employer rating or dividend calculations by any insurer or by

Pinnacol Assurance.

(3) The director and each administrative law judge

shall report to the division each time a penalty is imposed

pursuant to this section. Each such report shall include the

amount of the penalty, the name of the administrative law

judge awarding the penalty, if applicable, and the name of the

offending party.

(4) In any application for hearing for any penalty

pursuant to subsection (1) of this section, the applicant shall

state with specificity the grounds on which the penalty is being

asserted. After the date of mailing of such an application, an

alleged violator shall have twenty days to cure the violation. If

the violator cures the violation within such twenty-day period,

and the party seeking such penalty fails to prove by clear and

convincing evidence that the alleged violator knew or

reasonably should have known such person was in violation,

no penalty shall be assessed. The curing of the violation within

the twenty-day period shall not establish that the violator knew

or should have known that such person was in violation.

(5) A request for penalties shall be filed with the

director or administrative law judge within one year after the

date that the requesting party first knew or reasonably should

have known the facts giving rise to a possible penalty.

8-43-304.5. Penalties in rate-making. For purposes

of rate-making under sections 10-4-401, 10-4-402, and 10-4-

403, C.R.S., insurers shall not include, nor shall the insurance

commissioner consider, any penalties paid under section 8-43-

304 or any damages awarded in suits founded upon breach of

duty in handling a claim for compensation under section 8-41-

102.

8-43-305. Each day separate offense. Every day

during which any employer or insurer, or officer or agent of

either, or any employee, or any other person fails to comply

with any lawful order of an administrative law judge, the

director, or the panel or fails to perform any duty imposed by

articles 40 to 47 of this title shall constitute a separate and

distinct violation thereof. In any action brought to enforce the

same or to enforce any penalty provided for in said articles,

such violation shall be considered cumulative and may be

joined in such action.

8-43-306. Collection of fines, penalties, and

overpayments. (1) A certified copy of any final order of the

director or an administrative law judge ordering the payment

of any penalty or repayment of overpayments pursuant to

articles 40 to 47 of this title may be filed with the clerk of the

district court of any county in this state at any time after the

period of time provided by articles 40 to 47 of this title for

appeal or seeking review of the order has passed without

appeal or review being sought or, if appeal or review is sought,

after the order has been finally affirmed and all appellate

remedies and all opportunities for review have been exhausted.

The party filing the order shall at the same time file a certificate

to the effect that the time for appeal or review has passed

To Index

without appeal or review being undertaken or that the order has

been finally affirmed with all appellate remedies and all

opportunities for review having been exhausted. The clerk of

the district court shall record the order and the filing party's

certificate in the judgment book of said court and entry thereof

made in the judgment docket, and it shall thenceforth have all

the effect of a judgment of the district court, and execution may

issue thereon out of said court as in other cases. Any such order

may be filed by and in the name of the director or by and in the

name of the party in the worker's compensation action who was

injured by the violation of any provision of articles 40 to 47 of

this title or who was found to be entitled to repayment of

overpayments under said articles.

(2) All penalties, when collected, are payable to the

division and transmitted through the state treasurer for credit

to the Colorado uninsured employer fund created in section 8-

67-105.

8-43-307. Appeals to court of appeals. (1) The

final order of the director or the panel shall constitute the final

order of the division. Any person in interest, including

Pinnacol Assurance, being dissatisfied with any final order of

the division, may commence an action in the court of appeals

against the industrial claim appeals office as defendant to

modify or vacate any such order on the grounds set forth in

section 8-43-308.

(2) All such actions shall have precedence over any

civil cause of a different nature pending in such court, and the

court of appeals shall always be deemed open for the trial

thereof, and such actions shall be tried and determined by the

court of appeals in the manner provided for other civil actions.

(3) (Deleted by amendment, L. 95, p. 235, § 3,

effective April 17, 1995.)

(4) In any case before the court of appeals pursuant

to this section, the court may apply the sanctions of rule 38 of

the Colorado appellate rules if the court finds such application

to be appropriate.

8-43-308. Causes for setting aside award. Upon

hearing the action, the court of appeals may affirm or set aside

such order, but only upon the following grounds: That the

findings of fact are not sufficient to permit appellate review;

that conflicts in the evidence are not resolved in the record;

that the findings of fact are not supported by the evidence; that

the findings of fact do not support the order; or that the award

or denial of benefits is not supported by applicable law. If the

findings of fact entered by the director or administrative law

judge are supported by substantial evidence, they shall not be

altered by the court of appeals.

8-43-309. Actions in court tried within thirty

days. Any such action commenced in the court of appeals to

set aside or modify any order shall be heard within thirty days

after issue shall be joined, unless continued on order of the

court for good cause shown. No continuance shall be for longer

than thirty days at one time.

8-43-310. Error disregarded unless

prejudicial. The appeal shall be upon the record returned to

the court by the industrial claim appeals office. Upon the

hearing of any such action, the court shall disregard any

irregularity or error of the director or the panel unless it

affirmatively appears that the party complaining was damaged

thereby.

8-43-311. Court record transmitted to industrial

claim appeals office - when. It is the duty of the clerk of the

court of appeals, without order of court or application of the

panel, to transmit the record in any case to the industrial claim

appeals office within twenty-five days after the order or

judgment of the court unless in the meantime further appellate

review is granted by the supreme court. If the supreme court

grants further appellate review, the clerk shall return the record

immediately upon receipt of remittitur from the supreme court,

unless the order of the supreme court requires further action by

the court of appeals, and then within twenty-five days after

such further action.

8-43-312. Court may remand case or order entry

of award. Upon setting aside of any order, the court may

recommit the controversy and remand the record in the case

for further hearing or proceedings by the director,

administrative law judge, or panel, or it may order entry of a

proper award upon the findings as the nature of the case shall

demand. In no event shall such order for award be for a greater

amount of compensation than allowed by articles 40 to 47 of

this title, or in any manner conflict with the provisions thereof.

8-43-313. Summary review by supreme

court. Any affected party dissatisfied with the decision of the

court of appeals may seek review by writ of certiorari in the

supreme court. If the supreme court reviews the judgment of

the court of appeals, such review shall be limited to a summary

review of questions of law. Any such action shall be advanced

upon the calendar of the supreme court, and a final decision

shall be rendered within sixty days after the date the supreme

court grants further appellate review. The director, an

administrative law judge, the industrial claim appeals office,

or any other aggrieved party shall not be required to file any

undertaking or other security upon review by the supreme

court.

8-43-314. Fees - costs - duty of district attorneys

and attorney general. No fee shall be charged by the clerk of

any court for the performance of any official service required

by articles 40 to 47 of this title. On proceedings to review any

order or award, costs as between the parties shall be allowed

in the discretion of the court, but no costs shall be taxed against

said director or industrial claim appeals office. In any action

for the review of any order or award and upon any review

thereof by the supreme court, it is the duty of the district

attorney in the county wherein said action is pending, or of the

attorney general if requested by the director or industrial claim

appeals office, to appear on behalf of either or both, whether

any other party defendant should have appeared or been

represented in the action.

8-43-315. Witnesses and testimony - mileage - fees

- costs. (1) The director or any agent, deputy, or

administrative law judge may issue subpoenas to compel the

attendance of witnesses or parties and the production of books,

papers, or records and to administer oaths. Any person who

serves a subpoena shall receive the same fee as the sheriff.

Each witness who is subpoenaed on behalf of the director and

who appears in obedience thereto shall receive for attendance

the fees and mileage provided for witnesses in civil cases in

the district court, which are audited and paid from the state

treasury in the same manner as other expenses are audited and

paid, upon the presentation of a proper voucher approved by

To Index

the director. The director has the discretion to assess the cost

of attendance and mileage of witnesses subpoenaed by either

party to any proceeding against another party to the proceeding

when, in the director's judgment, the necessity of subpoenaing

the witnesses arises out of the raising of any incompetent,

irrelevant, or sham issues by the other party.

(2) The director, an agent, deputy, or administrative

law judge of the division, or an administrative law judge from

the office of administrative courts, may, upon a showing of

good cause, order the attendance at a hearing or deposition of

any party, or of an officer, director, employee, or agent of any

party, who is located in another state. A witness so ordered

shall appear as indicated in the order or shall be available by

telephone at the time and place set forth in the order.

(3) If a party or an officer, director, employee, or

agent of a party fails, in the absence of a reasonable excuse, to

obey an order issued pursuant to subsection (2) of this section,

the party, officer, director, employee, or agent is liable for

penalties as specified in section 8-43-304 (1).

8-43-316. Appearance by officer for closely held

entity. An officer of a closely held entity as defined in section

13-1-127 (1)(a) may appear on behalf of any such closely held

entity, which has obtained coverage as required by articles 40

to 47 of this title 8 in proceedings authorized under the

"Workers' Compensation Act of Colorado", articles 40 to 47 of

this title 8, where the amount at issue does not exceed ten

thousand dollars, except in proceedings before the industrial

claim appeals office under this part 3, appeals to the court of

appeals under section 8-43-307, and summary reviews by the

supreme court under section 8-43-313.

8-43-317. Service of documents. All documents

that are required to be exchanged under articles 40 to 47 of this

title shall be transmitted or served in the same manner or by

the same means to all required recipients.

8-43-318. Remand of case or order - time limit for

further proceedings consistent with ruling on appeal. If a

case or order is appealed to the panel, the court of appeals, or

the supreme court, and the case or order is remanded with

directions, the director, administrative law judge, or panel, as

the case may be, shall issue an order consistent with those

directions within thirty days from receipt of the remand. The

remanding tribunal has continuing jurisdiction to enforce the

remand order.

PART 4

ENFORCEMENT AND PENALTIES

8-43-401. District attorney or attorney of division

to act for director or office - penalties for failure of insurer

to pay benefits. (1) Upon the request of the director or the

industrial claim appeals office, the district attorney of any

district or any attorney-at-law employed by the division shall

institute and prosecute the necessary actions or proceedings for

the enforcement of any of the provisions of articles 40 to 47 of

this title, or any award or order of the director, an

administrative law judge, or the industrial claim appeals office,

or for the recovery of any money due to Pinnacol Assurance,

or any penalty provided in said articles, and shall defend in like

manner all suits, actions, or proceedings brought against the

director, an administrative law judge, or the industrial claim

appeals office.

(2) (a) After all appeals have been exhausted or in

cases where there have been no appeals, all insurers and self-

insured employers shall pay benefits within thirty days after

any benefits are due. If any insurer or self-insured employer

knowingly delays payment of medical benefits for more than

thirty days or knowingly stops payments, such insurer or self-

insured employer shall pay a penalty of eight percent of the

amount of wrongfully withheld benefits; except that no penalty

is due if the insurer or self-insured employer proves that the

delay was the result of excusable neglect. If any insurer or self-

insured employer willfully withholds permanent partial

disability benefits within thirty days of when due, the insurer

or self-insured employer shall pay a penalty to the division of

ten percent of the amount of such benefits due. The penalties

shall be apportioned, in whole or part, at the discretion of the

director or administrative law judge, among the aggrieved

party, the medical services provider, and the workers'

compensation cash fund created in section 8-44-112 (7)(a).

(b) All money collected as penalties by the division

pursuant to this subsection (2) shall be transmitted to the state

treasurer, who shall credit it to the Colorado uninsured

employer fund created in section 8-67-105.

8-43-401.5. Financial incentives to deny or delay

claim or medical care - prohibition - penalties. (1) No

insurer, employee or contractor of an insurer, self-insured

employer, employee or contractor of a self-insured employer,

health care provider, or employee or contractor of a health care

provider treating an injured worker under the provisions of

articles 40 to 47 of this title shall pay or receive any form of

financial remuneration that is based on any of the following:

(a) The number of days to maximum medical

improvement;

(b) The rate of claims approval or denial;

procedures, or treatment appointments approved; or

(d) Any other criteria designed or intended to

encourage a violation of any provision of articles 40 to 47 of

this title.

(2) (a) Payment of remuneration in violation of this

section constitutes an unfair act or practice in the business of

insurance, and the insurer or self-insured employer who pays

or directs the payment of the remuneration shall be subject to

penalties in accordance with part 11 of article 3 of title 10,

C.R.S.

(b) In addition to, or as an alternative to, any

penalties imposed pursuant to paragraph (a) of this subsection

(2), an insurer or self-insured employer who is found to have

violated subsection (1) of this section may be subject to fines

as determined by the director pursuant to section 8-43-304

(1.5).

(3) Nothing in this section:

(a) Restricts or limits the ability of a claims adjuster

or employee or contracted claims personnel to investigate,

detect, or prevent fraud; or

(b) Limits the payment or receipt of financial

incentives for any other lawful purpose.

To Index

8-43-402. False statement - felony. If, for the

purpose of obtaining any order, benefit, award, compensation,

or payment under the provisions of articles 40 to 47 of this title,

either for self-gain or for the benefit of any other person,

anyone willfully makes a false statement or representation

material to the claim, such person commits a class 5 felony and

shall be punished as provided in section 18-1.3-401, C.R.S.,

and shall forfeit all right to compensation under said articles

upon conviction of such offense.

8-43-403. Attorney fees. (1) No contingent fee

shall be applied to any medical benefits that have been

previously incurred and will be paid to the claimant or directly

to the medical care provider, in a permanent disability award,

either by admission or settlement. In the event that medical

benefits are the only contested issue, the fee agreement shall

provide for reasonable fees calculated on a per-hour basis or,

subject to approval by the director, may provide for a

contingent fee not to exceed the limitations imposed by this

section. On unappealed contested cases, a contingent fee

exceeding twenty percent of the amount of contested benefits

shall be presumed to be unreasonable. At the request of either

an employee or the employee's attorney, the director shall

determine what portion of the benefits awarded were

contested, or the reasonableness of the fee charged by such

attorney, or both. At the request of the employer or its

insurance carrier or the attorney for either of them, the director

shall determine the reasonableness of the fee charged by the

attorney for the insurance carrier. No request for determination

of the reasonableness of fees shall be considered by the

director if received later than one hundred eighty days after the

issuance of the final order, judgment, or opinion disposing of

the last material issue in the case and the expiration of any right

to review or appeal therefrom. In making this determination,

the director shall consider fees normally charged by attorneys

for cases requiring the same amount of time and skill and may

decrease or increase the fee payable to such attorney. If the

director finds that a review by the industrial claim appeals

office or an appeal to the court of appeals or to the supreme

court was perfected or if the director finds that such attorney

reasonably devoted an extraordinary amount of time to the

case, the director may award or approve a contingent fee or

other fee in a percentage or amount that exceeds twenty

percent of the amount of contested benefits. In determining the

reasonableness of fees charged by an attorney for an employer

or employer's insurance carrier, the director shall compare the

fees of such attorney with the fees charged by the claimant's

attorney in the same case and shall not approve an amount

substantially greater than the reasonable amount charged by

the said claimant's attorney or, if the claimant did not prevail,

the reasonable amount the said claimant's attorney would have

charged had the claimant prevailed, unless the director finds,

based on a showing by the attorney for the employer or carrier,

that higher fees are objectively justifiable. Legal costs not

found reasonable shall not be allowed as an expense in fixing

premium rates by the commissioner of insurance.

(2) Any attorney who represents any party in a

workers' compensation case shall provide the party with a

written fee agreement which sets forth, in full, the attorney's

specific fee arrangement, including the criteria upon which the

attorney bases his hourly or set fee and the circumstances in

which any modifications or adjustments to such fee will be

made, and specifying whether the client will be charged for the

attorney's expenses or advances made by the attorney on behalf

of the party, including without limitation costs of copying,

research, telephone calls, postage, and any other expenses

incident to the litigation which the attorney may be ethically

bound to undertake on behalf of the party pursuant to law or

pursuant to any court rule including the code of professional

responsibility as adopted by the supreme court of Colorado.

Contingent fee agreements shall be in conformity with all

applicable provisions of the said code or of rules of the

supreme court, and, in addition, such agreements shall set forth

the provisions of this section in easy to understand language in

at least ten-point bold-faced type. No such fee agreement may

be enforced against any party unless it complies with the

requirements of this section and is signed by both parties. Any

attempt by an attorney who intentionally does not comply with

this section and who seeks to enforce a fee agreement which

does not comply with the requirements of this section shall be

presumed to be a violation of the code of professional

responsibility as adopted by the supreme court of Colorado.

(3) Repealed.

8-43-404. Examination - refusal - personal

responsibility - physicians to testify and furnish results -

injured worker right to select treating physicians - injured

worker right to third-party communications - definitions -

rules. (1) (a) If in case of injury the right to compensation

under articles 40 to 47 of this title exists in favor of an

employee, upon the written request of the employee's

employer or the insurer carrying such risk, the employee shall

from time to time submit to examination by a physician or

surgeon or to a vocational evaluation, which shall be provided

and paid for by the employer or insurer, and the employee shall

likewise submit to examination from time to time by any

regular physician selected and paid for by the division.

(b) (I) At least three business days in advance of an

examination under paragraph (a) of this subsection (1), if

requested by the claimant, the employer or insurer shall pay to

the claimant the claimant's estimated expenses of attending the

examination, including transportation, mileage, food, and

hotel costs. In addition, if the claimant verifies that he or she

will incur uncompensated wage losses as a result of attending

the examination, the employer or insurer shall reimburse the

claimant at the rate of seventy-five dollars per day. Failure to

provide payment in accordance with this subparagraph (I)

constitutes grounds for the claimant to refuse to attend the

examination.

(II) If an employer pays estimated expenses under

this paragraph (b) and the claimant does not attend the

examination, the employer or insurer may recover the costs

paid for the employee's expenses from future indemnity

benefits.

(2) (a) The employee shall be entitled to have a

physician, provided and paid for by the employee, present at

any such examination. If an employee is examined by a

chiropractor at the request of the employer, the employee shall

be entitled to have a chiropractor provided and paid for by the

employee present at any such examination. After any

examination conducted under this section, the examiner shall

prepare a written report giving a description of the examination

To Index

performed, the written documents or any other materials

reviewed, and all findings or conclusions of the examiner. The

employee shall be entitled to receive from the examining

physician or chiropractor a copy of any report that the

physician or chiropractor makes to the employer, insurer, or

division upon the examination, and the copy shall be furnished

to the employee at the same time it is furnished to the

employer, insurer, or division. The employee shall also be

entitled to receive reports from any physician selected by the

employer to treat the employee upon the same terms and

conditions and at the same time the reports are furnished by the

physician to the employer. All such examinations shall be

recorded in audio in their entirety and retained by the

examining physician until requested by any party. Prior to

commencing the audio recording, the examining physician

shall disclose to the employee the fact that the exam is being

recorded. If requested, an exact copy of the recording shall be

provided to the parties. Nothing in this subsection (2) shall be

construed to prevent any party to the claim from making an

audio recording of the examination. The division shall

promulgate rules regarding such recordings that shall include

provisions for the protection of the audio recordings and the

privacy of information contained in such recordings. The

employer shall be entitled to receive reports from any

physician or chiropractor selected by the employee to treat or

examine the employee in connection with such injury upon the

same terms and at the same time the reports are furnished by

the physician or chiropractor to the employee.

(b) The amendments made to paragraph (a) of this

subsection (2) by Senate Bill 09-168, enacted in 2009, are

declared to be procedural and were intended to and shall apply

to all workers' compensation claims, regardless of the date the

claim was filed.

(3) So long as the employee, after written request by

the employer or insurer, refuses to submit to medical

examination or vocational evaluation or in any way obstructs

the same, all right to collect, or to begin or maintain any

proceeding for the collection of, compensation shall be

suspended. If the employee refuses to submit to such

examination after direction by the director or any agent,

referee, or administrative law judge of the division appointed

pursuant to section 8-43-208 (1) or in any way obstructs the

same, all right to weekly indemnity which accrues and

becomes payable during the period of such refusal or

obstruction shall be barred. If any employee persists in any

unsanitary or injurious practice which tends to imperil or retard

recovery or refuses to submit to such medical or surgical

treatment or vocational evaluation as is reasonably essential to

promote recovery, the director shall have the discretion to

reduce or suspend the compensation of any such injured

employee.

(4) Any physician or chiropractor who makes or is

present at any such examination may be required to testify as

to the results thereof. Any physician or chiropractor having

attended an employee in a professional capacity may be

required to testify before the division when it so directs. A

physician or chiropractor will not be required to disclose

confidential communications imparted to said physician or

chiropractor for the purpose of treatment and which are

unnecessary to a proper understanding of the case.

(5) (a) (I) (A) In all cases of injury, the employer or

insurer shall provide a list of at least four physicians or four

corporate medical providers or at least two physicians and two

corporate medical providers or a combination thereof where

available, in the first instance, from which list an injured

employee may select the physician who attends the injured

employee. At least one of the four designated physicians or

corporate medical providers offered must be at a distinct

location from the other three designated physicians or

corporate medical providers without common ownership. If

there are not at least two physicians or corporate medical

providers at distinct locations without common ownership

within thirty miles of the employer's place of business, then an

employer may designate physicians or corporate medical

providers at the same location or with shared ownership

interests. Upon request by an interested party to the workers'

compensation claim, a designated provider on the employer's

list shall provide a list of ownership interests and employment

relationships, if any, to the requesting party within five days of

the receipt of the request. If the services of a physician are not

tendered at the time of injury, the employee shall have the right

to select a physician or chiropractor. For purposes of this

section, "corporate medical provider" means a medical

organization in business as a sole proprietorship, professional

corporation, or partnership.

(B) If there are fewer than four physicians or

corporate medical providers within thirty miles of the

employer's place of business who are willing to treat an injured

employee, the employer or insurer may instead designate one

physician or one corporate medical provider, and

subparagraphs (III) and (IV) of this paragraph (a) shall not

apply. A physician is presumed willing to treat injured workers

unless he or she indicates to the employer or insurer to the

contrary.

corporate medical providers, but fewer than nine physicians or

corporate medical providers within thirty miles of the

employer's place of business who are willing to treat an injured

employee, the employer or insurer may instead designate two

physicians or two corporate medical providers or any

combination thereof. The two designated providers shall be at

two distinct locations without common ownership. If there are

not two providers at two distinct locations without common

ownership within thirty miles of the employer's place of

business, then an employer may designate two providers at the

same location or with shared ownership interests. Upon

request by an interested party to the workers' compensation

claim, a designated provider on the employer's list shall

provide a list of ownership interests and employment

relationships, if any, to the requesting party within five days of

the receipt of the request.

(D) Except as otherwise provided by sub-

subparagraph (E) of this subparagraph (I), any party may

request an expedited hearing on the issue of whether the

employer or insurer provided a list in compliance with this

subsection (5) if the application for expedited hearing is filed

within forty-five days after the claimant provides notice of the

injury to the employer.

(E) If the insurer or self-insured employer admits

liability for the claim, any party may request an expedited

To Index

hearing on the issue of whether the employer or insurer

provided a list in compliance with this subsection (5) if the

application for expedited hearing is filed within forty-five days

after the initial admission of liability for the claim. The director

shall set any expedited matter for hearing within sixty days

after the date of the application. The time schedule for an

expedited hearing is subject to the extensions set forth in

section 8-43-209. If the party elects not to request an expedited

hearing under this subsection (5), the time schedule for hearing

the matter is as set forth in section 8-43-209.

(II) (A) If the employer is a health care provider or a

governmental entity that currently has its own occupational

health care provider system, the employer may designate

health care providers from within its own system and is not

required to provide an alternative physician or corporate

medical provider from outside its own system.

(B) If the employer has its own on-site health care

facility, the employer may designate such on-site health care

facility as the authorized treating physician, but the employer

shall comply with subparagraph (III) of this paragraph (a). For

purposes of this sub-subparagraph (B), "on-site health care

facility" means an entity that meets all applicable state

requirements to provide health care services on the employer's

premises.

(III) An employee may obtain a one-time change in

the designated authorized treating physician under this section

by providing notice that meets the following requirements:

(A) The notice is provided within ninety days after

the date of the injury, but before the injured worker reaches

maximum medical improvement;

(B) The notice is in writing and submitted on a form

designated by the director. The notice provided in this

subparagraph (III) shall also simultaneously serve as a request

and authorization to the initially authorized treating physician

to release all relevant medical records to the newly authorized

treating physician.

to the employer's authorized representative, if self-insured, and

to the initially authorized treating physician and is deposited in

the United States mail or hand-delivered to the employer, who

shall notify the insurance carrier, if necessary, and the initially

authorized treating physician;

(D) The new physician is on the employer's

designated list or provides medical services for a designated

corporate medical provider on the list;

(E) The transfer of medical care does not pose a

threat to the health or safety of the injured employee;

(F) An insurance carrier, or an employer's authorized

representative if the employer is self-insured, shall track how

often injured employees change their authorized treating

physician pursuant to this subparagraph (III) and shall report

such information to the division upon request.

(IV) (A) When an injured employee changes his or

her designated authorized treating physician, the newly

authorized treating physician shall make a reasonable effort to

avoid any unnecessary duplication of medical services.

(B) The originally authorized treating physician shall

send all medical records in his or her possession pertaining to

the injured employee to the newly authorized treating

physician within seven calendar days after receiving a request

for medical records from the newly authorized treating

physician.

continue as the authorized treating physician for the injured

employee until the injured employee's initial visit with the

newly authorized treating physician, at which time the

treatment relationship with the initially authorized treating

physician shall terminate.

(D) The opinion of the originally authorized treating

physician regarding work restrictions and return to work shall

control unless and until such opinion is expressly modified by

the newly authorized treating physician.

(E) The newly authorized treating physician shall be

presumed to have consented to treat the injured employee

unless the newly authorized treating physician expressly

refuses in writing within five days after the date of the notice

to change authorized treating physicians. If the newly

authorized treating physician refuses to treat the injured

employee, the employee may return to the employer to request

an alternative authorized treating physician. If the employer

does not provide an alternative authorized treating physician

within five days after the employee's request, rules established

by the division shall control.

(V) If the authorized treating physician moves from

one facility to another, or from one corporate medical provider

to another, an injured employee may continue care with the

authorized treating physician, and the original facility or

corporate medical provider shall provide the injured

employee's medical records to the authorized treating

physician within seven days after receipt of a request for

medical records from the authorized treating physician.

(VI) (A) In addition to the one-time change of

physician allowed in subparagraph (III) of this paragraph (a),

upon written request to the insurance carrier or to the

employer's authorized representative if self-insured, an injured

employee may procure written permission to have a personal

physician or chiropractor treat the employee. The written

request must be completed on a form that is prescribed by the

director. If permission is neither granted nor refused within

twenty days after the date of the certificate of service of the

request form, the employer or insurance carrier shall be

deemed to have waived any objection to the employee's

request. Objection shall be in writing on a form prescribed by

the director and shall be served on the employee or, if

represented, the employee's authorized representative within

twenty days after the date of the certificate of service of the

request form. An insurance carrier, or an employer's authorized

representative if self-insured, shall track how often an injured

employee requests to change his or her physician and how

often such change is granted or denied and shall report such

information to the division upon request. Upon the proper

showing to the division, the employee may procure the

division's permission at any time to have a physician of the

employee's selection treat the employee, and in any

nonsurgical case the employee, with such permission, in lieu

of medical aid, may procure any nonmedical treatment

recognized by the laws of this state as legal. The practitioner

administering the treatment shall receive fees under the

medical provisions of articles 40 to 47 of this title as specified

by the division.

To Index

(B) If an injured employee is permitted to change

physicians under sub-subparagraph (A) of this subparagraph

(VI) resulting in a new authorized treating physician who will

provide primary care for the injury, then the previously

authorized treating physician providing primary care shall

continue as the authorized treating physician providing

primary care for the injured employee until the injured

employee's initial visit with the newly authorized treating

physician, at which time the treatment relationship with the

previously authorized treating physician providing primary

care is terminated.

former authorized treating physician from performing an

examination under subsection (1) of this section.

(D) If an injured employee is permitted to change

physicians pursuant to sub-subparagraph (A) of this

subparagraph (VI) resulting in a new authorized treating

physician who will provide primary care for the injury, then

the opinion of the previously authorized treating physician

providing primary care regarding work restrictions and return

to work controls unless that opinion is expressly modified by

the newly authorized treating physician.

(b) Any private insurer or self-insured employer

acting as its own insurance carrier as provided in section 8-44-

201 providing workers' compensation coverage shall pay for

chiropractic care as provided in paragraph (a) of this

subsection (5).

the employer or insurer of an injured worker regarding that

injured worker unless:

(I) The injured worker is present for the

communication; or

(II) The treating physician makes an accurate written

record of the communication, containing all relevant and

material information that was communicated, and provides the

injured worker access to the writing in the same manner as

medical records disclosures as required by director rules.

(6) Application or prosecution of a claim for benefits

shall be a waiver of any privilege concerning communications

relating to all medical issues raised by the claim, for the

purposes of a utilization review conducted pursuant to section

8-43-501.

(7) An employer or insurer shall not be liable for

treatment provided pursuant to article 285 of title 12, unless

such treatment has been prescribed by an authorized treating

physician.

(8) Upon request by an employee who has not

reached maximum medical improvement and whose

authorized treating physician is not level II accredited, an

insurer or self-insured employer shall select a level II

accredited physician as the authorized treating physician.

(9) (a) Health care services provided shall be deemed

authorized if the claim is found to be compensable when:

(I) Compensability of a claim is initially denied;

(II) The services of the physician selected by the

employer are not tendered at the time of the injury; and

(III) The injured worker is treated:

(A) At a public health facility in the state;

(B) At a public health facility within one hundred

fifty miles of the residence of the injured worker; or

(b) A claimant shall not be liable for payment for

treatment by the provider under this subsection (9) if the

treatment is reasonably needed and related to the injury.

(10) (a) If an authorized physician refuses to provide

medical treatment to an injured employee or discharges an

injured employee from medical care for nonmedical reasons

when the injured employee requires medical treatment to cure

or relieve the effects of the work injury, then the physician

shall, within three business days from the refusal or discharge,

provide written notice of the refusal or discharge by certified

mail, return receipt requested, to the injured employee and the

insurer or self-insured employer. The notice must explain the

reasons for the refusal or discharge and must offer to transfer

the injured employee's medical records to any new authorized

physician upon receipt of a signed authorization to do so from

the injured employee. The director or any administrative law

judge of the office of administrative courts has jurisdiction to

resolve disputes regarding whether a refusal to provide

medical treatment or a discharge from medical care was for

medical or nonmedical reasons.

(b) If the insurer or self-insured employer receives

written notice pursuant to paragraph (a) of this subsection (10),

or if the insurer or self-insured employer and the authorized

treating physician receive written notice by certified mail,

return receipt requested, from the injured employee or the

injured employee's legal representative that an authorized

physician refused to provide medical treatment to the injured

employee or discharged the injured employee from medical

care for nonmedical reasons when such injured employee

requires medical treatment to cure or relieve the effects of the

work injury, and there is no other authorized physician willing

to provide medical treatment, then the insurer or self-insured

employer shall, within fifteen calendar days from receiving the

written notice, designate a new authorized physician willing to

provide medical treatment. If the insurer or self-insured

employer fails to designate a new physician pursuant to this

paragraph (b), then the injured employee may select the

physician who attends to the injured employee.

8-43-405. Payment as discharge of liability -

conflicting claims. Payment of death benefits to one or more

dependents shall protect and discharge to that extent all

compensation under articles 40 to 47 of this title unless and

until any other person claiming to be a dependent has given the

division notice of said person's claim and until the division has

notified the employer or the employer's insurance carrier of

such claim. In such case, the director or an administrative law

judge shall determine the respective rights of said rival

claimants, and thereafter such death benefits shall be paid to

such dependents as the director or the administrative law judge

may find so entitled under the provisions of said articles.

8-43-406. Compensation in lump sum. (1) At any

time after six months have elapsed from the date of injury, the

claimant may elect to take all or any part of the compensation

awarded in a lump sum by sending written notice of the

election and the amount of benefits requested to the carrier or

the noninsured or self-insured employer. The carrier or self-

insured employer shall file the calculation of the lump sum due

and notice that the lump sum has been paid to the claimant

within ten days after the election. When the claimant is

To Index

unrepresented, the director shall calculate amounts to be paid

based on the present worth of partial payments, considering

interest at four percent per annum, and less a deduction for the

contingency of death. The director shall make the method of

calculation of lump sums available to all parties at all times,

including posting the information on the division's website.

Neither the director nor an administrative law judge shall in

any way attempt to condition the lump sum payment on the

claimant waiving the right to pursue permanent total disability

benefits.

(2) If a claimant who has been awarded

compensation is the injured worker or the sole dependent of a

deceased injured worker, the aggregate of all lump sums

granted to the claimant must not exceed eighty thousand eight

hundred sixty-eight dollars and ten cents.

(3) If a claimant who has been awarded

compensation is one of multiple dependents of a deceased

injured worker, the aggregate of all lump sums granted to the

claimant must be a proportionate share, as determined by the

director or administrative law judge, of an amount not to

exceed one hundred sixty-one thousand seven hundred thirty-

four dollars and fifteen cents.

(4) For injuries sustained on or after January 1, 2014,

the director shall adjust the lump-sum limits set forth in

subsections (2) and (3) of this section on July 1, 2014, and each

July 1 thereafter, by the percentage of the adjustment made by

the director to the state average weekly wage pursuant to

section 8-47-106. A claimant who has received compensation

under this section is not entitled to any further compensation

under this section related to the claim as a result of an

adjustment by the director pursuant to this subsection (4).

8-43-407. Election to waive vocational

rehabilitation benefits and become subject to permanent

partial disability provisions. In all cases arising under

articles 40 to 47 of this title prior to July 1, 1987, the employee,

the employer, and, if insured, the insurance carrier may elect,

upon unanimous agreement, in writing to waive vocational

rehabilitation which was awarded pursuant to section 8-49-101

as it existed prior to July 1, 1987, and become subject to the

permanent partial disability provisions pursuant to section 8-

42-110, as said section existed prior to July 1, 1991. Such

election shall be made in a form prescribed by the director and

shall not affect payments made prior to the filing of such

agreement. Failure to agree to the options available under the

provisions of this section shall not be evidence of bad faith in

any future litigation by either party.

8-43-408. Default of employer - additional

liability. (1) If an employer is subject to articles 40 to 47 of

this title 8 and, at the time of an injury, has not complied with

the insurance provisions of those articles or has allowed the

required insurance to terminate, or has not effected a renewal

thereof, the employee, if injured, or, if killed, the employee's

dependents may claim the compensation and benefits provided

in those articles.

(2) In all cases where compensation is awarded

under the terms of this section, the director or an administrative

law judge of the division shall compute and require the

employer to pay to a trustee designated by the director or

administrative law judge an amount equal to the present value

of all unpaid compensation or benefits computed at the rate of

four percent per annum; or, in lieu thereof, such employer,

within ten days after the date of such order, shall file a bond

with the director or administrative law judge signed by two or

more responsible sureties to be approved by the director or by

some surety company authorized to do business within the

state of Colorado. The bond shall be in such form and amount

as prescribed and fixed by the director and shall guarantee the

payment of the compensation or benefits as awarded. The

filing of any appeal, including a petition for review, shall not

relieve the employer of the obligation under this subsection (2)

to pay the designated sum to a trustee or to file a bond with the

director or administrative law judge.

(3) A certified copy of any award of the director,

administrative law judge, or panel ordering the payment of

compensation entered in such case may be filed with the clerk

of the district court of any county in this state at any time after

the order of the administrative law judge awarding

compensation, and the same shall be recorded by said clerk in

the judgment book of said court and entry thereof made in the

judgment docket, and it shall thenceforth have all the effect of

a judgment of the district court, and execution may issue

thereon out of said court as in other cases. Upon the reversal,

setting aside, modification, or vacation of said order or award

and upon payment to the trustee or furnishing of bond in

accordance with the terms of this section, then, upon

certification thereof by the director, administrative law judge,

or panel, said record in the judgment book and the entry in the

judgment docket shall be vacated, and any execution thereon

shall be recalled.

(4) Any employer who fails to comply with a lawful

order or judgment issued pursuant to subsection (2) or (3) of

this section is liable to the employee, if injured, or, if killed,

said employee's dependents, in addition to the amount in the

order or judgment, for an amount equal to fifty percent of such

order or judgment or one thousand dollars, whichever is

greater, plus reasonable attorney fees incurred after entry of a

judgment or order.

(5) In addition to any compensation paid or ordered

in accordance with this section or articles 40 to 47 of this title

8, an employer who is not in compliance with the insurance

provisions of those articles at the time an employee suffers a

compensable injury or occupational disease shall pay an

amount equal to twenty-five percent of the compensation or

benefits to which the employee is entitled to the Colorado

uninsured employer fund created in section 8-67-105.

(6) An employer who fails to comply with a lawful

order or judgment issued pursuant to subsection (2) or (3) of

this section shall be ordered to pay an amount equal to twenty-

five percent of the compensation or benefits to which the

employee is entitled to the Colorado uninsured employer fund

created in section 8-67-105 in addition to any other amount

ordered pursuant to this section or articles 40 to 47 of this title

8-43-409. Defaulting employers - penalties -

enjoined from continuing business - fines - procedure -

definition - repeal. (1) An employer subject to the terms and

provisions of articles 40 to 47 of this title who fails to insure

or to keep the insurance required by such articles in force,

allows the insurance to lapse, or fails to effect a renewal of the

insurance shall not continue business operations while such

To Index

default in effective insurance continues. Upon receiving

information that an employer is in default of its insurance

obligations, the director shall investigate and, if the

information can be substantiated, shall notify the employer of

the opportunity to request a prehearing conference on the issue

of default. As part of the director's investigation, the director

may verify that all employees of that employer are insured

through the employer's workers' compensation plan. The

director may forward any workers' compensation coverage

issue to the employer's workers' compensation carrier for

further investigation by the carrier. Thereafter, if necessary,

the director may set the issue of the employer's default for

hearing in accordance with hearing time schedule and

procedures set forth in articles 40 to 47 of this title and rules

promulgated by the director. Upon a finding that the employer

is in default of its insurance obligations, the director shall take

either or both of the following actions:

(a) Order the employer in default to cease and desist

immediately from continuing its business operations during

the period such default continues;

(b) For every day that the employer fails or has failed

to insure or to keep the insurance required by articles 40 to 47

of this title in force, allows or has allowed the insurance to

lapse, or fails or has failed to effect a renewal of such coverage,

impose a fine of:

(I) Not more than two hundred fifty dollars for an

initial violation; or

(II) Not less than two hundred fifty dollars or more

than five hundred dollars for a second and any subsequent

violation. For purposes of this subparagraph (II) only, if an

employer has been fined pursuant to subparagraph (I) of this

paragraph (b) and the director determines that substantially the

same people or entities were involved in forming a subsequent

employer, the initial violation referred to in subparagraph (I)

of this paragraph (b) shall be deemed to have already occurred

with regard to violations committed by the subsequent

employer.

(1.5) (a) A violation that occurs more than seven

years after the date the preceding violation ended is subject to

a fine up to the maximum amount permitted pursuant to

subsection (1)(b)(I) of this section.

(b) After any fines have been imposed pursuant to

subsection (1)(b)(I) or (1)(b)(II) of this section, the director has

the discretion to enter into a settlement agreement and accept

as consideration an amount less than the minimum fine

allowed by subsection (1)(b)(II) of this section.

fines pursuant to this section may be imposed only for periods

that take place no more than three years prior to the date an

employer is notified by the division of a potential violation of

the requirements of articles 40 to 47 of this title 8.

(d) This subsection (1.5) is repealed, effective July 1,

2022. Before its repeal, this subsection (1.5) is scheduled for

review in accordance with section 24-34-104.

(2) A cease-and-desist order issued or fine imposed

by the director under subsection (1) of this section shall include

specific findings of fact that reflect:

(a) The employer received notice of a hearing, when

applicable;

(b) The employer employs employees for whom it

must carry workers' compensation insurance under the

provisions of articles 40 to 47 of this title;

workers' compensation insurance in effect; and

(d) The employer continues or continued to operate

its business in the absence of such coverage.

(3) Notwithstanding any other provision of articles

40 to 47 of this title, after the entry of a cease and desist order

and upon the request of the director, the attorney general shall

immediately institute proceedings for injunctive relief against

the employer in the district court of any county in this state

where such employer does business. In any such district court

proceeding, a certified copy of any cease and desist order

entered by the director in accordance with the provisions of

subsection (1) of this section based upon evidence in the record

shall be prima facie evidence of the facts found in such record.

Such injunctive relief may include the issuance of a temporary

restraining order under rule 65 of the Colorado rules of civil

procedure, which order shall enjoin the employer from

continuing its business operations until it has procured the

required insurance or has posted adequate security with the

court pending the procurement of such insurance. The court, in

its discretion, shall determine the amount that shall constitute

adequate security.

(4) The issuance of an order to cease and desist, the

imposition of a fine pursuant to subsection (1) of this section,

or the issuance of an order for injunctive relief against an

employer for failure to insure or to keep insurance in force as

required by articles 40 to 47 of this title shall be the penalty for

such failure within the meaning of section 8-43-304 (1) and

such penalty shall be in addition to the increase in benefits that

section 8-43-408 requires.

(5) The director or administrative law judge shall

report to the division each time a fine is imposed pursuant to

subsection (1) of this section. Each such report shall include

the amount of the fine and the name of the offending party.

(6) A certified copy of any final order of the director

ordering the payment of a fine imposed pursuant to subsection

(1) of this section may be filed with the clerk of the district

court of any county in this state at any time after the period of

time provided by articles 40 to 47 of this title for appeal or

seeking review of the order has passed without appeal or

review being sought or, if appeal or review is sought, after the

order has been finally affirmed and all appellate remedies and

all opportunities for review have been exhausted. The party

filing the order shall at the same time file a certificate to the

effect that the time for appeal or review has passed without

appeal or review being undertaken or that the order has been

finally affirmed with all appellate remedies and all

opportunities for review having been exhausted. The clerk of

the district court shall record the order and the filing party's

certificate in the judgment book of the court and entry thereof

made in the judgment docket, and it shall thereafter have all

the effect of and constitute a judgment of the district court, and

execution may issue thereon from said court as in other cases.

Any such order may be filed by and in the name of the director.

(7) Fines collected pursuant to this section on or after

July 1, 2018, shall be transmitted to the state treasurer, who

To Index

shall credit the total amount of the fine to the Colorado

uninsured employer fund, created in section 8-67-105.

(8) For the purposes of this section, "construction

site" means a location where a structure that is attached or will

be attached to real property is constructed, altered, or

remodeled.

8-43-410. Right to compensation operates as lien -

interest on award. (1) The right of compensation granted by

articles 40 to 47 of this title and any awards made thereunder

shall have the same preference or lien without limit of amount

against the assets of the employer or the employer's insurer or

both as may be allowed by law for a claim for unpaid wages

for labor.

(2) Every employer or insurance carrier of an

employer shall pay interest at the rate of eight percent per

annum upon all sums not paid upon the date fixed by the award

of the director or administrative law judge for the payment

thereof or the date the employer or insurance carrier became

aware of an injury, whichever date is later. Upon application

and satisfactory showing to the director or administrative law

judge of the valid reasons therefor, said director or

administrative law judge, upon such terms or conditions as the

director or administrative law judge may determine, may

relieve such employer or insurer from the payment of interest

after the date of the order therefor; and proof that payment of

the amount fixed has been offered or tendered to the person

designated by the award shall be such sufficient valid reason.

PART 5

UTILIZATION REVIEW PROCESS -

INDEPENDENT MEDICAL EXAMINATIONS

8-43-501. Utilization review process - legislative

declaration - cash fund. (1) The general assembly hereby

finds and determines that insurers and self-insured employers

should be required to pay for all medical services pursuant to

this article which may be reasonably needed at the time of an

injury or occupational disease to cure and relieve an employee

from the effects of an on-the-job injury. However, insurers and

self-insured employers should not be liable to pay for care

unrelated to a compensable injury or services which are not

reasonably necessary or not reasonably appropriate according

to accepted professional standards. The general assembly,

therefore, hereby declares that the purpose of the utilization

review process authorized in this section is to provide a

mechanism to review and remedy services rendered pursuant

to this article which may not be reasonably necessary or

reasonably appropriate according to accepted professional

standards.

(2) (a) An insurer, self-insured employer, or claimant

may request a review of services rendered pursuant to this

article by a health care provider. Requests for utilization

review shall be submitted on forms promulgated by the

director by rule. At the time of submission of a review request,

the requester shall pay the division a fee prescribed by the

director by rule. Such fee shall cover the division's

administrative costs and the costs of compensating utilization

review committee members. If a claimant is successful in a

utilization review case brought pursuant to this section, the

division shall reimburse the fee charged pursuant to this

paragraph (a) and assess it against the insurer or self-insured

employer. The state treasurer shall credit fees collected

pursuant to this section to the utilization review cash fund,

which fund is hereby created. Moneys in the utilization review

cash fund are continuously appropriated to the division for the

purpose of administering the utilization review program and

may not revert to the general fund at the end of any fiscal year.

The division shall mail to any claimant, insurer, or self-insured

employer a notice that a case is to be reviewed and that the

claimant may be examined as a result of such review. The

claimant, insurer, or self-insured employer has thirty days from

the date of mailing of such notice to examine the medical

records submitted by the party who requested the review and

may add medical records to the utilization review file that the

party believes may be relevant to the utilization review. The

division shall maintain a special file for utilization review

cases. Such file shall be accessible only to interested parties in

a utilization review case and shall not otherwise be open to any

person.

(b) Prior to submitting a request for a utilization

review pursuant to this section, an insurer, self-insured

employer, or claimant shall hire a licensed medical

professional to review the services rendered in the case. A

report of the review shall be submitted with all necessary

medical records, reports, and the request for utilization review.

pursuant to this section if the claimant has been refused a

request pursuant to section 8-43-404 (5) to have a personal

physician or chiropractor attend the claimant. A claimant

requesting a utilization review pursuant to this paragraph (c)

shall file the request on forms promulgated by the director by

rule and shall pay the fee required by paragraph (a) of this

subsection (2).

(d) For purposes of this section only, "medical

records" means documents and transcripts of information

obtained from a patient or his or her medical professional that

are related to the patient's medical diagnosis, treatment, and

care.

(e) When an insurer, self-insured employer, or

claimant requests utilization review, no other party shall

request a hearing pursuant to section 8-43-207 until the

utilization review proceedings have become final, if such

hearing request concerns issues about a change of physician or

whether treatment is medically necessary and appropriate.

(f) Once a utilization review proceeding has become

final and no longer subject to appeal, the final disposition of

the issues in such proceeding shall be binding on the parties

and preclude a contrary ruling on such issues in a subsequent

hearing under section 8-43-207 unless a preponderance of

evidence is shown.

(3) (a) The director, with input from the medical

director serving pursuant to section 8-42-101 (3.6)(n), shall

appoint members of utilization review committees for

purposes of this section and section 8-42-101 (3.6). The

director shall establish committees based on the different areas

of health care practice for which requests for utilization review

may be made. The director shall establish the qualifications for

members of the different committees and the areas of health

care practice in which each such committee shall conduct

requested utilization reviews. Cases of requested utilization

To Index

review shall be referred to committees appointed pursuant to

this subsection (3) by the director based upon the areas of

health care practice for which each committee is appointed.

(b) Each committee established pursuant to

paragraph (a) of this subsection (3) shall be composed of three

members. Committee members shall be compensated for their

time by the division out of moneys in the utilization review

cash fund, created in paragraph (a) of subsection (2) of this

section. Any member of a committee appointed pursuant to

this subsection (3) shall be immune from criminal liability and

from suit in any civil action brought by any person based upon

an action of such a committee, if such member acts in good

faith within the scope of the function of the committee, has

made reasonable effort to obtain the facts of the matter as to

which action is taken, and acts in the reasonable belief that the

action taken is warranted by the facts. The immunity provided

by this paragraph (b) shall extend to any person participating

in good faith in any investigative proceeding pursuant to this

section.

by majority vote of such committee that no change be ordered

or that a change of provider be ordered.

(II) A committee may also, by unanimous vote,

recommend that the director order that payment for fees

charged for services in the case be retroactively denied.

(III) A committee may also, by unanimous vote,

recommend that the director order that a physician's

accreditation status under section 8-42-101 (3.6) be revoked.

(d) In preparing and issuing an order in any case, the

director shall review and give great weight to the reports and

recommendations of the committee.

(e) In appropriate cases pursuant to this section and

section 8-42-101 (3.6), the director may order that an insurer,

employer, or self-insured employer be permitted to deny

reimbursement to a provider for any medical care or services

rendered to a claimant; and such order may be effective for up

to three years. Bills for services rendered during the effective

period of any such order shall be unenforceable and shall not

result in any debt of the claimant. In deciding whether to issue

any such order, the director shall give great weight to the fact

that:

(I) The provider has, within any two-year period,

been the subject of two or more orders removing the provider

from the role of authorized treating physician; or

(II) The provider has, within any two-year period,

been the subject of two or more orders retroactively denying

the payment of the provider's fees; or

(III) The provider has, within any two-year period,

been the subject of two or more orders either retroactively

denying the payment of the provider's fees or removing the

provider from the role of authorized treating physician.

(4) If the director orders pursuant to subsection (3) of

this section that a change of provider be made in a case or that

the physician's accreditation status be revoked, the claimant,

insurer, or self-insured employer shall have seven days from

receipt of the director's order in which to agree upon a level I

provider. If the claimant, insurer, or self-insured employer can

not reach agreement within the seven day time period, the

director shall select three providers. A new provider shall be

chosen from the three providers so selected by the party who

was successful in the request for review. If no appeal is filed,

the successful party shall notify the division of the name of the

new provider within seven days of the selection of the three

potential providers. If the new health care provider is not

selected within such seven days, the director shall select the

provider.

(5) (a) Any party, including the health care provider,

may appeal to an administrative law judge for review of an

order specifying that no change occur or that a change of

provider be made with respect to a case. Such review shall be

limited to the record on appeal. The findings of a utilization

review committee regarding the change of provider in a case

shall be afforded great weight by the administrative law judge

in any proceeding. A party disputing the finding of such

utilization review committee shall have the burden of

overcoming the finding by clear and convincing evidence.

(b) If the director has entered an order specifying that

the payment of fees in the case be retroactively denied, or

permitting an insurer, employer, or self-insured employer to

deny payments for medical services or care rendered pursuant

to subsection (3)(e) of this section, the health care provider

may request a de novo hearing before an administrative law

judge by filing an application for hearing within thirty days

from the date of the certificate of mailing of the order. In a

hearing held pursuant to this paragraph (b), the record upon

which the director based the order shall be admissible in

evidence. The findings of the utilization review committee

regarding the retroactive denial of payment of fees in a case

shall be afforded great weight by the administrative law judge

in any proceeding. A party disputing the finding of such

utilization review committee shall have the burden of

overcoming the finding by clear and convincing evidence.

must be filed within forty days from the date of the certificate

of mailing of the director's order.

(d) Any party dissatisfied with an order entered by an

administrative law judge pursuant to paragraph (a) of this

subsection (5) may file a petition to review the order pursuant

to section 8-43-301.

(e) (Deleted by amendment, L. 91, p. 1326, § 43,

effective July 1, 1991.)

8-43-502. Independent medical

examinations. (1) The director shall maintain a list of

physicians which shall be known as the medical review panel.

The director shall utilize public and private resources as are

available and appropriate in determining standards and

qualifications for the medical review panel members. It shall

be the duty of the medical review panel to perform independent

medical examinations at the request of the director or an

administrative law judge.

(2) Any party to a workers' compensation proceeding

has the right to obtain an independent medical examination

with the physician selected by the director from the medical

review panel. The requesting party, when submitting a request

for the independent medical evaluation, shall specify the

professional specialty of the physician to be selected by the

director to perform the independent medical examination. The

director shall select, through a revolving selection process

established by the department, the physician from the medical

review panel to perform the examination. The cost of such

To Index

independent medical examination shall be borne by the

requesting party. In no instance shall the independent

examining physician become the authorized treating

physician.

(3) Whenever the director or an administrative law

judge deems it necessary to assist in resolving any issue of

medical fact or opinion, the director or administrative law

judge shall cause the employee to be examined by a physician

or physicians from the medical review panel. The director or

the administrative law judge shall have the authority and

discretion to charge the cost of such examination to the

employer or, if insured, the employer's insurance carrier.

Transportation expenses and all expenses necessary,

reasonable, and incidental to such examination shall be

included in the cost of such examination.

(4) Nothing in this section shall preclude any party

from obtaining an independent medical examination from a

physician who is not a member of the medical review panel.

(5) Upon written request of the employer, or if

insured, the insurer, the employee shall submit to a reasonable

number of independent medical examinations as provided for

in this section. The employee shall be entitled to have a

physician, provided and paid for by such employee, present at

any such independent medical examination. The employee

shall be entitled to receive from the independent examining

physician a copy of any report which said physician makes to

the employer, insurer, or the division. Said copy shall be

furnished to the employee at the same time it is furnished to

the employer, insurer, or division.

(6) Members of the medical review panel and any

person acting as a consultant, witness, or complainant shall be

immune from liability in any civil action brought against said

person for acts occurring while the person was acting as a panel

member, consultant, witness, or complainant, respectively, if

such person was acting in good faith within the scope of the

respective capacity, made a reasonable effort to obtain the facts

of the matter as to which action was taken, and acted in the

reasonable belief that the action taken by such person was

warranted by the facts.

(7) Any physician determining an impairment rating

on an injured worker pursuant to this title shall be immune

from civil liability in any action brought by any person based

on said impairment rating, absent the showing of malice or bad

faith on the part of the rating physician.

8-43-503. Utilization review of health care

providers. (1) The general assembly hereby finds and

determines that health care providers that provide medical care

or health care services that are not reasonably necessary or not

reasonably appropriate according to accepted professional

standards should not be allowed to provide such services to

workers' compensation claimants. The general assembly,

therefore, hereby declares that the purpose of the utilization

review process authorized in this section is to provide a

mechanism to review medical care or health care services

rendered pursuant to this article that may not be reasonably

necessary or reasonably appropriate according to accepted

professional standards and to provide a mechanism to prevent

such health care providers from providing medical care or

health care services.

(2) The provisions relating to the procedures for

utilization review found in section 8-43-501 (2), (3), (4),

(5)(a), (5)(c), and (5)(d) shall apply to utilization review under

this section. A unanimous vote by the committee created in

section 8-43-501 (3) shall be required for a recommendation to

the director that a health care provider not be allowed to

provide medical care or health care services to claimants.

(3) Employers, insurers, claimants, or their

representatives shall not dictate to any physician the type or

duration of treatment or degree of physical impairment.

Nothing in this subsection (3) shall be construed to abrogate

any managed care or cost containment measures authorized in

articles 40 to 47 of this title.

PART 6

PROVIDER REVIEW AND DISCLOSURE

8-43-601. Short title. This part 6 shall be known and

may be cited as the "Provider Review and Disclosure Act".

8-43-602. Legislative declaration. The general

assembly finds, determines, and declares that insurer

performance programs are used in marketing, sales, and other

efforts, and, as such, may impact an employer's selection of an

authorized health care provider. To protect patients,

employers, and providers, and to avoid improper profiling, all

performance programs must be fair, objective, consistently

applied, and accord providers due process. Consistent with

these goals, performance programs should align incentives not

only with efficient operations, but also with cost-effective,

high-quality care. Accordingly, the general assembly finds that

requiring minimum standards and full disclosure of

performance program data and methodologies will help

improve the quality and efficiency of health care delivered to

Colorado workers.

8-43-603. Definitions. As used in this part 6, unless

the context otherwise requires:

(1) "Insurer" means an entity that provides workers'

compensation insurance coverage required by article 44 of this

title, including any third-party insurer or self-insured

employer.

(2) "Methodology" means the method by which an

assessment or measurement is determined, including

algorithms or studies, evaluation of data, application of

guidelines, or performance measures.

(3) "Patient" means a person who qualifies for health

care benefits under articles 40 to 47 of this title.

(4) "Performance program" means any program,

system, or process through which an insurer rates or recognizes

the cost, efficiency, quality, or other assessment or

measurement of a provider's care, whether through awards,

payments, assignment, or characterization or representation

that is disclosed to patients, other providers, employers, or the

public.

(5) "Provider" means a physician licensed under the

"Colorado Medical Practice Act", article 240 of title 12, or a

clinic that provides health care pursuant to articles 40 to 47 of

this title 8.

8-43-604. Performance programs. (1) All

performance programs shall include, at a minimum:

To Index

(a) A quality of care component that is satisfied by

using standard treatment guidelines promulgated by the

director pursuant to section 8-42-101 or evidence-based

administrative, operational, or clinical performance measures

that improve care;

(b) A clear representation of the weight given to the

quality of care component in comparison with other factors,

which weight shall be equal to or greater than any other factor;

satisfaction element, a patient satisfaction element, which shall

be weighted equal to or greater than the employer satisfaction

element;

(d) Statistical analyses that are objective, accurate,

valid, reliable, and verifiable;

(e) A period of assessment of data, pertinent to the

performance program, which shall be updated at appropriate

intervals;

(f) If claims data are used, accurate claims data

appropriately attributed to the provider. When reasonably

available, the insurer shall use aggregated data from other

insurers to supplement its own claims data.

(g) The provider's responsibility for health care

decisions and the financial consequences of those decisions,

which shall be fairly and accurately attributed to the provider.

(2) Performance program results shall be reported to

each provider reviewed in the program and shall include

comparison of the provider's results to the results of the

provider's peers.

(3) Any disclosure to patients, other providers,

employers, or the public of the results of a performance

program shall be accompanied by a conspicuous disclaimer

written in bold-faced type stating that the information is

intended only as a guide, should not be the sole factor in

selecting a provider, has a risk of error, and should be

discussed with the provider.

8-43-605. Due process. (1) At least forty-five days

before disclosing the results of a performance program, an

insurer shall give a provider written notice of the availability

of the provider's individual result, specific instructions on how

the provider can access the result, and a description of the

implications to the provider. The written notice shall describe

the procedures by which the provider may request:

(a) The information required to be disclosed under

subsection (2) of this section; and

(b) An appeal of the result pursuant to subsection (3)

of this section.

(2) (a) Within ten business days after receiving a

request by or on behalf of a provider, an insurer shall disclose,

in a manner that is reasonably understandable and that allows

the provider to verify the data against his or her records, the

methodology and all data upon which a provider's performance

program result was calculated, with sufficient detail to allow

the provider to determine the effect of the methodology on the

data reviewed.

(b) An insurer shall not use the "Uniform Trade

Secrets Act", article 74 of title 7, C.R.S., to avoid compliance

with this section.

(3) Insurers shall establish procedures for providers

to appeal the results of a performance program. Such

procedures, in addition to the disclosures and the written notice

furnished, shall provide:

(a) A reasonable method by which the provider may

submit notice of the desire to appeal;

(b) The name, title, qualifications, and relationship to

the insurer of any person responsible for deciding the appeal,

who shall be authorized to uphold, modify, or reject results or

require additional action to ensure that results are fair,

reasonable, accurate, and comply with the requirements of this

part 6;

considered corrected data or other information relevant to the

results or the appropriateness of the methodology used. If

requested, a provider may appear at a face-to-face meeting

with those responsible for the appeal decision at a location

reasonably convenient to the provider or by teleconference.

The provider shall submit in writing any corrected data or

information in advance of the meeting.

(d) The provider's right to be assisted by a

representative, including an attorney;

(e) A detailed written decision regarding the appeal

that states the reasons for upholding, modifying, or rejecting

the appeal;

(f) Resolution of the appeal within forty-five days

after the date upon which the data and methodology are

disclosed unless otherwise agreed to by the parties to the

appeal; and

(g) A stay on the implementation, use, and disclosure

of and action upon the individual results of the performance

program until the appeal and any subsequent hearing requested

pursuant to section 8-43-207 has become final.

8-43-606. Enforcement. (1) An insurer shall not

limit, by contract or other means, the right of a provider to

enforce this part 6.

(2) This part 6 may be enforced through a hearing

pursuant to section 8-43-207 or in a civil action, and any

remedies at law and in equity are available.

(3) A violation of this part 6 constitutes an unfair or

deceptive act or practice under part 11 of article 3 of title 10,

C.R.S.

8-43-607. Filing with director. At least thirty days

before implementing any new or amended performance

program, an insurer shall file a detailed description of the

performance program with the director.

To Index

ARTICLE 44

Insurance

PART 1

GENERAL PROVISIONS

8-44-101. Insurance requirements. (1) Any

employer subject to the provisions of articles 40 to 47 of this

title shall secure compensation for all employees in one or

more of the following ways, which shall be deemed to be

compliance with the insurance requirements of said articles:

(a) By insuring and keeping insured the payment of

such compensation in the Pinnacol Assurance fund;

(b) By insuring and keeping insured the payment of

such compensation with any stock or mutual corporation

authorized to transact the business of workers' compensation

insurance in this state. If insurance is effected in such stock or

mutual corporation, the employer or insurer shall forthwith file

with the division, in form prescribed by it, a notice specifying

the name of the insured and the insurer, the business and place

of business of the insured, the effective and termination dates

of the policy, and, when requested, a copy of the contract or

policy of insurance.

executive director as provided in section 8-44-201, except for

public entity pools as described in section 8-44-204 (3), which

shall procure self-insurance certificates of authority from the

commissioner of insurance as provided in section 8-44-204;

(d) By procuring a self-insurance certificate of

authority from the commissioner of insurance as provided in

section 8-44-205.

(2) It shall be unlawful, except as provided in

sections 8-41-401 and 8-41-402, for any employer, regardless

of the method of insurance, to require an employee to pay all

or any part of the cost of such insurance.

(3) (a) (I) Except as otherwise provided in

subparagraph (II) of this paragraph (a), all public entities in the

state shall insure and keep insured the payment of

compensation by electing one of the methods provided in

subsection (1) of this section. A public entity having an insured

payroll of less than one million dollars annually shall not be

eligible for self-insurance; except that public entities forming

a pool pursuant to section 8-44-204 (3) shall be eligible if the

total of all the payrolls of the public entities in the pool exceeds

the required minimum.

(II) Any public entity in the state that is participating

in the federal prison industry enhancement certification

program pursuant to the federal "Justice System Improvement

Act of 1979", 18 U.S.C. sec. 1761 (c), shall insure and keep

insured the payment of compensation by electing one of the

methods provided in subsection (1) of this section; except that

the method for insuring the participants of such program need

not be the same method selected by the public entity pursuant

to subparagraph (I) of this paragraph (a).

(b) For purposes of this subsection (3), the

department of human services, by virtue of the self-insurance

program established pursuant to section 8-44-203, shall be

considered a public entity of the state.

8-44-102. Contract for insurance subject to

workers' compensation act. (1) Every contract for the

insurance of compensation and benefits as provided in articles

40 to 47 of this title or against liability therefor is subject to

articles 40 to 47 of this title, and all provisions in the contract

for insurance inconsistent with those articles are void. Any

contract of insurance issued under articles 40 to 47 of this title

by any insurance carrier, including stock and mutual

corporations and Pinnacol Assurance, may include and cover

any liability of the employer on account of personal injuries

sustained by or death resulting therefrom to any employee.

(2) (a) (I) Except as specified in subparagraph (III)

of this paragraph (a), every carrier providing workers'

compensation insurance that is authorized to conduct business

in Colorado shall submit an annual report to the commissioner

of insurance listing any policy forms as may be requested by

the commissioner. The listing must be submitted no later than

July 1 of each year and must contain a certification by an

officer of the carrier that, to the best of the officer's knowledge,

each policy form in use complies with Colorado law. The

commissioner shall determine the necessary elements of the

certification.

(II) (A) An advisory organization as defined in

section 10-4-402 (1), C.R.S., or a rating organization as

defined in section 10-4-402 (3), C.R.S., shall submit an annual

report to the commissioner of insurance listing any policy

forms as may be requested by the commissioner. The listing

must be submitted no later than July 1 of each year and must

contain a certification by an officer of the organization that, to

the best of the officer's knowledge, each policy form listed

complies with Colorado law. The commissioner shall

determine the necessary elements of the certification.

(B) As used in this section, "form" may include any

endorsement, rider, letter, notice, or other document affecting

an insurance policy or contract issued or delivered to any

policyholder in Colorado.

(III) If a carrier uses, in their entirety and without

modification, forms prepared by an advisory organization as

defined in section 10-4-402 (1), C.R.S., or a rating

organization as defined in section 10-4-402 (3), C.R.S., the

carrier shall notify the commissioner of insurance that it adopts

the annual report filed by the advisory organization or rating

organization under subparagraph (II) of this paragraph (a) and,

if it so notifies the commissioner, it need not submit the

certification required by subparagraph (I) of this paragraph (a).

If a carrier uses forms that deviate from the forms listed by the

advisory organization or rating organization, or if it uses forms

other than those listed by the advisory organization or rating

organization, the carrier shall submit the annual listing of

forms and certification as required by subparagraph (I) of this

paragraph (a).

(b) In addition to submitting the documentation

required under paragraph (a) of this subsection (2) and except

as specified in subparagraph (III) of this paragraph (b):

(I) Every carrier providing workers' compensation

insurance that is authorized to conduct business in Colorado,

every advisory organization as defined in section 10-4-402 (1),

C.R.S., and every rating organization as defined in section 10-

4-402 (3), C.R.S., shall submit to the commissioner a list of

any new or revised policy forms as may be requested by the

To Index

commissioner at least thirty-one days before a carrier uses the

forms. Unless a carrier notifies the division of insurance

otherwise, policy forms submitted on behalf of a member of an

advisory organization or rating organization are deemed to be

automatically adopted by the carrier without modification.

(II) The listing must also contain a certification by an

officer of the carrier or an officer of the advisory or rating

organization that, to the best of the officer's knowledge, each

new or revised policy form, endorsement, rider, letter, notice,

or other document proposed to be used complies with

Colorado law. The commissioner shall determine the

necessary elements of the certification.

(III) If an advisory organization or rating

organization certifies a form as required by subparagraph (II)

of this paragraph (b) and a carrier is a member of that

organization and uses the form in its entirety, the carrier need

not list that form as required by subparagraph (I) of this

paragraph (b) or submit a certification for that form as required

by subparagraph (II) of this paragraph (b).

workers' compensation carriers authorized to conduct business

in Colorado to determine whether workers' compensation

policy forms, as may be requested by the commissioner,

comply with the certification of the carrier and statutory

mandates.

8-44-103. Insurers to file system of rating -

approval. Every insurance carrier authorized to transact

business in this state that insures employers against liability for

compensation under the provisions of articles 40 to 47 of this

title shall file with the commissioner of insurance its

classification of risks, any premiums relating thereto, and any

subsequent proposed classification of risks and premiums,

together with all rates and any systems of rating.

8-44-104. Cutting rates - rebates - penalty. Every

insurance carrier that writes compensation insurance shall

write insurance at the rates filed with the commissioner of

insurance. The cutting of rates, rebating, or any other method

whereby, directly or indirectly, any employer is given the

benefit of or obtains a rate lower than that approved by the

commissioner of insurance is prohibited. The commissioner of

insurance may suspend the license of any insurance carrier,

agent, or broker who violates any provision of this section.

Also, any insurance carrier, any employer, or any officer,

agent, or employee thereof who violates any provision of this

section is guilty of a misdemeanor and, upon conviction

thereof, shall be punished by a fine of not more than one

hundred dollars for each such violation.

8-44-105. Provisions of policies - primary liability

- notice of injury. Every contract insuring against liability for

compensation or insurance policy evidencing the same shall

contain a clause to the effect that the insurance carrier shall be

directly and primarily liable to the employee and, in the event

of death, to said employee's dependents to pay compensation,

if any, for which the employer is liable, thereby discharging to

the extent of such payment the obligations of the employer to

the employee; that, as between the employee and the insurance

carrier, notice or knowledge of the occurrence of the injury on

the part of the employer shall be deemed notice or knowledge,

as the case may be, on the part of the insurance carrier; that

jurisdiction of the employer, for the purpose of articles 40 to

47 of this title, shall be jurisdiction of the insurance carrier; and

that the insurance carrier, in all things, shall be bound by and

subject to the orders, findings, decisions, or awards rendered

against the employer under the provisions of said articles. Such

policy shall also provide that the employee shall have a first

lien upon any amount which becomes owing to the employer

from the insurance carrier, and the insurance carrier shall pay

the same directly to the employee or the employee's

dependents, thereby discharging to the extent of such payment

the obligation of the employer to the employee. The policy

shall not contain any provisions relieving the insurance carrier

from payment when the employer becomes legally incapable

or insolvent or is discharged in bankruptcy or otherwise during

the period that the policy is in operation or the compensation

remains owing.

8-44-106. Insurer violation - suspension or

revocation of license. If any insurance carrier intentionally,

knowingly, or willfully violates any of the provisions of

articles 40 to 47 of this title, the commissioner of insurance, on

the request of the director, shall suspend or revoke the license

or authority of such carrier to do a compensation business in

this state.

8-44-107. Right of insurer to examine books of

employer. Any insurance carrier operating under the workers'

compensation act may apply to the commissioner of insurance

for permission to examine any of the books, payrolls, or other

documents of any employer insured by such carrier or of any

contractor, subcontractor, lessee, sublessee, or person covered

by the employer's compensation insurance to determine the

amount of wage expenditure of such employer or of any

contractor, subcontractor, lessee, sublessee, or person during

any period that such insureds were insured by the insurance

carrier. The commissioner of insurance may grant such carrier

authority in writing to make the investigation or may appoint

any agents of the division of insurance to conduct the

investigation.

8-44-108. Repayments for

misclassifications. (1) Every insurance carrier authorized to

transact business in this state, including Pinnacol Assurance,

which insures employers against liability for compensation

under the provisions of articles 40 to 47 of this title, is

authorized to charge and collect any amount of money that

should have been included in premiums paid by an insured but

were not included in such premiums as a result of job

misclassification. Upon written request by the employer, the

issue of whether a job misclassification occurred shall be

determined in writing by the insurance company. The

employer's request shall be made within thirty working days

after the anniversary date of the policy or the date of receipt by

the employer of notice of a change in job classification. The

insurance company's determination shall be made within thirty

days after receipt of the employer's written request. An

employer may appeal any determination of an insurance

company made pursuant to this subsection (1) to the workers'

compensation classification appeals board, pursuant to section

8-55-102. If it is determined that a job misclassification

occurred and that such misclassification was caused by the

failure of the insured to provide accurate or complete data in

order to determine the proper classification as requested by the

insurance carrier, the repayment may be collected during the

To Index

term of the contract for such insurance plus an additional

reasonable time not to exceed twelve months.

(2) Any employer who has purchased insurance

against liability for compensation under the provisions of

articles 40 to 47 of this title is authorized to recover any

amount of money which should not have been included in

premiums paid by the employer but which were included in

such premiums as a result of job misclassification. The

repayment may be collected during the term of the contract for

such insurance plus an additional reasonable time not to

exceed twelve months.

8-44-109. Notice - change in rate by classification

- policyholder's right to appeal classifications - availability

of medical case management services. (1) Any insurance

carrier authorized to transact business in this state, including

Pinnacol Assurance, which insures employers against liability

for compensation under the provisions of articles 40 to 47 of

this title, shall supply information regarding a change in the

rate by classification to any insured employer, if such

employer has requested that such information be supplied.

Such information shall be supplied within thirty days

following release of such information to such insurer by the

authorized rating organization and following approval of such

rate change by the division of insurance. As soon as reasonably

possible after the division of insurance's approval of a change

in rate by classification, the authorized rating organization

shall disseminate notice of such approval and change in rate.

(2) Every insurance carrier authorized to transact

business in Colorado, including Pinnacol Assurance, which

insures employers against liability for compensation under the

provisions of articles 40 to 47 of this title, shall clearly and

conspicuously inform policyholders of their rights to appeal

employee classification designations, the procedures to be

used for such an appeal, and the types of medical case

management that the carrier has available to employees to

promote medical cost containment.

8-44-110. Notice of cancellation. Every insurance

carrier authorized to transact business in this state, including

Pinnacol Assurance, which insures employers against liability

for compensation under the provisions of articles 40 to 47 of

this title, shall notify any employer insured by the carrier or

Pinnacol Assurance, and any agent or representative of such

employer, if applicable, by certified mail of any cancellation

of such employer's insurance coverage. Such notice shall be

sent at least thirty days prior to the effective date of the

cancellation of the insurance. However, if the cancellation is

based on one or more of the following reasons, then such

notice may be sent less than thirty days prior to the effective

date of the cancellation of the insurance: Fraud, material

misrepresentation, nonpayment of premium, or any other

reason approved by the commissioner of insurance.

8-44-111. Workers' compensation insurance -

deductibles - definition. (1) (a) Any employer may agree, as

a condition of any contract for the insurance of compensation

and benefits as provided in articles 40 to 47 of this title or

against liability therefor, to pay an amount not to exceed the

split point approved by the commissioner of insurance per

claim toward the total amount of any claim payable under

articles 40 to 47 of this title. The amount of premium to be paid

by an employer who agrees to pay such deductible shall be

reduced based upon such deductible in an amount determined

by the insurance carrier.

(b) As used in this subsection (1), "split point" means

the amount of each loss approved by the commissioner of

insurance that an insurer may apply as the primary loss in each

workers' compensation claim. The full amount of primary

losses counts in each employer's experience modification

calculation that determines the employer's percentage credit or

surcharge on workers' compensation coverage. The loss

amount above the split point is excess loss and constitutes part

of each employer's experience modification calculation.

responsibility to pay the full amount of any compensation and

benefits due under articles 40 to 47 of this title. It is a violation

of this title for an employer or, if insured, the insurer to require

any employee to pay any part of the compensation and benefits

due under articles 40 to 47 of this title.

(d) It is a violation of this title for an employer or, if

insured, the insurer to require an employee to use any other

type of insurance, regardless of whether it is provided as a

benefit of employment, or any other employment benefit, to

pay any portion of any compensation and benefits due under

articles 40 to 47 of this title.

(e) Nothing in this subsection (1) allows a carrier to

stop offering no-deductible policies.

(1.5) Whenever any insurer, including Pinnacol

Assurance created in section 8-45-101, issues a workers'

compensation policy in this state, and annually thereafter, the

insurer must issue a policy including the deductible provision

if requested by the insured employer; except that the

commissioner shall promulgate rules establishing criteria to

allow the insurer to deny a deductible policy to an employer

based on financial inability to reimburse the insurer for the

deductible plan selected.

(2) The existence of an insurance contract with a

deductible or the fact of payment as a result of a deductible

shall not affect the requirement of an employer to report an

injury or death to the division as required in section 8-43-103

(1).

(3) The deductible amounts paid by any employer

under the provisions of this section shall be excluded from

consideration by insurance carriers authorized to transact

business in Colorado, including Pinnacol Assurance, which

insures employers against liability for compensation under the

provisions of articles 40 to 47 of this title, in establishing the

modification factors based upon experience used by such

insurance carriers to determine premiums. For purposes of

experience modifications, medical only claims shall be

calculated in the same manner as claims with indemnity

payments.

(4) Every insurance carrier authorized to transact

business in Colorado, including Pinnacol Assurance, which

insures employers against liability for compensation under the

provisions of articles 40 to 47 of this title, shall clearly and

conspicuously inform policyholders of the availability of the

deductible option specified in subsection (1) of this section.

8-44-112. Surcharge on workers' compensation

insurance premiums - workers' compensation cash

fund. (1) (a) Notwithstanding the provisions of sections 10-3-

209 (1)(c) and 10-6-128 (3), C.R.S., for the purpose of

To Index

offsetting the direct and indirect costs of the administration of

the workers' compensation system, every person, partnership,

association, and corporation, whether organized under the laws

of this state or of any other state or country, every mutual

company or association, every captive insurance company, and

every other insurance carrier, including Pinnacol Assurance,

insuring employers in this state against liability for personal

injury to their employees or death caused thereby under the

provisions of the "Workers' Compensation Act of Colorado"

shall, as provided in this section, pay a surcharge upon the

premiums received, whether in cash or not, in this state, or on

account of business done in this state, for such insurance in this

state, at a rate established by the director by rule, which

surcharge shall be reviewed and adjusted annually based upon

appropriations made for the direct and indirect costs of the

administration of the workers' compensation system, as

provided in subsection (7) of this section. Such insurance

carriers shall be credited with all cancelled or returned

premiums actually refunded during the year of such insurance.

(b) (I) For the purpose of funding the direct and

indirect costs of the activities of the division related to the

"Workers' Compensation Cost Containment Act", article 14.5

of this title, there shall be added to the surcharge imposed

pursuant to paragraph (a) of this subsection (1) an increment

not to exceed three-hundredths of one percent upon the

premiums received, said surcharge to be reviewed and adjusted

annually and paid over to the division in the same manner as

specified in this section for the surcharge.

(II) Notwithstanding any other provisions of this

section, no employer acting as a self-insurer under the

provisions of the "Workers' Compensation Act of Colorado"

shall be subject to the increment added to the surcharge

pursuant to subparagraph (I) of this paragraph (b).

(III) All moneys collected pursuant to subparagraph

(I) of this paragraph (b) shall be transmitted to the state

treasurer, who shall credit the same to the cost containment

fund, created in section 8-14.5-108.

(2) Every such insurance carrier shall, on July 1,

1987, and semiannually thereafter, make a return, verified by

affidavits of its president and secretary, or other chief officers

or agents, to the division of workers' compensation, stating the

amount of all such premiums received and credits granted

during the period covered by such return. Every insurance

carrier required to make such return shall file the same with the

division within thirty days after the close of the period covered

thereby and shall, at the same time, pay to the division of

workers' compensation a surcharge ascertained as provided in

subsection (1) of this section, less return premiums on

cancelled policies.

(3) Every employer acting as a self-insurer under the

provisions of the "Workers' Compensation Act of Colorado"

shall, under oath, report to the division of workers'

compensation the business payroll in such form as may be

prescribed by the director and at the times in this section

provided for premium reports by insurance companies in

subsection (2) of this section. The division shall assess against

such payroll a surcharge for the purposes of this section

ascertained as provided in subsection (2) of this section on the

basic premiums chargeable against the same or most similar

industry or business taken from the manual insurance rates,

including any discount or experience modification allowed,

chargeable by the Pinnacol Assurance fund, and, upon receipt

of notice from the division of workers' compensation of the

surcharge so assessed, every such self-insurer shall, within

thirty days after the receipt of such notice, pay to the division

of workers' compensation the surcharge so assessed.

(4) If any such insurance carrier or self-insurer fails

or refuses to make the return required by this article, the

director shall assess the surcharge against such insurance

carrier or self-insurer at the rate provided for in this section on

such amount of premium as the director may deem just, and

the proceedings thereof shall be the same as if the return had

been made.

(5) If any such insurance carrier or self-insurer

withdraws from business in this state before the surcharge falls

due as provided in this section, or fails or neglects to pay such

surcharge, the director shall at once proceed to collect the

same; and the director is authorized to employ such legal

processes as may be necessary for that purpose. Suit shall be

brought by the director in any of the courts of this state having

jurisdiction.

(6) The director, in the enforcement of this section,

shall have all of the powers granted to said director in the

"Workers' Compensation Act of Colorado", and any insurance

carrier or self-insurer violating any of the provisions of this

section, or failing to pay the surcharge imposed in this section,

is guilty of violation of said act and subject to the penalties

therein prescribed.

(7) (a) All moneys collected pursuant to this section

shall be transmitted to the state treasurer, who shall credit the

same to the workers' compensation cash fund, which fund is

hereby created. The moneys in the workers' compensation cash

fund shall be subject to annual appropriation by the general

assembly for the direct and indirect costs of the administration

of the "Workers' Compensation Act of Colorado", articles 40

to 47 of this title. Any interest earned on the investment or

deposit of moneys in the workers' compensation cash fund

shall remain in the fund and shall not revert to the general fund

of the state at the end of any fiscal year.

(b) Notwithstanding any provision of paragraph (a)

of this subsection (7) to the contrary, on March 5, 2003, the

state treasurer shall deduct six million dollars from the

workers' compensation cash fund and transfer such sum to the

general fund.

of this subsection (7) to the contrary, on March 30, 2009, the

state treasurer shall deduct fifteen million seven hundred

thousand dollars from the workers' compensation cash fund

and transfer such sum to the general fund.

(d) The workers' compensation cash fund is exempt

from the limitations set forth in section 24-75-402.

8-44-113. Data from insurance carriers and self-

insured employers related to workers' compensation -

studies related to workers' compensation system.

(Repealed)

8-44-114. Determination of premium. The amount

of the premium to be paid by an employer for a contract of

insurance of compensation and benefits as provided in articles

40 to 47 of this title or against liability therefor shall be on the

basis of the annual expenditure of money by said employer for

To Index

the services of persons engaged in such employer's

employment; except that no portion of such expenditure

representing a per diem payment shall be considered unless

such payment is considered wages for federal income tax

purposes.

8-44-115. Calculation of premium - motor vehicle

accidents. (1) The amount by which an employer's

experience rating is modified, if at all, as the result of a motor

vehicle accident in which an employee is injured or killed shall

be reduced in accordance with this section if:

(a) The employee is entitled to benefits under articles

40 to 47 of this title; and

(b) The accident was not caused, wholly or in part,

by the employee or the employer; and

of the employer's business, as determined under rules

promulgated by the commissioner of insurance under section

10-4-408 (5)(e), C.R.S.

(2) (a) Any modification of an employer's

experience rating resulting from an accident described in

subsection (1) of this section shall reflect the deduction of a

loss limitation, the amount of which shall be determined by the

commissioner of insurance under rules adopted pursuant to

section 10-4-408 (5)(e), C.R.S.

(b) All loss experience remaining after deduction of

the loss limitation referred to in paragraph (a) of this

subsection (2) shall be distributed among all workers'

compensation classifications in use in the state as determined

by the commissioner of insurance. For purposes of such

distribution, classifications of businesses of which use of a

motor vehicle is an integral part may be treated differently

from classifications of businesses of which use of a motor

vehicle is not an integral part.

(3) This section applies to all insurers, including

Pinnacol Assurance created in section 8-45-101, offering

workers' compensation insurance under articles 40 to 47 of this

title. The provisions of this section shall be disclosed to all

policyholders annually.

8-44-116. Reversionary interests in indemnity

benefits prohibited. No provision in a contract for insurance

regulated by this article or any contract ancillary to such a

contract, including specifically a contract setting up an annuity

for indemnity benefits, shall establish a reversionary interest in

the insurer for the indemnity benefits. Any such provision is

void and unenforceable as against public policy.

PART 2

SELF-INSUREDS

8-44-201. Employer as own insurance carrier -

revocation of permission. (1) The executive director has the

discretion to grant to any employer who has accepted the

provisions of articles 40 to 47 of this title permission to be its

own insurance carrier for the payment of the compensation and

benefits provided by said articles. Such permission may be

granted by the executive director after the filing by an

employer of such statement and the giving of such information

as may be required by the executive director. The executive

director has the sole power to prescribe the rules, regulations,

orders, terms, and conditions upon which said permit shall be

granted or continued. Permission for self-insurance may be

revoked at any time by the executive director, and the

employer, upon notice of revocation, shall immediately insure

otherwise all liability.

(2) Notwithstanding the provisions of subsection (1)

of this section, the executive director shall not prescribe or

apply security requirements in granting or continuing

permission for the self-insurance program of the department of

human services established pursuant to section 8-44-203 but

shall provide instead for alternatives to such security

requirements including trust funds, surety bonds, excess

insurance, or other security acceptable to the executive

director. The alternative security requirements provided by this

subsection (2) shall apply only to claims arising on or after July

1, 1985, and before July 1, 1990. The trust fund in existence

on May 24, 1990, pursuant to the trust agreement between the

department of human services, a third party administrator, and

the state treasurer, dated June 27, 1985, shall remain in

existence through June 30, 1990.

(3) Notwithstanding the provisions of subsection (1)

of this section, the executive director shall not prescribe or

apply security requirements in continuing permission for an

employer which is acting as its own insurance carrier on July

1, 1986, which are in excess of those security requirements in

effect on July 1, 1986, unless there is a substantial change in

the economic condition or potential liability of such employer.

(4) Notwithstanding the provisions of subsection (1)

of this section, the executive director shall not prescribe or

apply security requirements in granting or continuing

permission for a self-insurance program established by the

state pursuant to section 24-30-1510.7, C.R.S.

8-44-202. Workers' compensation self-insurance

fund - created. (1) The executive director shall establish and

collect such fees as the executive director determines are

necessary to administer this section, which fees shall not

supplant funding for any other function of the department of

labor and employment. The fees established pursuant to this

subsection (1) shall not exceed two thousand dollars for an

initial application or for an annual review of any employer

acting as a self-insurer under this section.

(2) The executive director shall transmit any moneys

received pursuant to subsection (1) of this section to the state

treasurer, who shall place such moneys in the workers'

compensation self-insurance fund, which fund is hereby

created. The general assembly shall make appropriations from

such fund for the purposes of administering this section.

8-44-203. Department of human services - self-

insurance program. The general assembly hereby finds and

declares that a program shall be established by the department

of human services and the department of labor and

employment to provide for a self-insurance program for the

department of human services, which shall apply only to

claims arising on or after July 1, 1985, and before July 1, 1990.

8-44-204. Public entities - self-insurance

authorized for workers' compensation - pooled insurance -

definition. (1) "Public entity", as used in this section, means

and includes any county, municipality, school district, and any

other type of district or authority organized pursuant to law.

(2) A public entity may, after receiving permission

pursuant to section 8-44-101 (1)(c), act as its own insurance

To Index

carrier for compensation and benefits. Any public entity other

than a school district may establish and maintain an insurance

reserve fund for self-insurance purposes and may include in

the annual tax levy of the public entity such amounts as are

determined by its governing body to be necessary for the uses

and purposes of the insurance reserve fund, subject to the

limitations imposed by section 29-1-301, C.R.S. School

districts may establish and maintain an insurance reserve fund

in accordance with the provisions of section 22-45-103 (1)(e),

C.R.S., using moneys allocated thereto pursuant to the

provisions of section 22-54-105 (2), C.R.S. In the event that a

public entity has no annual tax levy, it may appropriate from

any unexpended balance in the general fund such amounts as

the governing body shall deem necessary for the purposes and

uses of the insurance reserve fund.

(3) Public entities may cooperate with one another to

form a self-insurance pool to provide the insurance coverage

required by this article for the cooperating public entities. Any

such insurance pool shall be formed pursuant to the provisions

of part 2 of article 1 of title 29, C.R.S. The provisions of

articles 10.5 and 47 of title 11, C.R.S., shall apply to moneys

of such self-insurance pool.

(4) [Editor's note: This version of subsection (4) is

effective until January 1, 2018.] Any self-insurance pool

authorized by subsection (3) of this section shall not be

construed to be an insurance company nor otherwise subject to

the provisions of the laws of this state regulating insurance or

insurance companies; except that the pool shall comply with

the applicable provisions of sections 10-1-203 and 10-1-204

(1) to (5) and (10), C.R.S.

(4) [Editor's note: This version of subsection (4) is

effective January 1, 2018.] Any self-insurance pool

authorized by subsection (3) of this section shall not be

construed to be an insurance company nor otherwise subject to

the laws of this state regulating insurance or insurance

companies; except that the pool shall comply with the

applicable provisions of sections 10-1-203 and 10-1-204 (1) to

(5).

(5) Prior to the formation of a self-insurance pool,

there shall be submitted to the commissioner of insurance a

complete written proposal of the pool's operation, including,

but not limited to, the administration, claims adjusting,

membership, plan for reinsurance, and capitalization of the

pool. The commissioner shall review the proposal within thirty

days after receipt to assure that proper insurance techniques

and procedures are included in the proposal. After such review,

the commissioner shall have the right to approve or disapprove

the proposal. If the commissioner approves the proposal, the

commissioner shall issue a certificate of authority. The costs

of such review shall be paid by the public entities desiring to

form such a pool.

(6) Each self-insurance pool for public entities

created in this state shall file, with the commissioner of

insurance on or before March 30 of each year, a written report

in a form prescribed by the commissioner, signed and verified

by its chief executive officer as to its condition.

(7) The commissioner of insurance, or any person

authorized by the commissioner of insurance, shall conduct an

insurance examination at least once a year to determine that

proper underwriting techniques and sound funding, loss

reserves, and claims procedures are being followed. This

examination shall be paid for by the self-insurance pool out of

its funds at the same rate as provided for foreign insurance

companies under section 10-1-204 (9), C.R.S.

(8) (a) The certificate of authority issued to a public

entity under this section may be revoked or suspended by the

commissioner of insurance for any of the following reasons:

(I) Insolvency or impairment;

(II) Refusal or failure to submit an annual report as

required by subsection (6) of this section;

(III) Failure to comply with the provisions of its own

ordinances, resolutions, contracts, or other conditions relating

to the self-insurance pool;

(IV) Failure to submit to examination or any legal

obligation relative thereto;

(V) Refusal to pay the cost of examination as

required by subsection (7) of this section;

(VI) Use of methods which, although not otherwise

specifically proscribed by law, nevertheless render the

operation of the self-insurance pool hazardous, or its condition

unsound, to the public;

(VII) Failure to otherwise comply with the law of

this state, if such failure renders the operation of the self-

insurance pool hazardous to the public.

(b) If the commissioner of insurance finds upon

examination, hearing, or other evidence that any participating

public entity has committed any of the acts specified in

paragraph (a) of this subsection (8) or any act otherwise

prohibited in this section, the commissioner may suspend or

revoke such certificate of authority if the commissioner deems

it in the best interest of the public. Notice of any revocation

shall be published in one or more daily newspapers in Denver

which have a general state circulation. Before suspending or

revoking any certificate of authority of a public entity, the

commissioner shall grant the public entity fifteen days in

which to show cause why such action should not be taken.

(9) (a) Any self-insurance pool organized pursuant to

this section may invest in securities meeting the investment

requirements established in part 6 of article 75 of title 24,

C.R.S., and may also invest in membership claim deductibles

and in any other security or other investment authorized for

such pools by the commissioner of insurance.

(b) Any public entity which is a member of a self-

insurance pool which is organized pursuant to this section or

any instrumentality formed by two or more of such members

may invest in subordinated debentures issued by such self-

insurance pool.

(10) In addition to workers' compensation coverage

pursuant to subsection (3) of this section, a self-insurance pool

authorized by subsection (3) of this section may provide

property coverage pursuant to section 29-13-102, C.R.S., and

liability coverage pursuant to section 24-10-115.5, C.R.S.

8-44-205. Employers - self-insurance pools

authorized for workers' compensation -

definition. (1) "Employers", as used in this section, means a

bona fide trade or professional association or two or more

employers which are engaged in the same or similar type of

business or are members of the same bona fide trade or

professional association.

To Index

(2) Employers may cooperate with one another to

form a self-insurance pool to provide the insurance coverage

required by this article for cooperating employers.

(3) [Editor's note: This version of subsection (3) is

effective until January 1, 2018.] Any self-insurance pool

authorized by subsection (2) of this section shall not be

construed to be an insurance company nor otherwise subject to

the provisions of the laws of this state regulating insurance or

insurance companies; except that the pool shall comply with

the applicable provisions of sections 10-1-203 and 10-1-204

(1) to (5) and (10), C.R.S., and shall be subject to proceedings

authorized by part 5 of article 3 of title 10, C.R.S.

(3) [Editor's note: This version of subsection (3) is

effective January 1, 2018.] Any self-insurance pool

authorized by subsection (2) of this section shall not be

construed to be an insurance company nor otherwise subject to

the laws of this state regulating insurance or insurance

companies; except that the pool shall comply with the

applicable provisions of sections 10-1-203 and 10-1-204 (1) to

(5), and is subject to proceedings authorized by part 5 of article

3 of title 10.

(4) Prior to the formation of a self-insurance pool,

there shall be submitted to the commissioner of insurance a

complete written proposal of the pool's operation, including,

but not limited to, the administration, claims adjusting,

membership, plan for reinsurance, capitalization of the pool,

and risk management programs. The commissioner shall

review the proposal within forty-five days after receipt to

assure that proper insurance techniques and procedures are

included in the proposal. After such review, the commissioner

shall have the right to approve or disapprove the proposal. If

the commissioner of insurance has not disapproved the

proposal within ninety days of receipt of the proposal, such

proposal shall be deemed approved. If the commissioner

approves the proposal, the commissioner shall issue a

certificate of authority. The costs of such review shall be paid

by the employers desiring to form such a pool.

(5) Each self-insurance pool for employers created in

this state shall file with the commissioner of insurance, on or

before March 30 of each year, a written report in a form

prescribed by the commissioner, signed and verified by its

chief executive officer as to its condition.

(6) The commissioner of insurance, or the

commissioner's designee, shall conduct an insurance

examination at least once a year to determine that proper

underwriting techniques and sound funding, loss reserves, and

claims procedures are being followed. This examination shall

be paid for by the self-insurance pool out of its funds at the

same rate as provided for foreign insurance companies under

section 10-1-204 (9), C.R.S.

(7) (a) The certificate of authority issued to an

employer self-insurance pool under this section may be

revoked or suspended by the commissioner of insurance for

any of the following reasons:

(I) Insolvency or impairment;

(II) Refusal or failure to submit an annual report as

required by subsection (5) of this section;

(III) Failure to comply with the provisions of its own

rules, resolutions, contracts, or other conditions relating to the

self-insurance pool;

(IV) Failure to submit to examination or any legal

obligation relative thereto;

(V) Refusal to pay the cost of examination as

required by subsection (6) of this section;

(VI) Use of methods which, although not otherwise

specifically proscribed by law, nevertheless render the

operation of the self-insurance pool hazardous, or its condition

unsound, to the public;

(VII) Failure to otherwise comply with the law of

this state, if such failure renders the operation of the self-

insurance pool hazardous to the public.

(b) If the commissioner of insurance finds upon

examination, hearing, or other evidence that any participating

employer self-insurance pool has committed any of the acts

specified in paragraph (a) of this subsection (7) or any act

otherwise prohibited in this section, the commissioner may

suspend or revoke such certificate of authority if the

commissioner deems it in the best interest of the public. Notice

of any revocation shall be published in one or more daily

newspapers in Denver which have a general state circulation.

Before suspending or revoking any certificate of authority of

an employer self-insurance pool, the commissioner shall grant

the employer self-insurance pool fifteen days in which to show

cause why such action should not be taken.

(8) The commissioner of insurance may supervise or

rehabilitate an employer self-insurance pool pursuant to the

provisions of parts 4 and 5 of article 3 of title 10, C.R.S., for

any of the following reasons:

(a) Insolvency or impairment;

(b) Failure to comply with the provisions of its own

rules, resolutions, contracts, or other conditions relating to the

self-insurance pool;

obligation relative thereto;

(d) Use of methods which, although not otherwise

specifically proscribed by law, nevertheless render the

operation of the self-insurance pool hazardous, or its condition

unsound, to the public;

(e) Failure to otherwise comply with the law of this

state, if such failure renders the operation of the self-insurance

pool hazardous to the public.

(9) The commissioner of insurance may promulgate

reasonable rules and regulations necessary to effectuate the

purposes of this section.

(10) Any self-insurance pool or any trust which

provides insurance coverage for purposes of articles 40 to 47

of this title which is in existence and is operating prior to July

10, 1987, is not subject to the requirements of this section and

may continue to operate such pool or trust as authorized by

law.

(11) Each self-insurance pool created under this

section shall establish a trust fund, on an annual basis, to

provide payment of the total workers' compensation loss cost

incurred by all pool members within each given year.

Aggregate excess insurance shall be provided by each self-

insurance pool to the statutory limit of coverage, attaching at

the maximum amount of each annual trust fund balance, or, in

lieu thereof, the commissioner of insurance shall set other

security standards which assure payment of workers'

To Index

compensation in the event that a self-insurance pool disbands

or defaults.

8-44-206. Guaranty fund - immediate payment

fund - special funds board - creation. (1) The general

assembly hereby finds and declares that benefits awarded

under articles 40 to 47 of this title to claimants employed by

self-insurers may be unreasonably delayed or not paid at all if

receipt of the proceeds of the bond required of the self-insurer

is delayed or if the self-insurer declares bankruptcy or has

insufficient reserves to cover the claim. The general assembly

further finds and declares that the creation of an immediate

payment fund and a guaranty fund will assure prompt and

complete payment of benefits awarded to such claimants.

(2) Creation of special funds board - duties.

(a) For the purposes of carrying out this section, there is

hereby created a special funds board which shall exercise its

powers and perform its duties and functions as specified in this

subsection (2) under the department of labor and employment

as if the same were transferred to the department by a type 2

transfer as such transfer is defined in the "Administrative

Organization Act of 1968", article 1 of title 24, C.R.S. Said

board shall be composed of five members: Four members who

are managers or employees of self-insured employers in good

standing, two of whom shall demonstrate knowledge of risk

management and finance, and the executive director.

(b) With the exception of the executive director, the

board members shall be appointed by the governor and

approved by the senate. The terms of the members of the board

first appointed shall be four years, three years, two years, and

one year, respectively. Thereafter, the term for each appointed

board member shall be four years. Members of the board may

be reappointed and the executive director shall serve

continuously.

compensation but shall be reimbursed for actual and necessary

traveling and subsistence expenses incurred in the

performance of their duties as members of the board.

(d) (I) The board shall determine the assessments to

be made pursuant to subsections (3) and (4) of this section and

shall determine the qualifications and requirements for any

claims administrators hired to adjust the claims of a self-

insurer who fails to meet his obligations with respect to

benefits awarded pursuant to articles 40 to 47 of this title.

(II) The board shall also participate, in an advisory

capacity only, in matters concerning the granting or

termination of self-insurance permits and the setting of

security requirements.

(3) Immediate payment fund - assessments -

creation of fund. (a) The board shall impose an assessment

upon each employer self-insured under section 8-44-201.

Assessments under this subsection (3) shall be based upon a

ratio equal to the self-insured employer's paid workers'

compensation medical and indemnity losses for the most

recent self-insurance permit year divided by the aggregate sum

of paid medical and indemnity losses by all self-insured

employers for that year. Such losses shall be determined on

July 1, 1990, for the most recently completed permit year, and

on the first day of July for each year thereafter until the

minimum fund balance has been reached. Contributions to the

fund shall not be assets of the self-insured employer.

(b) (I) All moneys received by the executive director

pursuant to this subsection (3) shall be deposited in the state

treasury in the immediate payment fund, which fund is hereby

created, and all moneys credited to such fund shall be used

solely for the administration and payment of benefits to

employees pursuant to this section. The general assembly shall

make annual appropriations out of such fund for the

administration of the fund. The moneys in such fund for the

payment of benefits are hereby continuously appropriated to

the department for payment of such benefits. Any moneys not

utilized in the fund shall not revert to the general fund.

(II) The minimum fund balance shall be three

hundred thousand dollars, to be assessed during the first three

years at the rate of one hundred thousand dollars annually.

Interest shall accrue to the fund to a maximum fund balance of

one million dollars. Thereafter, the fund balance shall be

maintained at one million dollars by refunding the excess

funds to each self-insured employer, on a pro rata basis, based

on that employer's contribution.

(4) Guaranty fund - assessments - creation of

fund. (a) When the board determines that existing security

held by an employer self-insured under section 8-44-201 is

insufficient to meet its existing liability for workers'

compensation benefits, the board shall impose an assessment

on each self-insured employer. The assessment shall be based

on a ratio which equals each self-insured employer's paid

workers' compensation medical and indemnity losses for the

most recent self-insurance permit year divided by the

aggregate sum of paid medical and indemnity losses by all self-

insured employers for that year. If necessary, the executive

director may direct the board to make an annual assessment

thereafter until such time as the present value of the guaranty

fund, created in paragraph (b) of this subsection (4), equals the

total liability for workers' compensation benefits which are in

excess of the security held by the defaulting self-insured

employers.

(b) (I) All moneys received by the executive director

pursuant to this subsection (4) shall be deposited in the state

treasury in the guaranty fund, which fund is hereby created.

Such moneys credited to the fund shall be used solely for the

administration and payment of benefits to employees pursuant

to this section. The general assembly shall make annual

appropriations out of such fund for the administration of the

fund. The moneys in such fund for the payment of benefits are

hereby continuously appropriated to the department for

payment of such benefits. Any moneys not utilized in the fund

shall not revert to the general fund.

(II) All interest shall accrue to the fund. No amounts

shall be refunded until all liability in excess of security held by

self-insured employers has been discharged and until the dates

imposing limitations on actions, as specified in sections 8-43-

103 and 8-43-303 have passed. When those conditions have

been met, the remaining moneys in the fund shall be refunded

to each self-insured employer, on a pro rata basis, based on that

employer's contribution.

201 shall be exempt from and shall not participate in this

subsection (4).

(5) The department shall select any claims

administrators required under this section based on the

To Index

qualifications and requirements established by the board. For

the purpose of contracting for such services, the department

shall not be subject to articles 101 to 114 of title 24, C.R.S.

ARTICLE 45

Pinnacol Assurance

8-45-101. Pinnacol Assurance - creation - powers

and duties. (1) There is hereby created Pinnacol Assurance,

which shall be a political subdivision of the state and shall

operate as a domestic mutual insurance company except as

otherwise provided by law. Pinnacol Assurance shall not be an

agency of state government, nor shall it be subject to

administrative direction by any state agency except as

provided in this article, and except for the purposes of the

"Colorado Governmental Immunity Act", article 10 of title 24,

C.R.S. Pinnacol Assurance shall not be dissolved except by the

general assembly. Section 10-12-411, C.R.S., shall not apply

to Pinnacol Assurance.

(2) (a) The powers of Pinnacol Assurance shall be

vested in the board of directors of Pinnacol Assurance, which

shall have nine members. The members of the board shall be

appointed by the governor with the consent of the senate. Of

the nine members, four shall be employers whose liability

under articles 40 to 47 of this title is insured by Pinnacol

Assurance with one of such employers to be a farmer or

rancher. Three of the nine members shall be employees of

employers whose liability under articles 40 to 47 of this title is

insured by Pinnacol Assurance. One of the nine members shall

be experienced in the management and operation of insurance

companies as defined in section 10-1-102 (6), C.R.S. Such

member shall not concurrently serve as an owner, a

shareholder, an officer, an employee, an agent of, or in any

other capacity with any business which competes with

Pinnacol Assurance. One of the nine members shall be

experienced in finance or investments, but shall not be an

employer whose liability under articles 40 to 47 of this title is

insured by Pinnacol Assurance. The term of office for each

such member shall be five years. The appointees may serve on

a temporary basis if the senate is not in session when they are

appointed until the senate is in session and is able to confirm

such appointments. Vacancies on the board shall be filled by

appointment of the governor for the remainder of any

unexpired terms. The board shall elect a chairman annually

from its membership.

(b) The members of the board who were serving as

of January 1, 2002, shall continue to serve until the completion

of each member's term. New members of the board shall be

appointed pursuant to paragraph (a) of this subsection (2).

duties as set forth in this article and otherwise provided by law.

(3) Members of the board shall be compensated one

hundred forty dollars per diem plus their actual and necessary

expenses. Per diem compensation, not to exceed thirty days in

any calendar year, shall be paid only when the board is

transacting official business.

(4) On and after July 1, 2002, the powers, duties, and

functions formerly exercised by the Colorado compensation

insurance authority may be exercised by Pinnacol Assurance.

(5) The board shall:

(a) (I) Appoint the chief executive officer of

Pinnacol Assurance who shall serve under contract and

appoint, hire, or delegate the authority to hire such other staff

To Index

as may be necessary to carry out the duties of Pinnacol

Assurance.

(II) If an executive officer of Pinnacol Assurance is

appointed pursuant to subparagraph (I) of this paragraph (a)

and such executive officer appoints, hires, or delegates duties

to any other staff necessary to carry out the duties of Pinnacol

Assurance, and the executive officer or other staff receives

total compensation, including bonuses or deferred

compensation, in an amount equal to or greater than one

hundred fifty thousand dollars annually, such compensation

information shall be a public record.

(b) Develop and approve an annual budget;

operation and administration of Pinnacol Assurance;

(d) (Deleted by amendment, L. 2002, p. 1865, § 1,

effective July 1, 2002.)

(e) Promulgate policies and procedures that establish

the basis by which employer premiums payable to Pinnacol

Assurance are determined. The board may establish different

rates for employers who meet the requirements established by

the board for any classification after complying with the

requirements of part 4 of article 4 of title 10, C.R.S., so long as

those rates are not excessive, inadequate, or unfairly

discriminatory.

(f) Offer to provide workers' compensation insurance

and employer's liability insurance covering any liability of

Colorado employers on account of personal injuries sustained

by, or the death of, any employee. Nothing in this article shall

be interpreted to permit Pinnacol Assurance to provide any

other type of insurance or to provide insurance to employers

that are not Colorado employers. Pinnacol Assurance shall not

refuse to insure any Colorado employer or cancel any

insurance policy due to the risk of loss or amount of premium,

except as otherwise provided in this title.

(g) Review and streamline administrative

procedures;

(h) Oversee the operations and make necessary

personnel changes;

(i) Review the investigative procedures and

implement changes to expedite investigations;

(j) Review and recommend legislation pertaining to

workers' compensation in articles 40 to 47 of this title and to

clarify legal concepts related thereto;

(k) Review the method of calculation of the

experience modification factor with the object of providing

maximum incentives for job safety;

(l) Establish general policies and procedures by rule

and regulation concerning medical care cost containment

practices under articles 40 to 47 of this title; and

(m) Post the date, time, and location of each board

meeting on the Pinnacol Assurance website at least seven

calendar days prior to the scheduled meeting.

(6) Article 4 of title 24, C.R.S., shall not apply to the

promulgation of any policies or procedures authorized by

subsection (5) of this section.

(7) Pinnacol Assurance may sell services, including

but not limited to medical bill processing, that are developed

pursuant to its powers under this article.

(8) Employees of Pinnacol Assurance shall be

exempt from the state personnel system but shall, by

acceptance of employment, be subject to the provisions of

article 51 of title 24, C.R.S. Pinnacol Assurance shall provide

for the deduction of employer and employee contributions

from salary and for payment to the association of such

deductions and for any other payments that would be due from

a state employer.

(9) Notwithstanding any provision of law to the

contrary, the claim files of injured employees, the policy files

of employers, and all business records relating to the

determination of rates that are not required to be disclosed by

any other insurance company shall not be subject to the

provisions of part 2 of article 72 of title 24, C.R.S.

(10) With respect to meetings of Pinnacol

Assurance, matters relating to the claim files of injured

employees and policy files of employers shall not be subject to

the provisions of part 4 of article 6 of title 24, C.R.S.

(11) Pinnacol Assurance may enter into cooperative

arrangements with any public or private entity for the purpose

of carrying out its powers, duties, and functions. Nothing in

this section shall require or be interpreted to require an

employer to provide health insurance coverage for its

employees.

(12) Notwithstanding the provisions of subsection

(1) of this section, upon the attainment of a reasonable surplus

as set forth in section 8-45-111, the "Colorado Governmental

Immunity Act", article 10 of title 24, C.R.S., shall not apply to

Pinnacol Assurance.

(13) Any member of the board who owns at least ten

percent of an entity that enters into a contract with Pinnacol

Assurance shall disclose the board member's ownership

interest in the entity. This disclosure shall be a public record.

8-45-102. Pinnacol Assurance fund created -

control of fund. (1) There is hereby created in the state

treasury a fund, to be known as the Pinnacol Assurance fund,

for the benefit of injured and the dependents of killed

employees, which shall be administered in accordance with the

provisions of this article by the board. Such administration

shall be without liability on the part of the state, beyond the

amount of said fund, constituted as provided in this article. The

state shall have no liability for the solvency or financial

condition of the fund.

(2) The chief executive officer is vested with full

power and jurisdiction over the administration of Pinnacol

Assurance and may appoint such subordinate officers as may

be necessary for the efficient operation of Pinnacol Assurance

and may do and perform all things, whether specifically

designated in this article or in addition thereto, that are

necessary or convenient in the exercise of any power or

jurisdiction over Pinnacol Assurance in the administration

thereof under the provisions of this article as fully and

completely as the head of a private insurance company might

or could do, subject, however, to all the provisions of this

article and other applicable law.

(3) Control of all moneys in the Pinnacol Assurance

fund shall be transferred to the board, which shall administer

the fund and use such moneys for the purposes of this article.

(4) The Pinnacol Assurance fund shall be a

continuing fund and shall consist of all premiums received and

paid into said fund for compensation insurance, all property

and securities acquired by and through the use of moneys

To Index

belonging to said fund, and all interest earned upon moneys

belonging to said fund and deposited or invested. Said fund

shall be applicable to the payment of the salaries of the

employees of the fund and to its other operating expenses and

to the payment of losses sustained or liabilities incurred under

the contracts or policies of insurance issued by Pinnacol

Assurance in accordance with the provisions of articles 40 to

47 of this title. All moneys in the fund previously known as the

Colorado compensation insurance authority fund shall be

transferred into the Pinnacol Assurance fund on July 1, 2002.

(5) The moneys in the Pinnacol Assurance fund shall

be continuously available for the purposes of this article and

shall not be transferred to or revert to the general fund of the

state at the end of any fiscal year. All revenues, moneys, and

assets of Pinnacol Assurance belong solely to Pinnacol

Assurance. The state of Colorado has no claim to nor any

interest in such revenues, moneys, and assets and shall not

borrow, appropriate, or direct payments from such revenues,

moneys, and assets for any purpose.

8-45-103. Board to fix rates - chief executive

officer to administer rates - sue and be sued - personal

liability limited. (1) The board shall have full power and it is

its duty to fix and determine the rates to be charged by Pinnacol

Assurance for compensation insurance.

(2) The chief executive officer shall manage and

conduct all business and affairs in relation to the rates to be

charged by Pinnacol Assurance for compensation insurance

which shall be conducted in the name of Pinnacol Assurance,

and in that name, without any other name, title, or authority,

the chief executive officer may:

(a) (I) Sue and be sued in all the courts of this state,

or of any other state, or of the United States, and in actions

arising out of any act, deed, matter, or thing made, omitted,

entered into, done, or suffered in connection with Pinnacol

Assurance and the administration, management, or conduct of

the business or affairs relating thereto; and the chief executive

officer shall be authorized to employ counsel to represent

Pinnacol Assurance in any action.

(II) Nothing in this paragraph (a) shall be construed

to waive any provisions of the "Colorado Governmental

Immunity Act", article 10 of title 24, C.R.S., nor shall it be

construed to waive immunity of the state of Colorado from suit

in federal court, guaranteed by the eleventh amendment to the

constitution of the United States.

(b) The chief executive officer shall not, nor shall

any officer or employee of Pinnacol Assurance, or entities or

parties with whom it contracts for services, be personally liable

in a private capacity for or on account of any act done or

omitted or contract or other obligation entered into or

undertaken in an official capacity in good faith and without

intent to defraud in connection with the administration,

management, or conduct of Pinnacol Assurance, its business,

or other affairs relating thereto.

effective July 1, 2002.)

8-45-104. Blanks furnished by state. (Repealed)

8-45-105. Places of employment classified -

amount of premiums. (1) The board may classify the places

of employment of employers insured by Pinnacol Assurance

into classes in accordance with the nature of the business in

which they are engaged and the probable hazard or risk of

injury to their employees. It shall determine the amount of the

premiums that such employers shall pay to Pinnacol

Assurance, and may prescribe in what manner such premiums

shall be paid, and may change the amount thereof both in

respect to any or all of such employers as circumstances may

require, and the condition of their respective plants,

establishments, or places of work in respect to the safety of

their employees may justify. All such premiums shall be levied

on a basis that shall be fair, equitable, and just as among such

employers.

(2) (Deleted by amendment, L. 2002, p. 1871, § 5,

effective July 1, 2002.)

8-45-106. Insurance at cost - board may impose

surcharges. (1) It is the duty of the board, in the exercise of

the powers and discretion conferred upon it by articles 40 to

47 of this title, ultimately to fix and maintain, for each class of

occupation, the lowest possible rates of premium consistent

with the maintenance of a solvent Pinnacol Assurance fund,

and the creation and maintenance of a reasonable surplus after

the payment of legitimate claims for injury and death, that may

be authorized to be paid from the Pinnacol Assurance fund for

the benefit of injured and dependents of killed employees.

(2) The board may impose a premium surcharge, not

to exceed an additional fifty percent, for up to twelve

continuous months, as a condition precedent to insure or

reinsure an employer whose policy was canceled or terminated

by any insurer for reasons of fraud or intentional

misrepresentation of a material fact; except that, if an employer

disputes the imposition of such surcharge, the employer may

make a complaint to the commissioner of insurance. If the

commissioner of insurance determines that the board, in

imposing a premium surcharge, has engaged in any conduct in

violation of part 11 of article 3 of title 10, C.R.S., the

commissioner may take any action the commissioner deems

appropriate and authorized by law.

8-45-107. Basis of rates - reserve -

surplus. (1) The rates shall be the percentage of the payroll of

any employer that, on the average, shall produce a sufficient

sum to:

(a) Carry all claims to maturity such that the rates

shall be based upon the reserve and not upon the assessment

plan;

(b) Produce a reasonable surplus as provided in

articles 40 to 47 of this title, cover the catastrophe hazard, and

ensure the payment to employees and their dependents of the

compensation provided in said articles.

(2) In determining the amount of reserve to be laid

aside to meet deferred payments according to awards, such

reserve may be ascertained by finding the present worth of

such deferred medical and indemnity payments calculated at a

rate of interest not higher than six percent per annum, and such

calculations of disability indemnity benefits shall be made

according to a table of mortality not lower than the American

experience table of mortality and, in the discretion of the

board, by such other and further methods as will result in the

establishment of adequate reserves.

(3) The amounts raised for the Pinnacol Assurance

fund shall ultimately become neither more nor less than

necessary to make the fund self-supporting, which includes the

To Index

attainment and maintenance of an adequate surplus as

determined in accordance with section 8-45-111, and the

premiums or rates levied for such purpose shall be subject to

readjustment from time to time by the board as may become

necessary.

8-45-108. Intentional misrepresentation by

employer. (Repealed)

8-45-109. Rate schedules posted. (Repealed)

8-45-110. Board to keep accounts - readjustment

by board of rates. (Repealed)

8-45-111. Portions of premiums paid carried to

surplus. The board shall set aside such proportion as it may

deem necessary of the earned premiums paid into the Pinnacol

Assurance fund, as a contribution to the surplus of the fund.

8-45-112. Amendment of rates - distribution to

policyholders. The board may amend at any time the rates for

any class. No contract of insurance between Pinnacol

Assurance and any employer shall be in effect until a policy or

binder has been actually issued by the board and the premium

therefor paid as and when required by this article. Not less

often than once a year the chief executive officer shall tabulate

the earned premiums paid by policyholders of Pinnacol

Assurance. Should the experience of the Pinnacol Assurance

fund show a credit balance and after payment of all amounts

that have fallen due because of operating expenses, injury, or

death, and after setting aside proper reserves, the board shall

distribute such credit balance to the policyholders who have a

balance to their credit in proportion to the premium paid and

losses incurred by each such policyholder during the preceding

insurance period. In the event any such policyholder fails to

renew a policy with Pinnacol Assurance for the period

following the period in which said dividends were earned, said

policyholder shall be entitled to said credit dividend if such

policy is terminated in good standing. In the event an employer

actually discontinues business, said employer's policy shall be

cancelled, and the dividend, if any, when ascertained, shall be

returned to the employer.

8-45-113. New policies issued - when. Pinnacol

Assurance shall not be required to issue a new policy of

insurance to an employer until all moneys due Pinnacol

Assurance have been paid, all premiums have been paid on all

cancelled policies, and the employer has complied with all

provisions of such cancelled policies.

8-45-114. Adjustment of premiums. (Repealed)

8-45-115. Determination of premium - payment

in advance - deductibles. (Repealed)

8-45-116. Reinsurance. (Repealed)

8-45-117. Regulation by commissioner of

insurance. (1) Pinnacol Assurance is subject to regulation by

the commissioner of insurance as provided in:

(a) Part 11 of article 3 of title 10, C.R.S., pertaining

to unfair competition and deceptive practices;

(b) Part 4 of article 4 of title 10, C.R.S., pertaining to

rate regulation; however, if the pure premium rates used by

Pinnacol Assurance are the national council on compensation

insurance rates previously approved by the commissioner of

insurance, Pinnacol Assurance may use different pure

premium rates for employers who meet the requirements

established by the board of directors after complying with the

requirements of part 4 of article 4 of title 10, C.R.S.,

concerning type II insurers;

1-109, and 10-1-102, except subsections (3) and (6), C.R.S.;

10-1-205 (1) to (6) and (8), C.R.S.; 10-3-109, C.R.S., except

for the publication requirements; 10-3-128, C.R.S.; 10-3-202,

C.R.S.; 10-3-207, C.R.S.; 10-3-208, C.R.S.; 10-3-231, C.R.S.;

10-3-239, C.R.S.; and parts 7 and 8 of article 3 of title 10,

C.R.S., except as these sections are inconsistent with this

article.

(2) (Deleted by amendment, L. 97, p. 936, § 5,

effective May 21, 1997.)

(3) Nothing in this section shall be construed to

subject Pinnacol Assurance to any premium tax assessed

pursuant to title 10, C.R.S.

(4) The cost of examinations performed in

accordance with section 8-45-121 (4) shall be billed by the

commissioner to Pinnacol Assurance at prevailing hourly rates

based upon time records kept by the commissioner. Any such

payment received by the commissioner is hereby appropriated

to the division of insurance in addition to any other funds

appropriated for its normal operation.

(5) At such time as a reasonable surplus of the

Pinnacol Assurance fund is reached pursuant to section 8-45-

111, Pinnacol Assurance shall be subject to regulation by the

commissioner of insurance as provided in section 10-1-205 (7)

and part 4 of article 3 of title 10, C.R.S., to the extent consistent

with the provisions of this article.

(6) Notwithstanding the provisions of sections 8-45-

102 (1) and 8-45-118, upon the attainment of a reasonable

surplus as set forth in section 8-45-111 and verified by audit

and examination performed in accordance with section 8-45-

121, all of the moneys in the Pinnacol Assurance fund shall be

transferred out of the state treasury and into the custody of the

board of Pinnacol Assurance. The board shall thereafter

control the investment of the fund pursuant to the requirements

set forth in part 2 of article 3 of title 10, C.R.S.

(7) Notwithstanding the provisions of sections 8-45-

102 (1) and 8-45-118, upon the transfer of the moneys in the

Pinnacol Assurance fund in accordance with subsection (6) of

this section, the board of Pinnacol Assurance shall make all

disbursements, and such disbursements shall not be made upon

state warrants.

(8) Notwithstanding the provisions of sections 8-45-

102 (1) and 8-45-119, upon the transfer of the moneys in the

Pinnacol Assurance fund in accordance with subsection (6) of

this section, the state treasurer shall not be required to give any

bond as custodian of the Pinnacol Assurance fund.

(9) After the transfer of the moneys in the Pinnacol

Assurance fund in accordance with subsection (6) of this

section, if the commissioner of insurance places Pinnacol

Assurance under direct supervision pursuant to the provisions

of section 10-3-405, C.R.S., the moneys in the Pinnacol

Assurance fund may be transferred back to the custody of the

state treasury pursuant to sections 8-45-102 (1), 8-45-118, and

8-45-119, and the state treasurer shall control the investment

of the fund pursuant to section 8-45-120. The transfer of funds

shall be under such conditions and within such time period as

the state treasurer and the commissioner of insurance deem

appropriate.

To Index

(10) Pinnacol Assurance shall not acquire or control

any other insurer.

8-45-118. Treasurer custodian of fund -

disbursements. (1) The state treasurer shall be the custodian

of the Pinnacol Assurance fund, and all disbursements

therefrom shall be paid either by the state treasurer upon

warrants drawn in accordance with law upon vouchers issued

by the board upon order of the chief executive officer, or by or

under the direction of the chief executive officer in such other

manner as the state treasurer may approve. In every case

occurring in which a warrant has been drawn in accordance

with law against the state treasurer upon vouchers issued by

the board for payment of any sum of money from the Pinnacol

Assurance fund, or when another form of payment has been

made from such fund by or under the direction of the chief

executive officer, and the time within which said warrant or

other form of payment shall be presented for payment in order

to be valid has not been stamped, printed, or written across the

face thereof, or otherwise specified, and a period of six months

has elapsed since the issuance of such warrant or other form of

payment, during which no person entitled thereto, or the

proceeds thereof, has presented the same to the state treasurer

for payment, or appeared to claim the funds so authorized to

be paid from the hands of the state treasurer or the chief

executive officer, such warrant or other form of payment may

in the discretion of the chief executive officer be posted for

cancellation, and thereafter cancelled and set aside.

(2) In every such case in which it is proposed to

cancel any such warrant, the chief executive officer shall cause

a notice to be drawn in duplicate, with a description of said

warrant containing the amount, number, date of issuance, and

name of payee, and shall cause one copy of said notice to be

posted in a conspicuous place that is open to the public in the

office of said board and one copy to be delivered to the state

treasurer. If, at the end of one month after the posting of such

notice and the delivery of a copy to the state treasurer, such

warrant is not presented for payment and no person entitled to

the proceeds thereof appears to claim the funds so authorized

to be paid in said warrant, said warrant may be cancelled as

provided in this section.

(3) (a) The state treasurer shall, upon the request of

the chief executive officer, transfer any such funds held to the

credit of or for the payment of such warrant back to the credit

of the Pinnacol Assurance fund. Except as otherwise provided

in paragraph (b) of this subsection (3), if at any time thereafter

application shall be made for the reissuance of such warrant,

the same may be reissued, if the claim that it represents appears

to be valid and still outstanding. Such reissued warrant shall be

made payable from the moneys on deposit in the Pinnacol

Assurance fund and shall be made payable to the person

entitled to the proceeds thereof.

(b) For warrants issued on or after August 6, 2003,

the funds transferred pursuant to paragraph (a) of this

subsection (3) shall be subject to the provisions of the

"Unclaimed Property Act", article 13 of title 38, C.R.S., and

for purposes of this paragraph (b), Pinnacol Assurance shall be

considered an insurance company as defined in section 38-13-

102 (6.5), C.R.S.

(4) Except as provided in section 8-45-117, the

powers and discretion granted in this section to the chief

executive officer and the state treasurer shall obtain in all cases

relating to the warrants or other forms of payment drawn on

the Pinnacol Assurance fund, anything to the contrary in any

statute notwithstanding.

8-45-119. State treasurer to give separate bond as

custodian. (1) The state treasurer shall give a separate and

additional bond in such amount as may be fixed by the board

with sureties to be approved by the governor, conditioned for

the faithful performance of the state treasurer's duties as

custodian of the Pinnacol Assurance fund, and as custodian of

all the bonds, warrants, investments, and moneys of, or

belonging to, said Pinnacol Assurance fund, subject to all

provisions of law governing bonds of the state treasurer. The

premium on said bond shall be paid out of the earnings of the

Pinnacol Assurance fund.

(2) The state treasurer shall give a separate and

additional bond in such amount as may be fixed by the

executive director of the department of labor and employment

with sureties to be approved by the governor, conditioned for

the faithful performance of the state treasurer's duties as

custodian of the funds under the jurisdiction of the director of

the division of workers' compensation, and as custodian of all

the bonds, warrants, investments, and moneys of, or belonging

to, the funds under the jurisdiction of the director of the

division of workers' compensation, subject to all provisions of

law governing bonds of the state treasurer. The premium on

said bond shall be paid out of the earnings of the funds under

the jurisdiction of the director of the division of workers'

compensation on a pro rata basis.

8-45-120. State treasurer to invest

funds. (1) Except as provided in subsection (2) of this section,

the state treasurer, after consulting with the board of directors

or the board's designated committee as to the overall direction

of the portfolio, shall invest any portion of the Pinnacol

Assurance fund, including its surplus or reserves, which is not

needed for immediate use. Such moneys may be invested in

the types of investments authorized in sections 24-36-109, 24-

36-112, and 24-36-113, C.R.S. Such moneys may also be

invested in common and preferred stock in the same manner as

a domestic insurance company pursuant to section 10-3-226,

C.R.S. The state treasurer shall determine the appropriate

percentage of the fund, not to exceed one hundred percent of

the surplus, to be invested in common and preferred stock and

the appropriate level of risk for such investments. The state

treasurer may make such investments in the form of mutual

funds and may contract with private professional fund

managers and employ portfolio managers.

(2) Subject to approval by the board, the chief

executive officer may authorize and direct the state treasurer

to invest a portion of the funds in the Pinnacol Assurance fund

for the purchase of real property, to house, contain, and

maintain the offices and operational facilities of Pinnacol

Assurance as may be deemed necessary to accommodate its

immediate and reasonably anticipated future needs. The chief

executive officer is authorized to purchase such real property,

buildings, and improvements thereon. Title to such real

property, buildings, and improvements thereon shall vest in

Pinnacol Assurance, and such assets shall be a part of the

Pinnacol Assurance fund. The chief executive officer may

lease or rent space not needed for the immediate requirements

To Index

of Pinnacol Assurance in such real property to other public

agencies or private businesses. Moneys received from such

rental or lease of space and moneys appropriated by the general

assembly for rental or lease of space in such real property shall

be deposited with the state treasurer for credit to the Pinnacol

Assurance fund. The chief executive officer shall not sell or

otherwise dispose of any property, buildings, or improvements

thereon so acquired, without consent of the board, and the

moneys received from such sale or disposition shall be credited

to the account of the Pinnacol Assurance fund.

(3) Repealed.

8-45-121. Visitation of fund by commissioner of

insurance - annual audit - examination. (1) Pinnacol

Assurance shall be open to visitation by the commissioner of

insurance at all reasonable times, and the commissioner of

insurance shall require from the chief executive officer reports

as to the condition of Pinnacol Assurance, as required by law

to be made by other insurance carriers doing business in this

state insofar as applicable to Pinnacol Assurance.

(2) The state auditor shall conduct an annual

financial audit of Pinnacol Assurance. In conducting such

audits, the state auditor may employ a firm of auditors and

actuaries, or both, with the necessary specialized knowledge

and experience. The cost of the annual audit shall be paid from

the operating funds of Pinnacol Assurance. The state auditor

shall report his or her findings from such audits, along with any

comments and recommendations, to the governor, the general

assembly, the executive director of the department of labor and

employment, and the commissioner of insurance. The state

auditor has continuing authority to conduct performance audits

of Pinnacol Assurance as the state auditor deems appropriate.

The cost of performance audits shall be paid from the operating

funds of Pinnacol Assurance.

(3) (Deleted by amendment, L. 2002, p. 1879, § 20,

effective July 1, 2002.)

(4) At least once every three years, the commissioner

of insurance shall conduct an examination of the fund, to be

conducted in the same manner as an examination of a private

insurance carrier. With respect to the examination, section 10-

1-204 applies. The commissioner of insurance shall transmit a

copy of the commissioner's examination to the state auditor.

8-45-122. Annual report. (1) The chief executive

officer of Pinnacol Assurance shall submit an annual report to

the governor; the business affairs and labor committee of the

house of representatives; the business, labor, and technology

committee of the senate; and the health and human services

committees of the house of representatives and the senate, or

their successor committees, reporting on the business

operations, resources, and liabilities of the Pinnacol Assurance

fund.

(2) The report required in subsection (1) of this

section shall include the following information for the previous

calendar year:

(a) The number of policies held by Pinnacol

Assurance;

(b) The total assets of Pinnacol Assurance;

(d) The amount of surplus;

(e) The number of claims filed;

(f) The number of claims admitted or contested

within the twenty-day period pursuant to section 8-43-203,

specifying the number of contested claims that are medical

only and those that are indemnity claims;

(g) The number of medical procedures denied;

(h) The amount of total compensation each executive

officer or staff member receives, including bonuses or deferred

compensation;

(i) The amount spent on commissions;

(j) The amount paid to trade associations for

marketing fees;

(k) All information relating to bonus programs; and

(l) Any other information the chief executive officer

deems relevant to the report.

8-45-123. Change of names - direction to

revisor. The revisor of statutes is authorized to change all

references to the Colorado compensation insurance authority

in the "Workers' Compensation Act of Colorado" and

everywhere else a reference is contained in the Colorado

Revised Statutes to Pinnacol Assurance and to change all

references to the Colorado compensation insurance authority

fund in the "Workers' Compensation Act of Colorado" and

everywhere else a reference is contained in the Colorado

Revised Statutes to the Pinnacol Assurance fund.

8-45-124. Review of cost-effectiveness of use of

national council on compensation insurance by the

authority. (Repealed)

8-45-125. Legislative interim committee on

operation of Pinnacol Assurance - creation - members -

study - report - repeal. (Repealed)

To Index

ARTICLE 46

Specific Insurance Funds

PART 1

SUBSEQUENT INJURY FUND

8-46-101. Subsequent injury fund. (1) (a) In a

case where an employee has previously sustained permanent

partial industrial disability and in a subsequent injury sustains

additional permanent partial industrial disability and it is

shown that the combined industrial disabilities render the

employee permanently and totally incapable of steady gainful

employment and incapable of rehabilitation to steady gainful

employment, then the employer in whose employ the

employee sustained such subsequent injury shall be liable only

for that portion of the employee's industrial disability

attributable to said subsequent injury, and the balance of

compensation due such employee on account of permanent

total disability shall be paid from the subsequent injury fund as

is provided in this section.

(b) (I) In addition to such compensation and after the

completion of the payments therefor, the employee shall

continue to receive compensation at said employee's

established compensation rate for permanent total disability

until death out of a special fund to be known as the subsequent

injury fund, hereby created for such purpose. The subsequent

injury fund shall be funded pursuant to the provisions of

section 8-46-102.

(II) The unrestricted year-end balance of the

subsequent injury fund, created pursuant to subparagraph (I)

of this paragraph (b), for the 1991-92 fiscal year shall

constitute a reserve, as defined in section 24-77-102 (12),

C.R.S., and, for purposes of section 24-77-103, C.R.S.:

(A) Any moneys credited to the subsequent injury

fund in any subsequent fiscal year shall be included in state

fiscal year spending, as defined in section 24-77-102 (17),

C.R.S.; and

(B) Any transfers or expenditures from the

subsequent injury fund in any subsequent fiscal year shall not

be included in state fiscal year spending, as defined in section

24-77-102 (17), C.R.S., for such fiscal year.

(1.5) Notwithstanding any provision of this section

to the contrary, on May 1, 2003, the state treasurer shall deduct

twenty million dollars from the subsequent injury fund and

transfer such sum to the general fund.

(1.7) Notwithstanding any provision of this section

to the contrary, on March 30, 2009, the state treasurer shall

deduct twenty-six million five hundred thousand dollars from

the subsequent injury fund and transfer such sum to the general

fund.

(2) If an employee entitled to additional benefits, as

provided in this section, obtains employment while receiving

compensation from the subsequent injury fund, such employee

shall be compensated out of said fund at the rate of one-half of

said employee's average weekly wage loss, subject to the

maximum and minimum provisions of the workers'

compensation act, during such period of employment.

(3) In case payment is or has been made under the

provisions of this section and dependency later is shown or if

payment is made by mistake or inadvertence or under such

circumstances that justice requires a refund thereof, the

division is authorized to refund such payment to the employer

or, if insured, the employer's insurance carrier.

(4) (a) The sums provided for the subsequent injury

fund created by this section shall be used to pay the costs

related to the administration of the fund and to make such

compensation payments as may be required by the provisions

of articles 40 to 47 of this title.

(b) Moneys in the subsequent injury fund are

continuously appropriated to the division for the payment of

benefits as provided in this section and legal fees.

(5) The director shall administer and conduct all

matters involving the subsequent injury fund in the name of

the division, and, in that name and without any other name,

title, or authority, the director may:

(a) (I) Sue and be sued in all the courts of this state,

of any other state, or of the United States and in actions arising

out of any act, deed, matter, or thing made, omitted, entered

into, done, or suffered in connection with the subsequent injury

fund and the administration or conduct of matters relating

thereto, including the authority to employ counsel to represent

the fund in any action.

(II) Nothing in this paragraph (a) shall be construed

to waive any provisions of the "Colorado Governmental

Immunity Act", article 10 of title 24, C.R.S., nor shall it be

construed to waive immunity of the state of Colorado from suit

in federal court, guaranteed by the eleventh amendment to the

constitution of the United States.

(b) Make and enter into contracts or obligations

relating to the subsequent injury fund as authorized or

permitted under the provisions of articles 40 to 47 of this title,

but neither the director nor any officer or employee of the

division shall be personally liable in any private capacity for

or on account of any act done or omitted or contract or other

obligation entered into or undertaken in an official capacity in

good faith and without intent to defraud in connection with the

administration or conduct of the subsequent injury fund, its

business, or other affairs relating thereto.

8-46-102. Funding for subsequent injury fund

and major medical insurance fund. (1) (a) For every

compensable injury resulting in death wherein there are no

persons either wholly or partially dependent upon the

deceased, the employer or the employer's insurance carrier, if

any, shall pay to the division the sum of twenty thousand

dollars, not to exceed one hundred percent of the death benefit,

to be transmitted to the state treasurer, as custodian, and

credited by the state treasurer to the Colorado uninsured

employer fund created in section 8-67-105. In the event that

there are only partially dependent persons dependent upon the

deceased, the employer or the employer's insurance carrier, if

any, shall first pay such benefits to such partial dependents and

shall transmit the balance of the sum of twenty thousand

dollars to the state treasurer, as custodian, who shall credit the

same to the Colorado uninsured employer fund.

(b) In the event that the deceased is a minor with no

persons either wholly or partially dependent upon the

deceased, the employer or the employer's insurance carrier, if

any, shall pay to the parents of the deceased the sum of fifteen

thousand dollars, not to exceed one hundred percent of the

death benefit. In the event that there are no surviving parents,

To Index

the employer or the employer's insurance carrier, if any, shall

pay such benefits to the division, to be transmitted to the state

treasurer, as custodian, and credited by the state treasurer to

the subsequent injury fund. In the event that there are persons

only partially dependent upon the deceased, the employer or

the employer's insurance carrier, if any, shall first pay such

benefits to such partially dependent persons and shall pay the

balance to the surviving parents of the deceased, or in the event

that there are no surviving parents, the remaining balance shall

be paid to the division, to be transmitted to the state treasurer,

as custodian, who shall credit the same to the subsequent injury

fund.

on each July 1 thereafter, the director shall adjust the amount

paid to the Colorado uninsured employer fund in this

subsection (1) by the percentage of the adjustment made by the

director to the state weekly wage pursuant to section 8-47-106.

(2) (a) (I) Notwithstanding sections 10-3-209 (1)(c)

and 10-6-128 (3), C.R.S., for the purpose of funding the

financial liabilities of the subsequent injury fund pursuant to

this section and of the major medical insurance fund pursuant

to section 8-46-202, every person, partnership, association,

and corporation, whether organized under the laws of this state

or of any other state or country, every mutual company or

association, every captive insurance company, and every other

insurance carrier, including Pinnacol Assurance, insuring

employers in this state against liability for personal injury to

their employees or death caused thereby under the provisions

of articles 40 to 47 of this title shall, as provided in this

subsection (2), be levied a tax upon the premiums received in

this state, whether or not in cash, or on account of business

done in this state for such insurance in this state at a rate

determined by the director to generate sufficient revenue for

claim payments and direct and indirect costs of administration

that are anticipated to be submitted in the following state fiscal

year for which such funds are liable. In determining the rate,

the director shall, in addition to revenue for claim payments

and direct and indirect costs of administration that are

anticipated to be due in the following state fiscal year, maintain

a cash balance in both the major medical insurance fund and

the subsequent injury fund of an amount of otherwise

unrestricted revenues equal to approximately one year's worth

of claim payments and direct and indirect administrative costs.

Such insurance carriers shall be credited with all cancelled or

returned premiums actually refunded during the year of such

insurance.

(II) Repealed.

(b) Every such insurance carrier shall, on July 1,

1988, and semiannually thereafter, make a return, verified by

affidavits of its president and its secretary or by affidavits of

its other chief officers or agents, to the division, stating the

amount of all such premiums received and credits granted

during the period covered by such return. Every insurance

carrier required to make such return shall file the same with the

division within thirty days after the close of the period covered

thereby and shall, at the same time, pay to the division a tax

ascertained as provided in paragraph (a) of this subsection (2),

less return premiums on cancelled policies.

provisions of articles 40 to 47 of this title shall, under oath,

report to the division the employer's payroll in such form as

may be prescribed by the director and at the times specified for

premium reports by insurance companies in paragraph (b) of

this subsection (2). The division shall assess against such

payroll a tax for the purposes of paragraph (b) of this

subsection (2) on the basic premiums chargeable against the

same or most similar industry or business taken from the

manual insurance rates, including any discount or experience

modification allowed, chargeable by Pinnacol Assurance, and,

upon receipt of notice from the division of the tax so assessed,

every such self-insurer shall, within thirty days after the receipt

of such notice, pay to the division the tax so assessed.

(d) If any such insurance carrier or self-insurer fails

or refuses to make the return or report required by paragraph

(b) or (c) of this subsection (2), the director shall assess the tax

against such insurance carrier or self-insurer at the rate

provided for in this subsection (2) on such amount of premium

as the director may deem just, and the proceedings thereof shall

be the same as if the return had been made.

(e) If any such insurance carrier or self-insurer

withdraws from business in this state before the tax provided

for in this subsection (2) falls due as provided in this section,

or fails or neglects to pay such tax, the director shall proceed

at once to collect the same; and the director is authorized to

employ such legal processes as may be necessary for that

purpose. Suit shall be brought by the director in any of the

courts of this state having jurisdiction.

(f) The director, in the enforcement of this subsection

(2), shall have all of the powers granted in articles 40 to 47 of

this title, and any insurance carrier or self-insurer who violates

any of the provisions of this subsection (2) or fails to pay the

tax thereby imposed is guilty of a violation of said articles and

shall be subject to the penalties therein prescribed.

(g) All moneys collected pursuant to this subsection

(2) shall be transmitted to the state treasurer, as custodian, who

shall credit the same to the subsequent injury fund and to the

major medical insurance fund as determined by the director in

accordance with subsection (3) of this section. Any interest

earned on the investment or deposit of moneys in said funds

shall remain in the funds and shall not revert to the general

fund of the state at the end of any fiscal year.

(3) (a) As determined by the director, a portion of the

revenue received each year pursuant to subsection (2) of this

section shall be deposited into the subsequent injury fund,

established in section 8-46-101 (1)(b), and a portion shall be

deposited into the major medical insurance fund, established

in section 8-46-202 (1). In addition, the director may move

revenue between the funds when the director determines that

doing so is necessary. The director shall continue to establish

a surcharge rate pursuant to subsection (2) of this section until

the balance in both such funds is sufficient to meet the future

claim payments plus the amount necessary to pay the direct

and indirect costs of administration of the funds, at which time

the surcharge rate established in paragraph (a) of subsection

(2) of this section shall be reduced to zero.

(b) For the purpose of determining the proper

allocation of the surcharge and making the estimates

contemplated in paragraph (a) of this subsection (3), the

director shall contract for the services of qualified private

actuaries.

To Index

8-46-103. State treasurer to invest funds. (1) The

state treasurer shall invest any portion of the subsequent injury

fund, including its surplus and reserves, which the division

determines is not needed for immediate use. All interest earned

upon such invested portion shall be credited to the fund and

used for the same purposes and in the same manner as other

moneys in the fund. Such moneys may be invested in the types

of investments authorized in sections 24-36-109, 24-36-112,

and 24-36-113, C.R.S.

(2) Repealed.

8-46-104. Closure of fund. No cases shall be

accepted into the subsequent injury fund for injuries occurring

on or after July 1, 1993, or for occupational diseases occurring

on or after April 1, 1994. When all payments have been made

for all cases accepted into the fund, any remaining balance

shall revert to the general fund.

8-46-105. Calculation of premium - permanent

total disability - employer may request

examination. (1) Effective July 1, 1993, in any case in which

an employee previously has sustained permanent partial

disability and, in a subsequent injury, sustains additional

permanent partial disability and it is shown that the combined

industrial disabilities render the employee permanently and

totally disabled, then the premiums of the employer in whose

employ the employee sustained such subsequent injury shall

be determined only on the basis of the impairment rating for

such subsequent injury and not on the basis of the employee's

permanent total disability. If such employer disputes the

impairment rating for the subsequent injury, the employer shall

request an independent medical examination pursuant to the

procedures set forth in section 8-42-107.2. The finding of the

independent medical examiner regarding the impairment

rating may be overcome only by clear and convincing

evidence. The total cost of the employee's permanent total

disability shall not be considered in determining the

employer's premiums, but shall be considered by the

commissioner of insurance in setting rates.

(2) In any case in which an employee becomes

disabled by an occupational disease and the employer is liable

for benefits pursuant to section 8-41-304 (2), then the

premiums of the employer in whose employ the employee

became disabled shall be determined only on the basis of the

impairment rating for the portion of the occupational disease

attributable to such employer and not on the basis of the

combination of such portion and any prior impairment

resulting from such occupational disease. For the purposes of

premium calculations, if such employer disputes the

impairment rating for the occupational disease, the employer

shall request an independent medical examination pursuant to

the procedures set forth in section 8-42-107.2. The finding of

the independent medical examiner regarding the impairment

rating may be overcome only by clear and convincing

evidence. The total cost of the employee's occupational disease

shall not be considered in determining the employer's

premiums, but shall be considered by the commissioner of

insurance in setting rates.

8-46-106. Abatement of taxes - independent

review of fund. The funding provisions of section 8-46-102,

including the provisions relating to the assessment and levying

of taxes, shall cease to be effective when an independent

actuary, retained by the division for such purpose, determines

that the fund has sufficient resources to pay benefits for

injuries occurring prior to July 1, 1993, and occupational

diseases occurring prior to April 1, 1994.

8-46-107. Report to general assembly and

governor. (Repealed)

8-46-108. Legislative council study of subsequent

injury fund. (Repealed)

8-46-109. Legislative declaration - claims

management. (1) The general assembly finds and declares

that the purpose of this section is to provide for prompt,

efficient, and fair settlement of all pending claims and the

closure of both the subsequent injury fund and the major

medical insurance fund as soon as is practicable.

(2) As necessary to augment the division's regular

staff, the director shall contract for the services of qualified

specialists in the area of settlements, who shall, on the

director's behalf, negotiate for and enter into settlements of

claims of the subsequent injury fund and the major medical

insurance fund for present value whenever possible.

(3) Repealed.

PART 2

COLORADO MAJOR MEDICAL

INSURANCE FUND ACT

8-46-201. Short title. This part 2 shall be known and

may be cited as the "Colorado Major Medical Insurance Fund

Act".

8-46-202. Major medical insurance fund - tax

imposed - returns. (1) (a) There is hereby established a major

medical insurance fund to defray medical, surgical, dental,

hospital, nursing, and drug expenses and expenses for medical,

hospital, and surgical supplies, crutches, apparatus, and

vocational rehabilitation, which shall include tuition, fees,

transportation, and weekly maintenance equivalent to that

which the employee would receive under section 8-42-105 for

the period of time that the employee is attending a vocational

rehabilitation course, which expenses are in excess of those

provided under the "Workers' Compensation Act of Colorado"

for employees who have established their entitlement to

disability benefits under said act, whether necessary to

promote recovery, alleviate pain, or reduce disability.

(b) The unrestricted year-end balance of the major

medical insurance fund, created pursuant to paragraph (a) of

this subsection (1), for the 1991-92 fiscal year shall constitute

a reserve, as defined in section 24-77-102 (12), C.R.S., and,

for purposes of section 24-77-103, C.R.S.:

(I) Any moneys credited to the major medical

insurance fund in any subsequent fiscal year shall be included

in state fiscal year spending, as defined in section 24-77-102

(17), C.R.S., for such fiscal year; and

(II) Any transfers or expenditures from the major

medical insurance fund in any subsequent fiscal year shall not

be included in state fiscal year spending, as defined in section

24-77-102 (17), C.R.S., for such fiscal year.

continuously appropriated to the division for the payment of

benefits as provided in this section and legal fees.

To Index

(1.5) (a) Notwithstanding any provision of this

section to the contrary, on May 1, 2003, the state treasurer shall

deduct one hundred fifty million dollars from the major

medical insurance fund and transfer such sum to the general

fund.

(b) On July 1, 2003, the state controller shall transfer

ten million dollars from the general fund to the major medical

insurance fund.

(1.6) Notwithstanding any provision of this section

to the contrary, on March 30, 2009, the state treasurer shall

deduct sixty-nine million five hundred thousand dollars from

the major medical insurance fund and transfer such sum to the

general fund.

(1.7) Notwithstanding any provision of this section

to the contrary, on March 31, 2010, the state treasurer shall

deduct twenty-six million five hundred thousand dollars from

the major medical insurance fund and transfer such sum to the

general fund.

(1.8) Notwithstanding any provision of this section

to the contrary, on June 30, 2011, the state treasurer shall

deduct ten million dollars from the major medical insurance

fund and transfer such sum to the general fund.

(2) The director shall administer the major medical

insurance fund and is hereby given jurisdiction to enforce the

provisions of this article. The director shall administer and

conduct all matters involving the major medical insurance fund

in the name of the division, and, in that name and without any

other name, title, or authority, the director may:

(a) (I) Sue and be sued in all the courts of this state,

of any other state, or of the United States and in actions arising

out of any act, deed, matter, or thing made, omitted, entered

into, done, or suffered in connection with the major medical

insurance fund and the administration or conduct of matters

relating thereto, including the authority to employ counsel to

represent the fund in any action.

(II) Nothing in this paragraph (a) shall be construed

to waive any provisions of the "Colorado Governmental

Immunity Act", article 10 of title 24, C.R.S., nor shall it be

construed to waive immunity of the state of Colorado from suit

in federal court, guaranteed by the eleventh amendment to the

constitution of the United States.

(b) Make and enter into contracts or obligations

relating to the major medical insurance fund as authorized or

permitted under the provisions of articles 40 to 47 of this title,

but neither the director nor any officer or employee of the

division shall be personally liable in any private capacity for

or on account of any act done or omitted or contract or other

obligation entered into or undertaken in an official capacity in

good faith and without intent to defraud in connection with the

administration or conduct of the major medical insurance fund,

its business, or other affairs relating thereto;

for medical and surgical treatment, services and supplies,

crutches and apparatus, and the care and nursing of injured

persons entitled to benefits from said fund and, in addition,

may contract for medical, surgical, hospital, and nursing

services and supplies in excess of the amount and period

otherwise limited in this article if said director determines that

the contracting of such extra medical, surgical, hospital, and

nursing services and supplies will reduce the period of

disability for which said fund would be liable for the payment

and compensation.

(3) to (5) Repealed.

8-46-203. Failure to make returns. (Repealed)

8-46-204. Use of funds limited. (Repealed)

8-46-205. Collection of taxes due. If any such

insurance carrier or self-insurer withdraws from business in

this state before the tax falls due as provided in this part 2, or

fails or neglects to pay such tax, the director shall at once

proceed to collect the same; and the director is authorized to

employ such legal processes as may be necessary for that

purpose. Suit shall be brought by the director in any of the

courts of this state having jurisdiction.

8-46-206. Enforcement powers - violations. The

director, in the enforcement of this article, shall have all of the

powers granted in the "Workers' Compensation Act of

Colorado", and any insurance carrier or self-insurer violating

any of the provisions of this article, or failing to pay the tax

imposed in this article, is guilty of violation of said act and

subject to the penalties therein prescribed.

8-46-207. Receipt and disbursement of moneys.

(Repealed)

8-46-208. Applications - awards. (1) Payments

from the major medical insurance fund shall be awarded by the

director only after an application therefor has been filed by a

claimant employee, the claimant's employer, or such

employer's insurance carrier, or one on their behalf, for

admission to the fund, in any case where the limits of liability

provided under section 8-42-101 have been exhausted.

(2) Following the filing of an application, the

director shall approve or disapprove the expenditure of further

sums of money from the major medical insurance fund and in

so doing may rely upon medical reports contained in the case

file if the director deems them adequate, or the director may

rely upon recommendations of the medical director, appointed

pursuant to section 8-1-103, or the director may appoint a

medical panel of not more than three medical experts to see

and examine the applicant, each of whom shall render a report

to the director, advising whether or not such expenditure of

further sums of money will promote recovery, alleviate pain,

or reduce disability, suggesting the form and manner of such

treatment or services and suggesting the reasonable cost

thereof. The director, in every case in which an award is made

from this fund, shall review said case at such time as the total

medical expenditures, including those expended under section

8-42-101, shall reach fifteen thousand dollars and at each ten

thousand dollars increment thereafter to determine and enter

an order regarding continuation or cessation of further

payments from said fund.

(3) The director shall award, and the state treasurer

shall pay from the major medical insurance fund, the

reasonable fees and expenses of the appointed members of the

medical panel when such procedure is used by the director.

8-46-209. Credit for reduced disability - when. In

any determination of permanent disability, the employer or the

employer's insurance carrier shall receive any credit or benefit

for the reduction of disability of any claimant employee under

the "Workers' Compensation Act of Colorado" directly

attributable to a compensable accident or disease when such

To Index

reduction of disability is accomplished by expenditures from

the major medical insurance fund.

8-46-210. State treasurer to invest funds. (1) The

state treasurer shall invest any portion of the major medical

insurance fund, including its surplus and reserves, which the

director of the division of workers' compensation determines

is not needed for immediate use. All interest earned upon such

invested portion shall be credited to the fund and used for the

same purposes and in the same manner as other moneys in the

fund. Such moneys may be invested in the types of investments

authorized in sections 24-36-109, 24-36-112, and 24-36-113,

C.R.S.

(2) Repealed.

8-46-211. Abatement of tax - when. (Repealed)

8-46-212. Closure of fund. Effective July 1, 1981,

no further cases shall be accepted into the major medical

insurance fund for injuries or occupational diseases occurring

after that date, nor shall any cases be transferred from the

medical disaster insurance fund to the major medical insurance

fund.

PART 3

COLORADO MEDICAL DISASTER

INSURANCE FUND

8-46-301. Short title. This part 3 shall be known and

may be cited as the "Colorado Medical Disaster Insurance

Fund Act".

8-46-302. Medical disaster insurance fund - tax

imposed - returns. (1) There is hereby established a medical

disaster insurance fund to defray medical, surgical, hospital,

nursing, and drug expenses in excess of those provided under

the "Workers' Compensation Act of Colorado" for employees

who have established their entitlement to disability benefits

under said act, whether necessary to promote recovery,

alleviate pain, or reduce disability.

(2) The director shall administer the medical disaster

insurance fund and is hereby given jurisdiction to enforce the

provisions of this part 3. The director shall approve or

disapprove admissions to the Colorado medical disaster

insurance fund.

8-46-303. Use of funds limited. (1) All funds

received by the division under the provisions of this article

shall be used solely to pay the costs related to the

administration of the medical disaster insurance fund and to

defray the cost of medical, surgical, and hospital expenses

necessary to effect the recovery, alleviate pain, or reduce the

disability of employees who have established their entitlement

to disability benefits under the "Workers' Compensation Act

of Colorado" in accordance with and subject to the provisions

of such act.

(2) Moneys in the medical disaster insurance fund

are continuously appropriated to the division for the payment

of benefits as provided in this section and legal fees.

8-46-304. Enforcement powers -

violations. (1) The director, in the enforcement of this article,

shall have all of the powers granted in the "Workers'

Compensation Act of Colorado", articles 40 to 47 of this title,

and any insurance carrier or self-insurer violating any of the

provisions of this article is guilty of a violation of said act and

shall be subject to the penalties therein prescribed.

(2) The director shall administer and conduct all

matters involving the medical disaster insurance fund in the

name of the division, and, in that name and without any other

name, title, or authority, the director may:

(a) (I) Sue and be sued in all courts of this state, of

any other state, or of the United States and in actions arising

out of any act, deed, matter, or thing made, omitted, entered

into, done, or suffered in connection with the medical disaster

insurance fund and the administration or conduct of matters

relating thereto, including the authority to employ counsel to

represent the fund in any action.

(II) Nothing in this paragraph (a) shall be construed

to waive any provisions of the "Colorado Governmental

Immunity Act", article 10 of title 24, C.R.S., nor shall it be

construed to waive immunity of the state of Colorado from suit

in federal court, guaranteed by the eleventh amendment to the

constitution of the United States.

(b) Make and enter into contracts or obligations

relating to the medical disaster insurance fund as authorized or

permitted under the provisions of articles 40 to 47 of this title,

but neither the director nor any officer or employee of the

division shall be personally liable in any private capacity for

or on account of any act done or omitted or contract or other

obligation entered into or undertaken in an official capacity in

good faith and without intent to defraud in connection with the

administration or conduct of the medical disaster insurance

fund, its business, or other affairs relating thereto;

for medical and surgical treatment, services and supplies,

crutches and apparatus, and the care and nursing of injured

persons entitled to benefits from said fund and, in addition,

may contract for medical, surgical, hospital, and nursing

services and supplies in excess of the amount and period

otherwise limited in this article if said director determines that

the contracting of such extra medical, surgical, hospital, and

nursing services and supplies will reduce the period of

disability for which said fund would be liable for the payment

and compensation.

8-46-305. Receipt and disbursement of

moneys. All moneys collected by the division pursuant to the

provisions of this part 3 shall be transmitted to the state

treasurer who shall deposit the same to the credit of the medical

disaster insurance fund, and all disbursements therefrom shall

be paid by the state treasurer in accordance with and subject to

final awards of the director, as provided in this article.

8-46-306. Applications - medical panel - awards -

limitations. (1) Payments from the medical disaster insurance

fund shall be awarded by the director only after an application

therefor has been filed by a claimant employee, the claimant's

employer, or such employer's insurance carrier, or one on their

behalf, and approved by the director for admission to the fund,

in any case where the limits of liability provided under section

8-42-101 have been exhausted.

(2) The director shall, in every case where an

application for payments from the medical disaster insurance

fund is filed, immediately, after receipt of such application,

appoint a medical panel of three medical experts to see and

examine the applicant, each of whom shall render a report to

To Index

the director, advising whether or not the expenditure of further

sums of money will promote recovery, alleviate pain, or reduce

disability, suggesting the form and manner of further treatment

or services and suggesting the reasonable cost thereof.

(3) The director, upon receipt of reports from each of

the medical experts appointed in accordance with subsection

(2) of this section, shall either deny the application or award

payments from the medical disaster insurance fund, based

upon such reports and as nearly as possible in accordance with

the majority opinion and suggestions of the medical panel.

(4) In making payment awards from the medical

disaster insurance fund, the director shall be limited in any one

case to the sum of fifty-five thousand dollars, less any amounts

of money expended by the employer or the employer's

insurance carrier for medical, surgical, or hospital services and

the costs of any prosthetic devices, or the reasonable value of

any such services or devices furnished by the employer or the

employer's insurance carrier.

(5) The director shall award, and the state treasurer

shall pay from the medical disaster insurance fund, the

reasonable fees and expenses of the appointed members of the

medical panel.

8-46-307. Credit for reduced disability -

when. (1) In any determination of permanent disability, the

employer or the employer's insurance carrier shall receive no

credit or benefit for the reduction of disability of any claimant

employee under the "Workers' Compensation Act of

Colorado" directly attributable to a compensable accident or

disease when such reduction of disability is accomplished by

expenditures from the medical disaster insurance fund, unless

it shall have been determined by a preponderance of the

evidence:

(a) That the claimant employee had refused hospital,

surgical, and medical services under the "Workers'

Compensation Act of Colorado" necessary to reduce the

employee's disability voluntarily offered by the employer; or

(b) That the claimant employee had reached

maximum improvement as determined by the director prior to

the filing of the application for payments from the medical

disaster insurance fund.

8-46-308. State treasurer to invest funds. (1) The

state treasurer shall invest any portion of the medical disaster

insurance fund, including its surplus and reserves, which the

director determines is not needed for immediate use. All

interest earned upon such invested portion shall be credited to

the fund and used for the same purposes and in the same

manner as other moneys in the fund. Such moneys may be

invested in the types of investments authorized in sections 24-

36-109, 24-36-112, and 24-36-113, C.R.S.

(2) Repealed.

8-46-309. Authority to utilize other

revenue. Revenues obtained from the tax imposed pursuant to

section 8-46-102 (2)(a) may be used, in the discretion of the

director, for the purpose of paying the costs incurred pursuant

to this article.

ARTICLE 47

Administration

PART 1

DIRECTOR'S POWERS AND DUTIES

8-47-101. Division of workers' compensation -

creation - powers, duties, and functions - transfer of

functions - change of statutory references. (1) There is

hereby created the division of workers' compensation in the

department of labor and employment. Pursuant to section 13

of article XII of the state constitution, the executive director of

the department of labor and employment shall appoint the

director of the division of workers' compensation, and the

director shall appoint such employees as are necessary to carry

out the duties and exercise the powers conferred by law upon

the division of workers' compensation and the director.

(2) The director and the division of workers'

compensation shall enforce and administer the provisions of

the "Workers' Compensation Act of Colorado", articles 40 to

47 of this title, as provided in said articles and the provisions

of article 14.5 of this title.

(3) (a) The division of workers' compensation shall,

on and after July 1, 1991, execute, administer, perform, and

enforce the rights, powers, duties, functions, and obligations

vested in the division of labor prior to July 1, 1991, concerning

the duties and functions transferred to the division of workers'

compensation. On July 1, 1991, all employees of the division

of labor whose principal duties are concerned with the duties

and functions transferred to the division of workers'

compensation and whose employment in the division of

workers' compensation is deemed necessary by the executive

director of the department of labor and employment to carry

out the purposes of this article 47 shall be transferred to the

division of workers' compensation and shall become

employees thereof. The employees shall retain all rights to the

state personnel system and retirement benefits under the laws

of this state, and their services shall be deemed to have been

continuous. All transfers and any abolishment of positions in

the state personnel system shall be made and processed in

accordance with state personnel system laws and rules.

(b) Repealed.

designated by any contract or other document in connection

with the duties and functions transferred to the division of

workers' compensation, such reference or designation is

deemed to apply to the division of workers' compensation. All

contracts entered into by the division of labor prior to July 1,

1991, in connection with the duties and functions transferred

to the division of workers' compensation, are hereby validated,

with the division of workers' compensation succeeding to all

the rights and obligations of such contracts. Any

appropriations of funds from prior fiscal years open to satisfy

obligations incurred under such contracts are hereby

transferred and appropriated to the division of workers'

compensation for the payment of such obligations.

(d) (I) Repealed.

(II) At the discretion of the state auditor, the state

auditor may conduct or cause to be conducted a performance

review of the administrative law judges in the office of

To Index

administrative courts who hear cases under articles 40 to 47 of

this title. The review must include, but is not limited to, the

following topics: The time elapsed from the date of hearing

until decisions are rendered by the administrative law judges;

the time elapsed from the point at which the file is complete

and the case is ready for order until the decision is rendered by

the administrative law judges; the number of decisions that are

reversed upon appeal to the industrial claim appeals panel and

to the court of appeals respectively; the workload or number of

cases assigned to each administrative law judge; and the public

perception of the quality of the performance of the office of

administrative courts with respect to matters arising under the

"Workers' Compensation Act of Colorado".

(4) Repealed.

(5) On and after July 1, 1991, when any provision of

articles 40 to 47 of this title 8 refers to the division of labor,

said law shall be construed as referring to the division of

workers' compensation.

(6) The revisor of statutes is authorized to change all

references to the director of the division of labor standards and

statistics and the division of labor standards and statistics in

articles 14.5 and 40 to 47 of this title to refer to the director of

the division of workers' compensation and the division of

workers' compensation.

8-47-102. Director to enforce orders. If any person

fails or refuses to comply with an order of the director, or to

obey any subpoena issued by the director or agents of the

division, or to furnish the statistics, data, and information

required to be furnished to the division by the provisions of

articles 40 to 47 of this title, or refuses to permit an inspection

as provided in said articles, or being in attendance refuses to

be sworn or examined, or to answer a question, or to produce

a book or paper when ordered to do so by the director or any

of the deputies, agents, or referees of the division, the director

may apply to the district court, upon proof by affidavit of the

facts, for an order, returnable in not less than three days nor

more than five days, directing such person to show cause

before the district court which made the order why such person

should not be committed to jail. Upon the return of such order,

the district court shall examine under oath such person and

give the person an opportunity to be heard. If the court

determines that the person has refused without legal excuse in

any one of the foregoing matters, it may commit the offender

to jail forthwith by warrant, there to remain until the person

submits to do the act which said person was required to do or

until said person is discharged according to law.

8-47-103. Orders of director or appeals office -

validity. All orders of the director or industrial claim appeals

office shall be valid and in force and prima facie reasonable

and lawful until found otherwise in an action brought for that

purpose, pursuant to the provisions of articles 40 to 47 of this

title, or until altered or revoked by the director or industrial

claim appeals office, as the case may be.

8-47-104. Orders and awards - technical

objections. Substantial compliance with the requirements of

articles 40 to 47 of this title shall be sufficient to give effect to

the orders or awards of the director or industrial claim appeals

office, and they shall not be declared inoperative, illegal, or

void for any omission of a technical nature in respect thereto.

8-47-105. Deposit on unpaid compensation or

benefits - trust fund - surplus. (1) The director has the

discretion, at any time, any provisions in articles 40 to 47 of

this title to the contrary notwithstanding, to compute and

require to be paid to the division, to be held by it in trust, an

amount equal to the present value of all unpaid compensation

or other benefits in any case computed at the rate of four

percent per annum. Such action may be taken after a finding

by the director as to the insolvency, the threatened insolvency,

or any other condition or danger which may cause the loss of,

or which has delayed or may impede, hinder, or delay prompt

payment of, compensation or benefits by any insurance carrier

or employer. The action and finding of the director shall not be

subject to review, and the director shall not be required to give

any notice of hearing or hold any hearing prior to taking such

action or making such finding.

(2) All moneys so paid in shall constitute a separate

trust fund in the office of the state treasurer, and, after any such

payment is so ordered, the employer or insurance carrier shall

thereupon be discharged from any further liability under such

award for which payment is made to the extent of the payment

made, and the payment of the award shall then be assumed to

the extent of payment made by the special trust fund so created.

If, for any reason, a beneficiary's right to the compensation

awarded and ordered paid into said special trust fund ceases,

lapses, or in any manner terminates by virtue of the terms and

provisions of articles 40 to 47 of this title so that a surplus not

surviving or accruing to any other beneficiary remains in said

trust fund of the amount ordered paid into it on behalf of the

beneficiary, the insurance carrier or employer who has made

said payment shall be entitled to a refund of the present value

of said surplus, if any, computed at the rate of four percent per

annum. The state treasurer shall invest any portion of the

special trust fund, including its surplus and reserves, which the

director determines is not needed for immediate use.

8-47-106. State average weekly wage - method of

computation. The state average weekly wage shall be

established by the director annually on or before July 1 of each

year. The state average weekly wage shall be determined from

the average weekly earnings referenced in section 8-73-102

(1), computed by the division in June on the basis of the most

recent available figures, and applicable to the ensuing twelve

months beginning July 1. Such state average weekly wage

shall automatically form the basis for establishing maximum

benefits under the "Workers' Compensation Act of Colorado"

as of 12:01 a.m., July 1, 1974, and at each succeeding time and

date annually thereafter.

8-47-107. Adoption of rules. The director has the

power to adopt reasonable and proper rules relative to the

administration of articles 40 to 47 of this title and proper rules

to govern proceedings and hearings of the division, and the

director has the discretion to amend the rules from time to time.

No such rule shall limit the jurisdiction of an administrative

law judge in the office of administrative courts to hear and

decide all matters arising under articles 40 to 47 of this title;

except that in any matter where the director has issued an order

to enforce a provision of the "Workers' Compensation Act of

Colorado", an administrative law judge in the office of

administrative courts shall not hear and decide the same matter

To Index

while it is pending before the director. The rules shall be

promulgated in accordance with section 24-4-103, C.R.S.

8-47-108. Workers' compensation study - report

to general assembly. (Repealed)

8-47-109. Report to general assembly. (Repealed)

8-47-110. Public officers to enforce orders -

furnish information. It is the duty of all officers and

employees of the state, counties, and municipalities, upon the

request of the director, to enforce in their respective

departments all lawful orders of the director insofar as the

same may be applicable and consistent with the general duties

of such officers and employees. It is also their duty to make to

the director such reports as the director may require concerning

matters within their knowledge pertaining to the purposes of

articles 40 to 47 of this title and to furnish the director such

facts, data, statistics, and information as, from time to time,

may come to them pertaining to the purposes of said articles

and the duties of the division thereunder, and particularly all

information coming to their knowledge respecting the

condition of all places of employment subject to the provisions

of said articles with regard to the health, protection, and safety

of employees and the hazard of risk of such places of

employment.

8-47-111. Division efforts to ensure employer

compliance with workers' compensation coverage

requirements - legislative declaration. (1) The general

assembly finds, determines, and declares that it is in the best

interests of the public to assure that all employers who fall

under the provisions of articles 40 to 47 of this title have in

effect current policies of insurance or self-insurance for

workers' compensation liability.

(2) In order to implement the declaration in

subsection (1) of this section, the division shall develop a

procedure for verifying whether or not all employers doing

business in the state of Colorado comply with the requirements

of article 44 of this title. This procedure must include cross-

referencing employer records of the division of unemployment

insurance and the division of workers' compensation. Upon

identifying employers that are not in compliance with article

44 of this title, the division, with the assistance and cooperation

of the attorney general, shall use all available means under

articles 40 to 47 of this title to ensure compliance. Every

insurance carrier authorized to transact business in this state,

including Pinnacol Assurance, which insures employers

against liability for compensation under the provisions of

articles 40 to 47 of this title, shall furnish the division, upon

request, all information required by it to accomplish the

purposes of this section.

8-47-112. Division website - procedures to file

complaints. The director shall clearly post on the division's

website the procedure for an injured worker to follow to file a

complaint with the division regarding any issue over which the

director or his or her designee has authority to pursue, settle,

or enforce pursuant to articles 40 to 47 of this title.

PART 2

GENERAL POWERS

8-47-201. Information to division - blanks -

verification. Every employer receiving from the division any

blanks with directions to fill out the same or requests for

information required for the purposes of articles 40 to 47 of

this title shall properly fill out the blanks and furnish the

information so requested fully and correctly. The director may

require that any information requested by the division be

verified under oath and may fix the time within which said

information shall be returned.

8-47-202. Information furnished to division -

confidential use. Every employer shall furnish the division,

upon request, all information required by it to accomplish the

purposes of articles 40 to 47 of this title. The information shall

be for the confidential use of the division, unless otherwise

ordered by the director, and shall not be open to the public nor

used in any court or any action or proceeding pending therein,

unless the director is a party to such action or proceeding.

8-47-203. Access to files, records, and

orders. (1) Notwithstanding the provisions of section 8-47-

202, the filing of a claim for compensation is deemed to be a

limited waiver of the doctor-patient privilege to persons who

are necessary to resolve the claim. Access to claim files

maintained by the division will be permitted only as follows:

(a) Workers' compensation claim files shall be

available for inspection upon request by the parties to the

claim, including the claimant, the employer, and the insurer or

their attorneys or other designated representatives. The parties

to a claim may review other claim files relating to the said

claimant.

(b) Persons who are not parties to a claim, or their

attorneys or designated representatives, and who wish to

inspect or obtain information from claim files may submit a

request to inspect a particular file, stating the purpose for such

inspection. The director may disallow such requests if the

purpose of the inspection is to further commercial interests or

to disseminate information to nonparties. Any such request

shall be considered and determined by the division within

seventy-two hours.

governmental entities only as required for the performance of

their official duties and only if those official duties relate to

enforcement of provisions of articles 40 to 47 of this title;

except that the department of revenue may access results of

any inquiry made by the division to determine whether an

employer has any liability pursuant to articles 22 to 29 of title

39, C.R.S. As used in this subparagraph (I), "enforcement"

includes duties of governmental entities involved in the

administration of the provisions of articles 40 to 47 of this title

or if such duties relate to the enforcement of child support

under section 26-13-122, C.R.S. This provision is not intended

to restrict the rights of persons otherwise provided for in

articles 40 to 47 of this title to inspect and copy files.

(II) The general assembly intends that any contract,

agreement, or any other means to transfer information between

the department of labor and employment and any other

governmental entity related to access to claim files in effect

prior to May 27, 1997, shall be conformed to the provisions of

To Index

this paragraph (c), as amended, or terminated as authorized by

law.

(III) Notwithstanding articles 40 to 47 of this title 8,

the director may provide information to the Colorado

uninsured employer board created in section 8-67-106, as

necessary, to exercise its powers and duties.

(d) Persons entitled to review claim files may obtain

copies upon payment of the fee set by the division. Such

persons shall not disseminate information contained in those

files except as required to resolve the claim, or as permitted by

the director, or as permitted by law.

(e) Claimants may waive the protection of this

statute by executing a waiver for the release of information.

The waiver must be dated and will be effective for ninety days

thereafter.

(2) All orders entered by the director or an

administrative law judge pursuant to articles 40 to 47 of this

title shall be made available by the division for inspection or

copying for a fee reflecting actual costs; except that the name

and other identifying information concerning the claimant and

employer shall be excised.

8-47-203.3. Release of location information

concerning individuals with outstanding felony arrest

warrants. (1) Notwithstanding any provision of state law to

the contrary and to the extent allowable under federal law, at

the request of the Colorado bureau of investigation, the

division shall provide the bureau with information concerning

the location of any person whose name appears in the division's

records who is the subject of an outstanding felony arrest

warrant. Upon receipt of such information, it shall be the

responsibility of the bureau to provide appropriate law

enforcement agencies with location information obtained from

the division. Location information provided pursuant to this

section shall be used solely for law enforcement purposes. The

division and the bureau shall determine and employ the most

cost-effective method for obtaining and providing location

information pursuant to this section. Neither the division nor

its employees or agents shall be liable in civil action for

providing information in accordance with the provisions of this

subsection (1).

(2) As used in subsection (1) of this section, "law

enforcement agency" means any agency of the state or its

political subdivisions that is responsible for enforcing the laws

of this state. "Law enforcement agency" includes but is not

limited to any police department, sheriff's department, district

attorney's office, the office of the state attorney general, and

the Colorado bureau of investigation.

8-47-204. Employees of division -

qualifications. The executive director has the power to

employ, pursuant to section 13 of article XII of the state

constitution, such deputies, experts, statisticians, accountants,

inspectors, clerks, and other employees as may be necessary to

carry out the provisions of articles 40 to 47 of this title or to

perform the duties and exercise the powers conferred by law

upon the division.

8-47-205. Salaries of employees of division. All

deputies, statisticians, accountants, clerks, experts, and other

employees of the division shall receive such compensation as

may be fixed by law. The salaries so fixed shall be paid

monthly from the fund appropriated for the use of the division

after approval by the director.

8-47-206. Employees of division - bonds. Such

employees of the division as shall be directed by the director

shall furnish surety company bonds in such sum as may be

fixed by the director, the premiums therefor to be paid as other

expenses of the division are paid.

8-47-207. Collection of statistics. The director or

any agents of the division may enter into any place of

employment for the purpose of collecting facts and statistics,

examining the provisions made for the health, protection, and

safety of the employees, and bringing to the attention of every

employer any rule, order, or requirement of the division, or any

law, or any failure on the part of any employer to comply

therewith.

8-47-208. Records of employers open to

inspection of division. All books, records, and payrolls of

employers or of any contractor, subcontractor, lessee,

sublessee, or person showing or reflecting in any way upon the

amount of wage expenditure of such employers, contractor,

subcontractor, lessee, sublessee, or person and all other facts,

data, and statistics appertaining to the purposes of this article

shall always be open for inspection by the director or any

agents of the division for the purpose of ascertaining the

correctness of the reported wage expenditure, number of

persons employed, and such other information as may be

necessary for the uses and purposes of the division in the

administration of the "Workers' Compensation Act of

Colorado".

8-47-209. Expenses of division. All expenses

incurred by the division pursuant to the provisions of the

"Workers' Compensation Act of Colorado" shall be paid from

funds appropriated for the use of the division upon claims

therefor which shall be itemized and sworn to by the person

who incurred the same. The claims shall be allowed by the

director subject to the approval of the controller. The traveling

expenses of the director or of any employees of the division,

incurred while on business of the division outside of the state

of Colorado, shall be paid in the manner aforesaid, but only

when such expenses are authorized in advance by the

controller to be incurred by the division.

To Index

ARTICLE 55

Workers' Compensation

Classification Appeals Board

8-55-101. Workers' compensation classification

appeals board - creation. (1) There is hereby created, in the

division of insurance in the department of regulatory agencies,

the workers' compensation classification appeals board. The

board shall hear grievances brought by employers against

insurers and Pinnacol Assurance concerning the calculation of

experience modification factors and classification assignment

decisions. The board shall consist of five voting members,

each of whom shall be knowledgeable about workers'

compensation classification and experience modification

factors, and one nonvoting member, as follows:

(a) Two members shall be either salaried employees

of an insurance company that issues workers' compensation

insurance policies in this state or representatives of Pinnacol

Assurance. Such two members shall not both represent

Pinnacol Assurance or the same insurance company. In

addition, one person shall be selected to serve as an alternate

member to represent the interests of the insurance industry or

Pinnacol Assurance. The alternate shall represent such

interests in the event the primary member recuses himself or

herself.

(b) One member, who shall be a nonvoting member,

shall be an employee of a workers' compensation rating

organization functioning under the provisions of section 10-4-

408, C.R.S. The workers' compensation rating organization

shall serve as a technical resource for the board.

employers. Each private employer member shall be

knowledgeable with respect to workers' compensation

insurance, rules, and classifications, and shall be familiar with

the business environment and community in this state. No

private employer member shall be an employee of an insurance

company, insurance broker, insurance agent, law firm, actuary,

Pinnacol Assurance, or any association of such entities or

persons. All private employer board memberships shall be held

in the name of an individual. At least one private employer

member shall represent the construction industry.

(2) The private employer members and the members

representing insurers and Pinnacol Assurance shall be

appointed by the commissioner of insurance. The workers'

compensation rating organization representative shall be

appointed by the chief executive officer of such organization

or by another officer designated to make such appointment.

The commissioner may solicit a list of nominees from any

interested party before making such appointments. The

commissioner shall immediately notify the workers'

compensation rating organization concerning the identity of

any appointees.

(3) Each member shall serve one three-year term,

and, in addition:

(a) (Deleted by amendment, L. 2002, p. 1889, § 46,

effective July 1, 2002.)

(b) A private employer member or member

representing the insurance industry or Pinnacol Assurance may

serve a second consecutive three-year term; and

compensation rating organization may be reappointed without

limitation.

(4) Any vacancy on the board shall be filled for the

unexpired term in the same manner as the original

appointment. The member appointed to fill such vacancy shall

be from the same category described in subsection (1) of this

section as the member vacating the position.

(5) Members of the board shall serve without

compensation, but their reasonable expenses incurred when

performing their duties as board members shall be reimbursed

from the workers' compensation cash fund created in section

8-44-112 (7). Such expenses shall be limited to travel, food,

and lodging expenses.

(6) Members of the board, in their capacity as

members, shall be immune from liability in all claims for

injury that lie in tort or could lie in tort, regardless of whether

that may be the type of action or the form of relief chosen by

the claimant.

8-55-102. Right to appeal - notice of appeal

procedures. An employer may appeal to the workers'

compensation classification appeals board any issue

concerning the calculation of experience modification factors

and classification assignment decisions under the workers'

compensation laws of this state by filing written notice with

said board within thirty days after the employer has exhausted

all appeal review procedures provided by the insurance

company. Every insurance carrier authorized to transact

business in this state, including Pinnacol Assurance, shall

provide employers with a written copy or summary of their

appeal procedures, together with a written notice of the

availability of an appeal under this article, at the beginning of

each policy year and when notice is provided to the employer

of a change in experience modification factors or job

classification.

8-55-103. Hearings - conflicts of interest. (1) The

board shall commence each term on January 1 of each year and

shall terminate each term on December 31.

(2) At the beginning of each term the board shall

either in person or by teleconference:

(a) Elect a chair who shall be responsible for

conducting each hearing;

(b) Appoint the member representing the workers'

compensation rating organization as secretary; and

rules as are deemed necessary.

(3) The board shall meet as needed and in accordance

with the following:

(a) The board shall schedule a hearing within thirty

days after receipt of an appeal.

(b) The board shall provide written notice of a

hearing to the appellant, the insurer, and the workers'

compensation rating organization within thirty days after

receipt of an appeal, but not less than ten days before the

hearing.

the board is present, either in person or by teleconference. A

quorum shall consist of a simple majority of the voting

members, including at least two private sector members.

To Index

(d) Any decision of the board shall be by majority

vote of the voting members who are present at the hearing.

(e) A member's vote shall be cast only by such

member.

(f) If a board member has a conflict of interest with

respect to any matter scheduled for hearing before the board,

such member shall recuse himself or herself from any

discussion and decisions on said matter unless, after full

disclosure of the facts giving rise to such conflict, all parties to

the appeal agree to waive such conflict. For purposes of this

paragraph (f), a member shall be deemed to have a conflict of

interest if such member:

(I) Has a conflict that would call into question such

member's ability to render an unbiased decision; and

(II) Is associated with either party to the appeal. A

member is "associated" with a party to an appeal if:

(A) The member and the party to the appeal are

involved in a common business enterprise or are members of a

controlled group, as defined in section 1563(a) of the federal

"Internal Revenue Code of 1986", as amended; or

(B) The member has a familial relationship with the

party to the appeal.

(g) Notwithstanding the provisions of paragraph (f)

of this subsection (3), the member representing the workers'

compensation rating organization shall not be deemed to have

a conflict of interest with respect to any appeal based solely on

his or her affiliation with his or her organization.

(4) The secretary of the board shall carry out the

administrative functions of the board and shall be responsible

for providing notice of, preparing the agenda for, and

arranging the facilities for each hearing and meeting. The

secretary shall also prepare a memorandum after each hearing

that includes the vote of the board. Such memoranda shall be

signed by the chair of the board and, each month, the secretary

shall deliver copies of that month's memoranda to the workers'

compensation rating organization.

8-55-104. Review of board decisions. (1) A

decision of the board shall be final and not subject to appeal

unless the employer, insurance company, or Pinnacol

Assurance provides written notice to the office of the

commissioner of insurance, who shall determine whether a job

misclassification occurred, as required pursuant to section 8-

44-108. An employer may hold disputed premium amounts in

abeyance from the date an appeal is filed pursuant to section

8-55-102 until the later of:

(a) The date a final decision is made by the board

concerning such appeal; or

(b) The date of any written decision of the

commissioner of insurance issued pursuant to subsection (3) of

this section.

(2) Each employer, insurance company, or Pinnacol

Assurance, as the case may be, shall be advised of the right to

appeal to the office of the commissioner of insurance.

(3) An employer, insurance company, or Pinnacol

Assurance shall provide written notice of an appeal to the

commissioner of insurance within thirty days after the date of

the board's decision. The commissioner shall review any

decision of the board properly appealed pursuant to this section

and shall provide a written decision within thirty days after the

request for such review.

(4) Any employer that holds disputed premium

amounts in abeyance pursuant to subsection (1) of this section

and loses its appeal shall pay the disputed premium amount

plus interest at the rate of one percent of such disputed amount

per month. Such interest shall accrue from the date of the

premium rate increase to the date of payment.

8-55-105. Repeal of article. (1) This article is

repealed, effective July 1, 2021.

(2) Prior to said repeal, the workers' compensation

classification appeals board shall be reviewed as provided in

section 24-34-104, C.R.S.

To Index

ARTICLE 67

Colorado Uninsured Employer Act

8-67-101. Short title. The short title of this article 67

is the "Colorado Uninsured Employer Act".

8-67-102. Legislative declaration. (1) The general

assembly hereby finds and declares that the purpose of this

article 67 is to provide a mechanism for the payment of

covered claims to workers injured while employed by

employers who have failed to obtain and maintain the required

workers' compensation insurance and to avoid excessive delay

in payment and financial loss to injured workers.

(2) Therefore, it is the intent of the general assembly

to require employers to maintain workers' compensation

insurance and that the requirement be vigorously enforced in

order to protect compliant employers from those who would

gain a competitive advantage at the expense of the safety and

well-being of employees.

8-67-103. Definitions. As used in this article 67,

unless the context otherwise requires:

(1) "Board" means the uninsured employer board

created in section 8-67-106.

(2) "Covered claim" means a claim for benefits

resulting from an injury occurring on or after January 1, 2020,

that has been adjudicated to be compensable, for which the

employer has been determined to be uninsured, and for which

the employer has failed to pay the full amount of benefits as

ordered.

(3) "Department" means the department of labor and

employment.

(4) "Director" means the director of the division of

workers' compensation.

(5) "Division" means the division of workers'

compensation in the department of labor and employment.

(6) "Fund" means the Colorado uninsured employer

fund.

8-67-104. Exclusions. (1) The following persons

may not recover compensation or other benefits from the fund:

(a) A partner in a partnership or an owner of a sole

proprietorship;

(b) A director or officer of a corporation;

company;

(d) An individual who was responsible for obtaining

and maintaining the employer's workers' compensation

insurance coverage and who failed to do so;

(e) An individual who was eligible to be covered

under a workers' compensation insurance policy and

voluntarily rejected the coverage under section 8-41-202, 8-

41-404 (4)(a)(V), or 8-41-404 (4)(a)(VI);

(f) An individual who is not an "employee" as

defined in sections 8-40-202 and 8-40-301 or who is otherwise

ineligible to receive benefits under articles 40 to 47 of this title

8-67-105. Colorado uninsured employer

fund. (1) The Colorado uninsured employer fund is hereby

created in the state treasury. A board of directors established

under section 8-67-106 shall administer the fund under a plan

of operation established under section 8-67-108.

(2) (a) The money collected for the fund pursuant to

articles 40 to 47 of this title 8 shall be transmitted to the state

treasurer, who shall credit the money to the fund. The money

credited to the fund and all interest earned thereon are hereby

continuously appropriated for the payment of the direct costs

of administering the program, including benefits paid pursuant

to this article 67 and payments to third parties retained

pursuant to this article 67.

(b) The internal staffing costs, not including

payments to third parties contracted by the board, associated

with uninsured employer programs shall be paid out of the

workers' compensation cash fund in accordance with

appropriations made pursuant to section 8-44-112 (7).

(I) Civil penalties, fines, and other revenue collected

by the division and specifically allocated to the fund pursuant

to articles 40 to 47 of this title 8;

(II) Any public or private gifts, grants, or donations

to the fund received by the department;

(III) Any appropriations made to the fund; and

(IV) Earned interest, which the state treasurer shall

deposit in the fund.

(d) The department may use revenues in the fund for

benefits to be paid out of the fund pursuant to this article 67 as

well as administrative costs of the board.

(e) The money in the fund:

(I) Shall remain in the fund and not be credited or

transferred to the general fund at the end of any fiscal year;

(II) Is exempt from section 24-75-402; and

(III) Is not subject to annual appropriation by the

general assembly.

(3) No later than June 1, 2022, the state auditor shall

conduct or cause to be conducted a performance audit of the

Colorado uninsured employer fund.

8-67-106. Creation of board. (1) There is hereby

created in the division the uninsured employer board,

consisting of the director of the division or the director's

representative and four members appointed by the governor

and confirmed by the senate. Appointed members of the board

must include at least one individual to represent each of the

following:

(a) Employers;

(b) Labor organizations;

(d) Attorney representatives of injured workers.

(2) The board shall exercise its powers and perform

its functions under the department and the director as if the

board were transferred to the department by a type 2 transfer,

as such transfer is defined in the "Administrative Organization

Act of 1968", article 1 of title 24.

(3) The appointed members of the board shall serve

for terms of three years and may be reappointed; except that,

of the members first appointed, one shall serve for an initial

term of three years, two shall serve for initial terms of two

To Index

years, and one shall serve for an initial term of one year. A

member may serve no more than three consecutive terms.

(4) Members of the board are not entitled to

compensation for their services but shall be reimbursed for

actual and necessary traveling and expenses incurred in the

performance of their official duties as members of the board.

8-67-107. Powers of the board - rules. (1) The

board has the following powers and duties:

(a) To establish standards and criteria for payment of

benefits from the fund;

(b) To set minimum and maximum benefit rates;

except that benefits paid by the fund shall not exceed the

maximum allowed under articles 40 to 47 of this title 8 or set

forth by order of the director. Minimum benefit rates shall be

at the level required by articles 40 to 47 of this title 8 unless

the fund lacks sufficient money as determined by the board. If

benefits are paid below the amount mandated by articles 40 to

47 of this title 8, benefits shall be prioritized and paid as

follows:

(I) Medical benefits;

(II) Funeral benefits;

(III) Temporary disability;

(IV) Death benefits;

(V) Permanent total disability;

(VI) Permanent partial disability;

(VII) Disfigurement.

contracting with any appropriate entities designated as third-

party administrators. Designation of a third-party

administrator is subject to the approval of the director.

(d) To pay the expenses of the board as authorized by

this section;

(e) To disseminate information regarding the fund;

(f) To adopt rules as necessary to carry out the

purposes of this article 67, including rules regarding admission

to the fund and payment of benefits in order to ensure the

financial stability of the fund;

(g) To investigate claims brought for benefits and to

adjust, compromise, settle, and pay covered claims to the

extent permitted by statute and rule; to deny payment of

benefits from the fund of all other claims and to review

settlements, releases, and final orders to which the uninsured

employer and injured worker were parties; and to determine

the extent to which such settlements, releases, and orders may

effect eligibility for benefits.

(2) The board may:

(a) Employ or retain persons as necessary to handle

claims and perform other duties of the board;

(b) Intervene as a party before any court or

administrative tribunal in this state that has jurisdiction over an

uninsured employer or other party potentially responsible for

payment of benefits;

necessary to carry out the purposes of this article 67;

(d) Perform other acts necessary or proper to

effectuate the purposes of this article 67;

(e) Purchase or otherwise obtain insurance and

reinsurance policies to limit the liability of the fund for

payment of benefits under this article 67; and

(f) Deny entry to the fund or payment of benefits if

the underlying claim appears to be premised on fraudulent

activity.

8-67-108. Plan of operation - rules. (1) The board

shall, by rule, adopt a plan of operation and any amendments

necessary or suitable to assure the fair, reasonable, and

equitable administration of the fund.

(2) If the board fails to adopt a plan of operation on

or before September 1, 2018, the director shall, after notice and

hearing, adopt and promulgate reasonable rules as necessary

or advisable to effectuate this article 67. The rules shall

continue in force until modified or superseded by the board.

(3) The plan of operation shall:

(a) Establish the procedures by which all the powers

and duties of the board under section 8-67-107 will be

performed;

(b) Establish the amount and method of reimbursing

members of the board under section 8-67-106 (4);

filed with the board, including establishing acceptable forms

of proof of covered claims;

(d) Establish procedures for pursuing actions against

uninsured employers pursuant to section 8-67-110;

(e) Establish regular places and times for meetings of

the board;

(f) Establish procedures for maintaining records of

all financial transactions of the board;

(g) Contain additional provisions necessary or

proper for the execution of the powers and duties of the board;

and

(h) Establish procedures for contracting with third-

party administrators to administer claims paid by the fund.

8-67-109. Effect of benefits. (1) Notwithstanding

this section or articles 40 to 47 of this title 8, a person seeking

benefits under this article 67 from the fund is deemed to have

assigned his or her rights under articles 40 to 47 of this title 8

to the board to the extent of the benefits paid by the fund. Every

injured worker seeking the protection of this article 67 shall

cooperate with the board to the same extent as he or she would

have been required to cooperate with the employer.

(2) If an employer has no insurance and fails to pay

the full amount of benefits as required by articles 40 to 47 of

this title 8, the injured worker may apply to the board for

payment of the compensation benefits, including medical

benefits, to which the injured worker is entitled, to be paid

from the fund. Benefits to which the injured worker is entitled

from the fund do not include any penalties assessed against the

employer.

(3) The board has the right to appear as a creditor in

a bankruptcy proceeding involving an uninsured employer

who has been found liable to an injured worker admitted to the

fund.

(4) The receiver, liquidator, or statutory successor of

an uninsured employer is bound by settlements of covered

claims with the board. The court having jurisdiction shall grant

such claims priority equal to that which the injured worker

would have been entitled in the absence of this article 67

against the assets of the employer. The expenses of the board

shall be accorded the same priority as the liquidator's expenses.

To Index

(5) Upon the acceptance of a claim into the fund, the

board shall record, as provided by subsection (6) of this

section, a certificate prepared and furnished by the division

showing the date on which the claim was filed, the date of the

injury, the name and last-known address of the employer

against whom it was filed, the names and last-known addresses

of the employer's principals, and the fact that the employer has

not secured the payment of compensation as required. Upon

recording, the certificate constitutes a valid lien against the

assets of the employer and its principals in favor of the fund

for the whole amount that may be due as compensation. Any

lien secured pursuant to this article 67 has priority in the order

filed. The board shall serve a copy of the certificate upon the

employer and its principals.

(6) The certificate constituting a lien in favor of the

fund must be filed in the following offices:

(a) The offices of the county clerks of the counties in

which the principals of the defendant employer reside;

(b) The office of the county clerk of the county in

which the defendant employer has its principal place of

business; and

where the employer's property is located.

(7) If an uninsured employer becomes insolvent, the

board may convert all future payments of workers'

compensation weekly benefits, medical expenses, or other

payments pursuant to articles 40 to 47 of this title 8 to a present

lump sum. The board shall fix the lump sum of probable future

medical expenses and weekly compensation benefits, or other

benefits payable pursuant to articles 40 to 47 of this title 8,

capitalized at their present value upon the basis of interest at

the rate of four percent per annum. The board shall then file

with the receiver or liquidator of an insolvent employer the

statement of the lump sum, which shall preserve the rights of

the board against the assets of the insolvent employer. The

employer is discharged from all further liability for the

commuted workers' compensation claim upon payment of the

present lump sum to either the injured worker or, subject to

approval by the board, to a licensed insurer for purchase of an

annuity or other periodic payment plan for the benefit of the

injured worker.

(8) Payment from the fund does not relieve the

obligation of the employer to pay benefits as required by

articles 40 to 47 of this title 8 to the injured worker; except that

any benefits due to the injured worker will be reduced by the

amount of the benefits paid by the fund to the injured worker.

All benefits required pursuant to articles 40 to 47 of this title 8

remain the liability of the employer.

8-67-110. Collection of benefit

reimbursements. (1) The board shall institute practices and

procedures as it deems necessary to collect any money due the

fund in the form of reimbursement for benefits paid from the

fund to an injured worker.

(2) The board, in its role as guardian of fund dollars,

is exempt from section 24-30-202.4. If the board determines

an account to be uncollectible, the account may be referred to

the controller for collection. Reasonable fees for collection, as

determined by the board and the controller, shall be added to

the amount of debt. The debtor is liable for repayment of the

total of the amount of outstanding debt plus the collection fee.

All money collected by the controller shall be returned to the

fund; except that all fees collected shall be retained by the

controller. If less than the full amount is collected, the

controller shall retain only a proportionate share of the

collection fee.

(3) If, after due notice, an employer defaults in the

repayment of any benefits paid by the fund to an injured

worker on that employer's behalf, the board may seek

collection from the employer by instituting a civil action,

which shall include the right of attachment in the name of the

fund. Court costs shall not be charged to the board, but any

employer against whom judgment is taken shall be charged

with all costs of the action. All costs collected by the fund shall

be paid into the registry of the court.

(4) The board may employ counsel and other

personnel necessary to collect reimbursements as described in

this section.

8-67-111. Payment of benefits. (1) Benefits paid

under this article 67 are treated as benefits paid by an insurer

or self-insured employer under articles 40 to 47 of this title 8.

(2) A person having a single claim against multiple

employers is not entitled to receive benefits unless each of the

liable employers is uninsured.

(3) When paying benefits, the board is entitled to

claim any reduction of benefits, to claim overpayments, or to

make any other adjustments allowed under articles 40 to 47 of

this title 8.

(4) Benefits awarded under this article 67 must be

reduced by any benefits paid by the uninsured employer.

8-67-112. Medical benefits. (1) Medical benefits

paid under this article 67 are treated as benefits paid by an

insurer or self-insured employer under articles 40 to 47 of this

title 8.

(2) Upon acceptance of a claim for benefits from the

fund, the board may designate a new authorized treating

physician. Application to the fund shall be deemed as

acceptance by the injured worker of the new designated

physician if the designation is made. The previously

authorized treating physician providing primary care shall

continue as the authorized treating physician providing

primary care for the injured employee until the injured

employee's initial visit with the newly authorized treating

physician, at which time the treatment relationship with the

previously authorized treating physician providing primary

care is terminated.

(3) Notwithstanding articles 40 to 47 of this title 8,

the board is permitted to negotiate rates of reimbursement for

medical providers.

8-67-113. Procedure. (1) A controversy

concerning any issue arising under this section shall be

resolved through hearings in accordance with sections 8-43-

207 and 8-43-207.5. In any such hearing, a decision of the

board to deny benefits may only be set aside upon a showing

of abuse of discretion.

(2) The division shall notify the board of any claim

determined or suspected to be uninsured, either at the time of

filing or otherwise. Upon the notification, the board is

permitted to join the claim as a party upon written notice to all

other parties.

To Index

(3) A hearing must not proceed on the issue of lack

of coverage without the board having been notified and

provided an opportunity to join the claim as a party.

(4) The board, its agents, or employees have no

liability for any action taken against them for the performance

of their duties under this article 67.

To Index

INDEX TO WORKERS’ COMPENSATION ACT

ABROGATION OF DEFENSES ...................................................................... 8-41-101(1)......................................................................................... 9

ACCEPTANCE OF ACT .................................................................................. 8-41-104 ............................................................................................. 9

ACCIDENT

arising out of employment ............................................................................... 8-41-301(1)(b), (c)

............................................................................ 13

benefits (see BENEFITS)

definition .......................................................................................................... 8-40-201(1), (2)

.................................................................................. 3

heart attack ....................................................................................................... 8-41-302(2)....................................................................................... 14

report by employee .......................................................................................... 8-43-102(1)(a) .................................................................................. 34

report by employer ........................................................................................... 8-43-101(1)....................................................................................... 34

stress ................................................................................................................ 8-41-302(1)....................................................................................... 14

ACCREDITATION PROGRAM ..................................................................... 8-42-101(3.6)(a) ............................................................................... 19

accessibility of program ................................................................................... 8-42-101(3.6)(e) ............................................................................... 20

costs ................................................................................................................. 8-42-101(3.6)(d), (m) ....................................................................... 20

facilities ........................................................................................................... 8-42-101(3.6)(b) ............................................................................... 19

list of accredited physicians ............................................................................. 8-42-101(3.6)(k) ............................................................................... 20

non-lost time injuries ....................................................................................... 8-42-101(3.6)(i) ................................................................................ 20

physician assistant ........................................................................................... 8-42-101(3.5)(a)(I)(B) ...................................................................... 19

physician defined ............................................................................................. 8-42-101(3.5)(a)(I)(A) ...................................................................... 19

Level I .......................................................................................................... 8-42-101(3.6)(a)(I) ........................................................................... 19

Level II ........................................................................................................ 8-42-101(3.6)(a)(II) .......................................................................... 19

impairment ratings if not Level II accredited ........................................... 8-42-101(3.6)(o) ............................................................................... 20

not level II accredited............................................................................... 8-42-107(8)(b.5) ............................................................................... 27

registration fees ................................................................................................ 8-42-101(3.6)(l) ................................................................................ 20

review of program ............................................................................................ 8-42-101(3.6)(r)(II) .......................................................................... 20

revocation of accreditation ............................................................................... 8-42-101(3.6)(g), 8-43-501(3)(c)(III)(4) .................................... 20, 55

time of accreditation ........................................................................................ 8-42-101(3.6)(f) ................................................................................ 20

ACCRUED COMPENSATION ON DEATH.................................................. 8-41-503(2)....................................................................................... 17

ACTIONS

abolished .......................................................................................................... 8-41-102

............................................................................................. 9

ADMINISTRATIVE HEARINGS, DIVISION OF

(see Office of Administrative Courts) ........................................................... 24-30-1001

ADMINISTRATIVE LAW JUDGE

appeals from, to Industrial Claim Appeals Panel ............................................. 8-43-301(6)

....................................................................................... 43

appointment ..................................................................................................... 24-30-1003

determine competency of witnesses & parties to settlement ............................ 8-43-207(1)(m), 8-43-207.5(2) ......................................................... 40

dismiss issues ................................................................................................... 8-43-207(1)(n) .................................................................................. 40

guardians ad litem, appoint .............................................................................. 8-43-207(1)(l) ................................................................................... 40

jurisdiction ....................................................................................................... 8-43-207(1)(m) ................................................................................. 40

order of (see ORDER)

power and authority ......................................................................................... 8-43-207(1)

....................................................................................... 40

report on penalties imposed ............................................................................. 8-43-304(3)....................................................................................... 45

require repayment of overpayments ................................................................. 8-43-207(1)(q) .................................................................................. 40

review by Industrial Claim Appeals Panel ....................................................... 8-43-301(6)....................................................................................... 43

subpoenas......................................................................................................... 8-43-207.5(2).................................................................................... 40

ADMISSION OF LIABILITY .......................................................................... 8-43-203(1)(a) .................................................................................. 36

compensation information requirements .......................................................... 8-43-203(2)(b)(I) .............................................................................. 37

contest final admission..................................................................................... 8-43-203(2)(b)(II)(A) ....................................................................... 37

filed after Division Independent Medical Examination ................................... 8-42-107.2(4)(a), 8-43-203(2)(b)(II)(A) ..................................... 29, 37

AGRICULTURAL LABOR (see FARM AND RANCH LABOR)

AGGRIEVED PARTY for apportionment of fines ........................................... 8-43-304(1), 8-43-401(2)(a)

....................................................... 45, 47

ALCOHOL

conviction, evidence ........................................................................................ 8-43-210 ........................................................................................... 41

reducing compensation .................................................................................... 8-42-112.5(1).................................................................................... 31

ALIEN ................................................................................................................ 8-40-202(1)(b) .................................................................................... 6

8-40-202(1)(a)(VI)(b) ......................................................................... 6

contract capacity ..............................................................................................

AMA GUIDES

impairment rating guidelines ........................................................................... 8-42-101(3)(a)(I) .............................................................................. 19

medical impairment ratings.............................................................................. 8-42-107(8)(c) .................................................................................. 27

physical impairment ratings ............................................................................. 8-42-101(3.7).................................................................................... 20

AMPUTATION ................................................................................................. 8-42-107(5), 8-42-107(8)(c.5) .................................................... 26, 28

ANNUITY .......................................................................................................... 8-44-116 ........................................................................................... 62

APPEAL

to Court of Appeals .......................................................................................... 8-43-307 thru 312 ............................................................................. 46

Find what you were looking for?

costs ......................................................................................................... 8-43-314 ........................................................................................... 46

by division ....................................................................................................... 8-43-301(7) ....................................................................................... 43

error disregarded ...................................................................................... 8-43-310 ........................................................................................... 46

fees ........................................................................................................... 8-43-314 ........................................................................................... 46

grounds .................................................................................................... 8-43-308 ........................................................................................... 46

heard in 30 days ....................................................................................... 8-43-309 ........................................................................................... 46

precedence ............................................................................................... 8-43-307(2) ....................................................................................... 46

remand ..................................................................................................... 8-43-312 ........................................................................................... 46

time for filing ........................................................................................... 8-43-301(10) ..................................................................................... 43

when panel fails to act .............................................................................. 8-43-301(11) ..................................................................................... 43

of utilization review process ............................................................................ 8-43-501(5)(a) .................................................................................. 55

to director or administrative law judge ............................................................ 8-43-301(2) ....................................................................................... 43

briefs, time for filing ................................................................................ 8-43-301(4) ....................................................................................... 43

petition to review, time for filing ............................................................. 8-43-301(2) ....................................................................................... 43

supplemental orders ................................................................................. 8-43-301(4), (5) ................................................................................ 43

transcript, ordering ................................................................................... 8-43-301(2) ....................................................................................... 43

to Industrial Claim Appeals Panel .................................................................... 8-43-301(6) ....................................................................................... 43

briefs, time for filing ................................................................................ 8-43-301(6) ....................................................................................... 43

multiple employers ................................................................................... 8-43-301(13) ..................................................................................... 44

order, time for entering ............................................................................ 8-43-301(8) ....................................................................................... 43

petition for review .................................................................................... 8-43-301(6) ....................................................................................... 43

power to alter findings ............................................................................. 8-43-301(8) ....................................................................................... 43

procedural orders ..................................................................................... 8-43-301(9) ....................................................................................... 43

record, transmittal .................................................................................... 8-43-301(7) ....................................................................................... 43

remand ..................................................................................................... 8-43-318 ........................................................................................... 47

to Supreme Court ............................................................................................. 8-43-313 ........................................................................................... 46

transcripts ................................................................................................. 8-43-213(3) ....................................................................................... 42

APPLICATION FOR HEARING

after IME .......................................................................................................... 8-42-107.2(4), 8-43-203(2)(b)(II) ............................................... 29, 37

claims management - application for hearing - rejection of ............................. 8-43-218(4) ....................................................................................... 42

de novo utilization review ................................................................................ 8-43-501(5)(b) .................................................................................. 55

expedited hearing ............................................................................................. 8-42-105(2)(a), 8-43-203(1)(a) ................................................... 24, 36

for penalty ........................................................................................................ 8-43-304(4) ....................................................................................... 45

request for mediation after ............................................................................... 8-43-205(1) ....................................................................................... 39

APPOINTED OFFICIALS ............................................................................... 8-40-202(1)(a)(I)(A) ........................................................................... 4

APPORTION BENEFITS

death ................................................................................................................. 8-42-121

........................................................................................... 33

diseases ............................................................................................................ 8-41-304(2) ....................................................................................... 14

permanent total ................................................................................................ 8-46-105(1) ....................................................................................... 74

previous disability ............................................................................................ 8-42-104(5) ....................................................................................... 23

recovery ........................................................................................................... 8-42-104(6) ....................................................................................... 23

APPORTION PENALTIES .............................................................................. 8-43-304(1) ....................................................................................... 45

ARBITRATION, right to ................................................................................... 8-43-206.5 ........................................................................................ 39

ARISING OUT OF EMPLOYMENT .............................................................. 8-41-301(1)(b), (c) ............................................................................ 13

ARTIFICIAL LIMB .......................................................................................... 8-42-101(1)(b) .................................................................................. 18

ASSIGNABILITY OF COMPENSATION...................................................... 8-42-124(1), (6) .......................................................................... 33, 34

ASSUMPTION OF RISK .................................................................................. 8-41-101(1) ......................................................................................... 9

ATTACHMENT OF COMPENSATION ........................................................ 8-42-124(1), (6) .......................................................................... 33, 34

ATTORNEY FEES ............................................................................................ 8-43-403(1) ....................................................................................... 48

determination of reasonableness ...................................................................... 8-43-403(1) ....................................................................................... 48

limits ................................................................................................................ 8-43-403(1) ....................................................................................... 48

submission of fee agreement ............................................................................ 8-43-403(2) ....................................................................................... 48

frivolous appeal ................................................................................................ 8-43-301(14) ..................................................................................... 44

improper actions .............................................................................................. 8-43-301(14) ..................................................................................... 44

no lien .............................................................................................................. 8-42-124(1) ....................................................................................... 33

power of attorney, distributing funds ............................................................... 8-42-124(2)(b) .................................................................................. 33

subrogation ...................................................................................................... 8-41-203(1)(e), 8-41-203(4)(d) .............................................. 10, 11-12

unripe issues ..................................................................................................... 8-43-211(3) ....................................................................................... 41

ATTORNEY GENERAL, acting for Industrial Claim Appeals Panel

or director ......................................................................................................... 8-43-401(1)

....................................................................................... 47

AUTHORIZED TREATING PHYSICIAN (see TREATING PHYSICIAN)

AVERAGE WEEKLY WAGE

COBRA recalculation ...................................................................................... 8-42-103(2)

....................................................................................... 23

computations .................................................................................................... 8-42-102(3) ....................................................................................... 21

employee's........................................................................................................ 8-42-102(2) ....................................................................................... 21

later injury ........................................................................................................ 8-42-104(1) ....................................................................................... 23

minor ................................................................................................................ 8-42-102(4) ....................................................................................... 21

Find what you were looking for?

III

recalculate upon termination of fringe benefit ................................................. 8-42-103(2)....................................................................................... 23

state ................................................................................................................. 8-47-106 ........................................................................................... 78

TTD, TPD, and PTD rate cannot exceed 91% of SAWW ............................... 8-42-105(1)....................................................................................... 24

wages, “at the time of injury” .......................................................................... 8-42-102(5)(a) .................................................................................. 22

AWARD (see ORDER)

administrative law judge issue ......................................................................... 8-43-207(1)(k)

.................................................................................. 40

defined ............................................................................................................. 8-40-201(15)....................................................................................... 4

director issue .................................................................................................... 8-43-207(1)(k) .................................................................................. 40

error disregarded .............................................................................................. 8-43-310 ........................................................................................... 46

garnishment or administrative lien ................................................................... 8-43-204(4)....................................................................................... 38

notice ............................................................................................................... 8-43-215(1)....................................................................................... 42

technical omission ........................................................................................... 8-47-104 ........................................................................................... 78

BENEFICIARIES (see DEPENDENTS)

BENEFITS AND COMPENSATION .............................................................. 8-42-101 thru 124

........................................................................ 18-33

accrued at death ............................................................................................... 8-41-503(2)....................................................................................... 17

acts of employee reducing ............................................................................... 8-42-112(1)....................................................................................... 30

failure to obey safety rules ........................................................................... 8-42-112(1)(b) .................................................................................. 30

to use safety devices .................................................................................... 8-42-112(1)(a) .................................................................................. 30

intoxication .................................................................................................. 8-42-112.5(1).................................................................................... 31

admission of denial of liability for ................................................................... 8-43-203(1)(a) .................................................................................. 36

time limits .................................................................................................... 8-43-203(1)(a) .................................................................................. 36

penalty ......................................................................................................... 8-43-203(2)....................................................................................... 37

amputation ....................................................................................................... 8-42-107(1)(a) .................................................................................. 25

assignability ..................................................................................................... 8-42-124(1), 8-43-204(1) ........................................................... 33, 38

attachment, exempt from ................................................................................. 8-42-124(1)....................................................................................... 33

attorney fees ..................................................................................................... 8-43-403(1)....................................................................................... 48

assigned ........................................................................................................... 8-42-124(1)....................................................................................... 33

basis for wages ................................................................................................. 8-42-102(1)....................................................................................... 21

cap ................................................................................................................. 8-42-107.5 ........................................................................................ 30

cease benefits to recover overpayments ........................................................... 8-42-113.5(1)(b) ............................................................................... 31

claims ............................................................................................................... 8-43-103(1)....................................................................................... 35

filing of by other than claimant .................................................................... 8-43-103(1)....................................................................................... 35

nonassignable and exempt ........................................................................... 8-42-124(1)....................................................................................... 33

notice of ....................................................................................................... 8-43-103(1)....................................................................................... 35

conditions of recovery ..................................................................................... 8-41-301(1)....................................................................................... 13

continued payment of wages, effect ................................................................. 8-42-124(1)....................................................................................... 33

death (see DEATH BENEFITS)

decrease for permanent total able to return to employment ............................. 8-43-303(3)

....................................................................................... 44

disfigurement ................................................................................................... 8-42-108(1)....................................................................................... 30

earnings

average weekly wage

how computed .......................................................................................... 8-42-102(2)

....................................................................................... 21

exceptional cases...................................................................................... 8-42-102(3)....................................................................................... 21

minor ........................................................................................................ 8-42-102(4)....................................................................................... 21

previous injury ......................................................................................... 8-42-104(1)....................................................................................... 23

first installment paid ........................................................................................ 8-42-105(2)(a) .................................................................................. 24

fraud ................................................................................................................. 8-43-304(2)....................................................................................... 45

incompetent ..................................................................................................... 8-41-503(3)....................................................................................... 18

insanity of dependent ....................................................................................... 8-41-503(3)....................................................................................... 18

interest charged on ........................................................................................... 8-43-410(2)....................................................................................... 54

levy, exempt from ............................................................................................ 8-42-124(1)....................................................................................... 33

lien for ............................................................................................................. 8-43-410(1)....................................................................................... 54

limit ................................................................................................................. 8-42-107.5 ........................................................................................ 30

lump sums ........................................................................................................ 8-43-406(1)....................................................................................... 51

garnishment or administrative lien ............................................................... 8-43-204(4)....................................................................................... 38

medical, surgical, hospital................................................................................ 8-42-101(1)(a) .................................................................................. 18

after MMI .................................................................................................... 8-42-107(8)(f) ................................................................................... 28

nonmedical treatment ................................................................................... 8-43-404(1)....................................................................................... 48

physician or surgeon examine ...................................................................... 8-43-404(1)....................................................................................... 48

willful delay of payment .............................................................................. 8-43-401(2)(a) .................................................................................. 47

mental .............................................................................................................. 8-41-301(2)....................................................................................... 13

non-assignable ................................................................................................. 8-42-124(1)....................................................................................... 33

notice of injury-time limit ................................................................................ 8-43-103(1)....................................................................................... 35

offset, social security & pension plan .............................................................. 8-42-103(1)(c)(I), (d)(I) .................................................................... 22

offset for fraud ................................................................................................. 8-43-304(2)....................................................................................... 45

Find what you were looking for?

overpayment, recovery of ................................................................................ 8-42-113.5(1) .................................................................................... 31

payment after appeals ...................................................................................... 8-43-401(2)(a) .................................................................................. 47

permanent partial disability (also see DISABILITY) ..................................... 8-42-107(1)(a) .................................................................................. 25

compensation rate modified ......................................................................... 8-42-107(6)(b) .................................................................................. 26

limits on combined temporary and permanent partial payments .................. 8-42-107.5 ........................................................................................ 30

nonscheduled injuries (medical impairment benefits) .................................. 8-42-107(8) ....................................................................................... 26

scheduled injuries......................................................................................... 8-42-107(2) ....................................................................................... 25

wage assignment .......................................................................................... 8-42-124(6) ....................................................................................... 34

permanent total disability ................................................................................. 8-42-111(1) ....................................................................................... 30

award ceases ................................................................................................ 8-43-303(1) ....................................................................................... 44

calculation of premium ................................................................................ 8-46-105(1) ....................................................................................... 75

capable of rehabilitation ............................................................................... 8-42-111(3) ....................................................................................... 30

increases in compensation ............................................................................ 8-42-111(4) ....................................................................................... 31

paid for life................................................................................................... 8-42-111(1) ....................................................................................... 30

reopening ..................................................................................................... 8-43-303(3) ....................................................................................... 44

refusal of work or voc rehab ........................................................................ 8-42-111(3) ....................................................................................... 30

power of attorney to collect, void .................................................................... 8-42-124(2) ....................................................................................... 33

previous disability or impairment .................................................................... 8-42-104(1) ....................................................................................... 23

prisoner repay if ineligible ............................................................................... 8-42-113(1.5)(b) ............................................................................... 31

rate (later injury) .............................................................................................. 8-42-104(1) ....................................................................................... 23

reduction

calculation .................................................................................................... 8-42-112(2)

....................................................................................... 30

controlled substance ..................................................................................... 8-42-112.5(1) .................................................................................... 31

intoxication .................................................................................................. 8-42-112.5(1) .................................................................................... 31

misleads employer ....................................................................................... 8-42-112(1)(d) .................................................................................. 30

non-use of safety device ............................................................................... 8-42-112(1)(a) .................................................................................. 30

safety rule violation ...................................................................................... 8-42-112(1)(b) .................................................................................. 30

statutory offsets ............................................................................................ 8-42-103(1)(c), (d), (e), (f) ......................................................... 22, 23

unemployment benefits ................................................................................ 8-42-103(1)(f) ................................................................................... 23

release .............................................................................................................. 8-42-124(1) ....................................................................................... 33

retirement benefits ........................................................................................... 8-42-103(1)(c)(II) ............................................................................. 22

settlement ......................................................................................................... 8-43-204(1) ....................................................................................... 38

garnishment or administrative lien ............................................................... 8-43-204(4) ....................................................................................... 38

social security .................................................................................................. 8-42-103(1)(c)(I) .............................................................................. 22

specific injuries ................................................................................................ 8-42-107(1)(a) .................................................................................. 25

additional compensation for additional injuries ........................................... 8-42-109 ........................................................................................... 30

amputation between joints ........................................................................... 8-42-107(5) ....................................................................................... 26

dental treatment ............................................................................................ 8-42-101(1)(a), (b) ............................................................................ 18

disfigurement ............................................................................................... 8-42-108(1) ....................................................................................... 30

paralysis ....................................................................................................... 8-42-107(4) ....................................................................................... 26

permanent partial, in lieu of ......................................................................... 8-42-107(8) ....................................................................................... 26

remain on schedule ...................................................................................... 8-42-107(7)(b) .................................................................................. 26

total loss of body part ................................................................................... 8-42-107(8)(c.5) ............................................................................... 28

two losses, added ......................................................................................... 8-42-107(7) ....................................................................................... 26

weekly amounts, limits ................................................................................ 8-42-107(6) ....................................................................................... 26

suspension for failure to apply for benefits ...................................................... 8-42-103(1)(d)(II) ............................................................................. 22

teeth, injury to, dental benefits ......................................................................... 8-42-101(1)(a), (b) ............................................................................ 18

temporary ......................................................................................................... 8-42-105(1), 8-42-106(1) ............................................................ 24, 25

temporary partial disability .............................................................................. 8-42-106(1) ....................................................................................... 25

ceases ........................................................................................................... 8-42-106(2) ....................................................................................... 25

temporary total disability ................................................................................. 8-42-105(1) ....................................................................................... 24

additional ..................................................................................................... 8-42-109 ........................................................................................... 30

ceases ........................................................................................................... 8-42-105(1) ....................................................................................... 24

limit .............................................................................................................. 8-42-107.5 ........................................................................................ 30

suspended, fail to appear at rescheduled appointment ................................. 8-42-105(2)(c) .................................................................................. 24

termination, when permitted ........................................................................ 8-42-105(3) ....................................................................................... 24

termination for refusal to accept modified employment--exceptions ........... 8-42-105(4)(b) & (c) ................................................................... 24, 25

time limits ........................................................................................................ 8-43-103(1) ....................................................................................... 35

after appeals ................................................................................................. 8-43-401(2)(a) .................................................................................. 47

disability indemnity ..................................................................................... 8-42-105(1) ....................................................................................... 24

disability periods

commencement of .................................................................................... 8-42-103(1)

....................................................................................... 22

new disability ........................................................................................... 8-41-206 ........................................................................................... 12

Find what you were looking for?

schedule of specific .................................................................................. 8-42-107(1)(a) .................................................................................. 25

time of payment ............................................................................................... 8-42-105(2)(a) .................................................................................. 24

trust fund for payments .................................................................................... 8-47-105(1)....................................................................................... 78

unaccrued, at death .......................................................................................... 8-42-116(1), 8-42-117 ...................................................................... 32

unemployment ................................................................................................. 8-42-103(1)(f) ................................................................................... 23

unpaid, deposit required, when ........................................................................ 8-47-105(1)....................................................................................... 78

verification of inability to work ....................................................................... 8-42-105(2)(b) .................................................................................. 24

wages, basis of ................................................................................................. 8-42-102(1)....................................................................................... 21

waiting period .................................................................................................. 8-42-103(1)(b) .................................................................................. 22

BOARD AND LODGING ................................................................................. 8-40-201(19)(b) .................................................................................. 4

BOND, non-insured ............................................................................................. 8-43-408(2)....................................................................................... 52

BOOKS, right to examine ................................................................................... 8-44-107, 8-47-208 ..................................................................... 59, 80

BRIEFS ............................................................................................................... 8-43-301(4)....................................................................................... 43

BROCHURE describing claims process/rights. ................................................. 8-43-203(3)....................................................................................... 37

BURDEN OF PROOF

cured violation ............................................................................................. 8-43-304(4)

....................................................................................... 45

Division independent medical examination

impairment rating ..................................................................................... 8-42-107(8)(c), 8-46-105(1)

....................................................... 27, 75

maximum medical improvement.............................................................. 8-42-107(8)(b), (b.5) .................................................................. 26, 27

employer/employee relationship .................................................................. 8-40-202(2)(b)(V)(d) .......................................................................... 7

finding of utilization review committee ....................................................... 8-43-501(5)....................................................................................... 55

generally ...................................................................................................... 8-43-201(1)....................................................................................... 36

injury due to intoxication ............................................................................. 8-42-112.5(1).................................................................................... 31

permanent total disability ............................................................................. 8-40-201(16.5)(a) ............................................................................... 4

preponderance of evidence .......................................................................... 8-40-202(2)(b) .................................................................................... 6

conditions of independent trade ........................................................... 8-40-202(2)(b) .................................................................................... 6

credit for reduced disability ................................................................. 8-46-307(1)....................................................................................... 77

entitlement to benefits .......................................................................... 8-43-201(1)....................................................................................... 36

final disposition of utilization review. .................................................. 8-43-501(2)....................................................................................... 54

BURIAL EXPENSES ........................................................................................ 8-42-123 ........................................................................................... 33

CALCULATIONS

average weekly wage ....................................................................................... 8-42-102(2)

....................................................................................... 21

death benefits ................................................................................................... 8-42-114 ........................................................................................... 32

permanent total ................................................................................................ 8-42-111(1)....................................................................................... 30

safety rule ........................................................................................................ 8-42-112(1)....................................................................................... 30

reductions combined .................................................................................... 8-42-112(2)....................................................................................... 30

scheduled impairment rate ............................................................................... 8-42-107(6)....................................................................................... 26

temporary total disability ................................................................................. 8-42-105(1)....................................................................................... 24

temporary partial disability .............................................................................. 8-42-106(1)....................................................................................... 25

whole person impairment ................................................................................. 8-42-107(8)(d) .................................................................................. 28

CAP ON BENEFITS ......................................................................................... 8-42-107.5 ........................................................................................ 30

CARRIERS, common by railroad ...................................................................... 8-41-201 ........................................................................................... 10

CASE MANAGEMENT.................................................................................... 8-42-101(3.6)(p)(I)(A)...................................................................... 20

CASUAL LABOR .............................................................................................. 8-40-302(3), (4) .................................................................................. 8

CEASE AND DESIST ....................................................................................... 8-43-409(1) thru (4) .......................................................................... 52

prima facie ....................................................................................................... 8-43-409(3)....................................................................................... 53

CERTIORARI ................................................................................................... 8-43-313 ........................................................................................... 46

CHANGE OF CONDITION ............................................................................. 8-43-303(1)....................................................................................... 44

CHANGE OF PHYSICIAN (see PHYSICIANS)

CHILDREN

dependent ......................................................................................................... 8-41-501(1)(b), (c)............................................................................ 17

illegitimate ....................................................................................................... 8-41-505 ........................................................................................... 18

CHILD SUPPORT............................................................................................. 8-42-124(1), (6), 8-43-204(4) ............................................... 33, 34, 38

CHIROPRACTORS

accreditation ..................................................................................................... 8-42-101(3.6)(a)(I)

........................................................................... 19

treatment limits ................................................................................................ 8-42-101(3)(a)(III)............................................................................ 19

CLAIMANT

defined ............................................................................................................. 8-40-201(3.6)...................................................................................... 3

reimbursement of medical expenses ................................................................ 8-42-101(6)....................................................................................... 21

CLAIM FILE ..................................................................................................... 8-43-203(4)....................................................................................... 38

CLAIMS MANAGEMENT

application for hearing, rejection of ................................................................. 8-43-218(4)....................................................................................... 42

director to appoint managers ............................................................................ 8-43-218(1)....................................................................................... 42

legislative declaration ...................................................................................... 8-43-217 ........................................................................................... 42

penalty for failure to cooperate with ................................................................ 8-43-218(3)....................................................................................... 42

Find what you were looking for?

rejection of ....................................................................................................... 8-43-218(4) ....................................................................................... 42

response to application for hearing, rejection of .............................................. 8-43-218(4) ....................................................................................... 42

CLASSIFICATION

appeals board ................................................................................................... 8-55-101(1)

....................................................................................... 81

premiums ......................................................................................................... 8-44-103 ........................................................................................... 59

risks ................................................................................................................. 8-44-103, 8-45-105(1) ................................................................ 59, 68

CLEAR AND CONVINCING EVIDENCE

cured violation ................................................................................................. 8-43-304(4)

....................................................................................... 45

Division independent medical examination

impairment rating ......................................................................................... 8-42-107(8)(c), 8-46-105(1)

....................................................... 27, 75

maximum medical improvement .................................................................. 8-42-107(8)(b), (b.5)................................................................... 26, 27

twenty-four months ...................................................................................... 8-42-107(8)(b)(III) ........................................................................... 27

finding of utilization review committee ........................................................... 8-43-501(5) ....................................................................................... 55

injury due to intoxication ................................................................................. 8-42-112.5(1) .................................................................................... 31

CLOSING CASES ............................................................................................. 8-43-203(2) ....................................................................................... 37

COBRA, fringe benefits………………………………………………………… 8-40-201(19)(b) .................................................................................. 4

average weekly wage recalculation .................................................................. 8-42-103(2) ....................................................................................... 23

COMMON CARRIERS

by railroad ........................................................................................................ 8-41-201 ........................................................................................... 10

coverage offered .............................................................................................. 8-40-301(6) ......................................................................................... 8

employee excludes ........................................................................................... 8-40-301(5) ......................................................................................... 8

intrastate ........................................................................................................... 8-41-201 ........................................................................................... 10

interstate ........................................................................................................... 8-41-201 ........................................................................................... 10

statutory employment exclusion ...................................................................... 8-41-401(7) ....................................................................................... 16

COMMON LAW DEFENSES .......................................................................... 8-41-103 ............................................................................................. 9

COMPENSATION RATE

minor .............................................................................................................. 8-40-202(1)(a)(III) .............................................................................. 5

student ............................................................................................................ 8-40-202(1)(a)(III), 8-40-202(1)(a)(VI)....................................... 5, 5-6

volunteer .......................................................................................................... 8-40-202(1)(a)(II) ............................................................................... 5

COMPETENCY OF WITNESSES AND PARTIES

TO SETTLEMENT ....................................................................................... 8-43-207(1)(m) ................................................................................. 40

CONDITIONS OF RECOVERY, MENTAL IMPAIRMENT....................... 8-41-301(2) ....................................................................................... 13

CONSTRUCTION WORK

applicability ..................................................................................................... 8-41-404(1), (4) ................................................................................ 16

definitions as used in section ........................................................................... 8-41-404(5) ....................................................................................... 17

proof of coverage required ............................................................................... 8-41-404(1) ....................................................................................... 16

violations.......................................................................................................... 8-41-404(3) ....................................................................................... 16

CONTEMPT ...................................................................................................... 8-47-102 ........................................................................................... 78

CONTEST

expedited hearing ............................................................................................. 8-42-105(2)(a), 8-43-203(1) ....................................................... 24, 36

notice of ........................................................................................................... 8-43-203(1) ....................................................................................... 36

CONTRACT, capacity ....................................................................................... 8-40-202(1)(a)(VI)(b) ......................................................................... 6

CONTRACTORS AND LESSEES ................................................................... 8-41-401(1)(a)(I) thru 403 ........................................................... 14-16

agricultural ....................................................................................................... 8-41-403(3) ....................................................................................... 16

exemption ........................................................................................................ 8-41-401 thru 403 ........................................................................ 14-16

for-hire transportation ...................................................................................... 8-41-401(6) ....................................................................................... 16

owner insure, in default of real estate .............................................................. 8-41-401, 401(5), 402 ........................................................... 14, 15, 16

right against defaulting contractor/lessee ......................................................... 8-41-401 thru 403 ........................................................................ 14-16

subcontractors and sublessees .......................................................................... 8-41-401, 8-41-402 ..................................................................... 14, 16

CONTRACTOR, insurer may examine books of ............................................... 8-44-107 ........................................................................................... 59

CONTROLLED SUBSTANCES ...................................................................... 8-42-112.5(1) .................................................................................... 31

CORPORATE OFFICERS ............................................................................... 8-41-202(1) ....................................................................................... 10

COST CONTAINMENT, premium ................................................................... 8-14.5-101 thru 109 ......................................................................... 1-2

board ................................................................................................................ 8-14.5-104 .......................................................................................... 1

certification ...................................................................................................... 8-14.5-107 .......................................................................................... 2

defined ............................................................................................................. 8-14.5-103 .......................................................................................... 1

director duties .................................................................................................. 8-14.5-106 .......................................................................................... 1

surcharge on premiums .................................................................................... 8-44-112(1)(b) .................................................................................. 61

COST OF LIVING, increase on permanent total ............................................... 8-42-111(4) ....................................................................................... 31

COSTS, court ...................................................................................................... 8-43-314 ........................................................................................... 46

transcripts, fees for ........................................................................................... 8-43-213(3) ....................................................................................... 42

witnesses .......................................................................................................... 8-43-315(1) ....................................................................................... 46

COURSE OF EMPLOYMENT ........................................................................ 8-41-301(1)(b), (c) ............................................................................ 13

COURT OF APPEALS, review of Industrial Claim Appeals

Panel decision .................................................................................................. 8-43-301(10) ..................................................................................... 43

CO-WORKER, negligence of ............................................................................ 8-41-101(1)(b) .................................................................................... 9

CRIME OF VIOLENCE, mental impairment ................................................... 8-41-301(2)(b) ............................................................................. 13-14

Find what you were looking for?

VII

CURE, penalties .................................................................................................. 8-43-304(4)....................................................................................... 45

CUSTODIAN, bond of ....................................................................................... 8-45-119(1)....................................................................................... 70

DAMAGES, if otherwise compensable .............................................................. 8-41-401(3)

....................................................................................... 15

DATA GATHERING ........................................................................................ 8-42-125 ........................................................................................... 34

DEATH, accrued benefits-disposition ................................................................ 8-41-503(1), 8-42-115(1)(a) ....................................................... 17, 32

after two years, presumption ............................................................................ 8-41-207 ........................................................................................... 12

DEATH BENEFITS .......................................................................................... 8-41-501(1) thru 505, 8-42-114 thru 123.......................... 17-18, 32-33

apportionment .................................................................................................. 8-42-121 ........................................................................................... 33

burial expenses................................................................................................. 8-42-123 ........................................................................................... 33

claims for, not assignable ................................................................................. 8-42-124(1)....................................................................................... 33

death after two years ........................................................................................ 8-41-207 ........................................................................................... 12

death not proximate result ............................................................................... 8-42-116(1)....................................................................................... 32

permanent partial ......................................................................................... 8-42-116(1)(b), 8-42-117(1)(b) ........................................................ 32

permanent total ............................................................................................ 8-42-116(1)(a), 8-42-117(1)(a) ......................................................... 32

death a proximate result ................................................................................... 8-42-115(1)....................................................................................... 32

no dependents .............................................................................................. 8-42-115(1)(a), 8-46-102(1)(a) ................................................... 32, 72

partial dependents ........................................................................................ 8-42-115(1)(c), 8-42-119, 8-46-102(1)(a), (b) ............................ 32, 72

whole dependents ......................................................................................... 8-42-114 thru 123, 8-42-115(1)(b) ........................................ 32-33, 32

dependents (see DEPENDENTS)

exemption of .................................................................................................... 8-42-124(1)

....................................................................................... 33

funeral benefits ................................................................................................ 8-42-123 ........................................................................................... 33

lien on assets of employer and insurer ............................................................. 8-43-410(1)....................................................................................... 54

lump sum payment ........................................................................................... 8-43-406(1)....................................................................................... 51

maximum, minimum ........................................................................................ 8-42-114 ........................................................................................... 32

minor, deceased ............................................................................................... 8-46-102(1)(b) .................................................................................. 72

notice of ........................................................................................................... 8-43-103(1)....................................................................................... 35

time limit...................................................................................................... 8-43-103(1)....................................................................................... 35

overpayment, recovery of ................................................................................ 8-42-113.5(1).................................................................................... 31

payment of

conflicting claims ......................................................................................... 8-43-405

........................................................................................... 51

discharge of liability .................................................................................... 8-43-405 ........................................................................................... 51

minor dependents ......................................................................................... 8-42-122 ........................................................................................... 33

parents .......................................................................................................... 8-46-102(1)(b) .................................................................................. 72

period of time ................................................................................................... 8-42-114 ........................................................................................... 31

remarriage ........................................................................................................ 8-42-120 ........................................................................................... 32

survival of shares to other dependents ............................................................. 8-42-120 ........................................................................................... 32

termination of rights ........................................................................................ 8-42-120 ........................................................................................... 32

minor ............................................................................................................ 8-42-120 ........................................................................................... 32

weekly amount ................................................................................................. 8-42-114 ........................................................................................... 32

DEATHS, reported.............................................................................................. 8-43-103(1)....................................................................................... 35

DEFENSES ........................................................................................................ 8-41-101(1)......................................................................................... 9

abrogated ......................................................................................................... 8-41-101(1)......................................................................................... 9

assumption of risk ............................................................................................ 8-41-101(1)......................................................................................... 9

DEFINITIONS

accident ............................................................................................................ 8-40-201(1)......................................................................................... 3

case management ............................................................................................. 8-42-101(3.6)(p)(I)(A)...................................................................... 20

claimant ........................................................................................................... 8-40-201(3.6)...................................................................................... 3

corporate officer............................................................................................... 8-41-202(4)(a) .................................................................................. 10

cost containment .............................................................................................. 8-14.5-103 .......................................................................................... 1

director ............................................................................................................. 8-40-201(5)......................................................................................... 3

disease.............................................................................................................. 8-40-201(14), 8-41-302(1) ........................................................... 3, 14

employee .......................................................................................................... 8-40-201(6), 8-40-202, 8-40-301(1) ........................................... 3, 4, 7

employer

charitable, fraternal, religious ...................................................................... 8-40-302(2)

......................................................................................... 8

city ............................................................................................................... 8-40-203(1)(a) .................................................................................... 7

corporation ................................................................................................... 8-40-203(1)(b) .................................................................................... 7

county .......................................................................................................... 8-40-203(1)(a) .................................................................................... 7

drainage district ........................................................................................... 8-40-203(1)(a) .................................................................................... 7

farms and ranches ........................................................................................ 8-40-302(3)......................................................................................... 8

irrigation district .......................................................................................... 8-40-203(1)(a) .................................................................................... 7

private person............................................................................................... 8-40-203(1)(b) .................................................................................... 7

public institutions ......................................................................................... 8-40-203(1)(a) .................................................................................... 7

Find what you were looking for?

VIII

school district ............................................................................................... 8-40-203(1)(a) .................................................................................... 7

state .............................................................................................................. 8-40-203(1)(a) .................................................................................... 7

town ............................................................................................................. 8-40-203(1)(a) .................................................................................... 7

employment ..................................................................................................... 8-40-201(8) ......................................................................................... 3

for accreditation program ................................................................................. 8-42-101(3.5)(a)(I)(A) ...................................................................... 19

heart attack ....................................................................................................... 8-41-302(2) ....................................................................................... 14

independent contractor ..................................................................................... 8-41-401(3) ....................................................................................... 15

Industrial Claim Appeals Panel ........................................................................ 8-40-201(16) ....................................................................................... 4

injury ................................................................................................................ 8-40-201(2), 8-41-302(1) .............................................................. 3, 14

limited liability company member ................................................................... 8-41-202(4)(b) .................................................................................. 10

managed care ................................................................................................... 8-42-101(3.6)(p)(I)(B) ...................................................................... 20

maximum medical improvement (MMI) .......................................................... 8-40-201(11.5) .................................................................................... 3

mediation ......................................................................................................... 8-40-201(12) ....................................................................................... 3

medical records for utilization review .............................................................. 8-43-501(2)(d) .................................................................................. 54

medical treatment guidelines............................................................................ 8-42-101(3)(b) .................................................................................. 19

mental impairment ........................................................................................... 8-41-301(2) thru (3) .......................................................................... 13

non-medical benefits ........................................................................................ 8-42-112.5(2) .................................................................................... 31

occupational disease......................................................................................... 8-40-201(14), 8-41-302(2) ............................................................ 3, 14

order ................................................................................................................. 8-40-201(15) ....................................................................................... 4

overpayment .................................................................................................... 8-40-201(15.5) .................................................................................... 4

per diem ........................................................................................................... 8-40-201(19)(c) .................................................................................. 4

permanent total disability ................................................................................. 8-40-201(16.5) .................................................................................... 4

physician .......................................................................................................... 8-42-101(3.5)(a)(I)(A) ...................................................................... 19

place of employment ........................................................................................ 8-40-201(17) ....................................................................................... 4

psychologically traumatic event ....................................................................... 8-41-301(3) ....................................................................................... 14

serious bodily injury ........................................................................................ 8-41-301(3) ....................................................................................... 14

statutory employer ........................................................................................... 8-41-401(1)(a)(III) ............................................................................ 15

temporary help contracting firm ....................................................................... 8-40-201(18.5) .................................................................................... 4

wages ............................................................................................................... 8-40-201(19) ....................................................................................... 4

DENTIST ............................................................................................................ 8-42-101(3.5)(a)(I) ........................................................................... 19

DEPENDENCY

adopted children ............................................................................................... 8-41-501(1)(b)

.................................................................................. 17

determined as of date of accident ..................................................................... 8-41-503(1) ....................................................................................... 17

illegitimate children ......................................................................................... 8-41-505 ........................................................................................... 18

posthumous children ........................................................................................ 8-41-501(1)(b) .................................................................................. 17

DEPENDENTS

actual ................................................................................................................ 8-41-502 ........................................................................................... 17

brother .............................................................................................................. 8-41-502 ........................................................................................... 17

children ............................................................................................................ 8-41-501(1)(b), (c) ............................................................................ 17

adopted ......................................................................................................... 8-41-501(1)(b), (c) ............................................................................ 17

guardian ad litem.......................................................................................... 8-43-207(1)(l) ................................................................................... 40

illegitimate ................................................................................................... 8-41-505 ........................................................................................... 18

minor, safeguarding payments ..................................................................... 8-42-122 ........................................................................................... 33

posthumous .................................................................................................. 8-41-501(1)(b) .................................................................................. 17

designated beneficiary ..................................................................................... 8-41-501(1)(a.5) ............................................................................... 17

compensation, rate and amount ........................................................................ 8-42-114, 8-42-115(1) ...................................................................... 32

determination of ............................................................................................... 8-41-503(1) ....................................................................................... 17

father ................................................................................................................ 8-41-502 ........................................................................................... 17

grandfather ....................................................................................................... 8-41-502 ........................................................................................... 17

grandmother ..................................................................................................... 8-41-502 ........................................................................................... 17

lump sum maximum ........................................................................................ 8-43-406(2) ....................................................................................... 52

minors .............................................................................................................. 8-41-501(1)(b), (c), 8-42-122 ..................................................... 17, 33

mother .............................................................................................................. 8-41-502 ........................................................................................... 17

none ................................................................................................................. 8-46-102(1)(b) .................................................................................. 72

partial ............................................................................................................... 8-42-119 ........................................................................................... 32

death not proximate result ............................................................................ 8-42-117 ........................................................................................... 32

parties of interest .............................................................................................. 8-41-504 ........................................................................................... 18

presumed .......................................................................................................... 8-41-501(1) ....................................................................................... 17

sister ................................................................................................................. 8-41-502 ........................................................................................... 17

student under 21 ............................................................................................... 8-41-501(1)(c) .................................................................................. 17

subrogation ...................................................................................................... 8-41-203(3) ....................................................................................... 11

termination ....................................................................................................... 8-42-120 ........................................................................................... 32

wholly dependent compensation ...................................................................... 8-41-501(1) ....................................................................................... 17

DEPOSITIONS .................................................................................................. 8-43-207.5(2), 8-43-210 ............................................................. 40, 41

for testimony .................................................................................................... 8-43-210 ........................................................................................... 41

Find what you were looking for?

DIRECTOR, DIVISION OF WORKERS’ COMPENSATION

adopt rules........................................................................................................ 8-47-107 ........................................................................................... 78

allow expenses ................................................................................................. 8-47-209 ........................................................................................... 80

appoint utilization review committees ............................................................. 8-43-501(3)(a) .................................................................................. 54

approve medical plan ....................................................................................... 8-42-101(2)....................................................................................... 18

approve settlements ......................................................................................... 8-43-204(3)....................................................................................... 38

approve salaries ............................................................................................... 8-47-205 ........................................................................................... 80

attorney fees allowed by .................................................................................. 8-43-403(1)....................................................................................... 48

collect statistics ................................................................................................ 8-47-207 ........................................................................................... 80

compel attendance ........................................................................................... 8-43-315(1)....................................................................................... 46

cost containment duties .................................................................................... 8-14.5-106(1)...................................................................................... 1

defined ............................................................................................................. 8-40-201(5)......................................................................................... 3

determine and apportion benefits ..................................................................... 8-42-121 ........................................................................................... 33

district attorney to appear for appeal ................................................................ 8-43-314 ........................................................................................... 46

employer shall furnish information to .............................................................. 8-47-201 ........................................................................................... 79

enforce act........................................................................................................ 8-47-101(1)....................................................................................... 77

enforcement of orders ...................................................................................... 8-43-401(1), 8-47-102 ................................................................ 47, 78

enter place of employment ............................................................................... 8-47-207 ........................................................................................... 80

establish time schedule for hearings ................................................................ 8-43-209(1)....................................................................................... 41

examine provisions for health and safety ......................................................... 8-47-207 ........................................................................................... 80

excess fee approval .......................................................................................... 8-42-101(3)(a)(I) .............................................................................. 19

hearings (see HEARINGS)

impose fine, failure to insure ........................................................................... 8-43-409(1)(b)

.................................................................................. 53

inspect records of employer ............................................................................. 8-47-208 ........................................................................................... 80

investigations by .............................................................................................. 8-43-208(1)....................................................................................... 41

orders of, enforcement ..................................................................................... 8-47-102 ........................................................................................... 78

application to district court .......................................................................... 8-47-102 ........................................................................................... 78

commitment to jail ....................................................................................... 8-47-102 ........................................................................................... 78

matters pending before the director .............................................................. 8-47-107 ........................................................................................... 78

prima facie valid .......................................................................................... 8-47-103 ........................................................................................... 78

public officers to enforce ............................................................................. 8-47-103 ........................................................................................... 78

substantial compliance with Act .................................................................. 8-47-104 ........................................................................................... 78

technical objections...................................................................................... 8-47-104 ........................................................................................... 78

state average weekly wage ............................................................................... 8-47-106 ........................................................................................... 78

validity of orders .............................................................................................. 8-47-103 ........................................................................................... 78

DISABILITY (see BENEFITS AND COMPENSATION)

claim for, time limit ......................................................................................... 8-43-103(1)

....................................................................................... 35

injuries, multiple .............................................................................................. 8-42-109, 8-46-101(1)(a) ............................................................ 30, 72

paralysis ........................................................................................................... 8-42-107(4)....................................................................................... 26

permanent partial ............................................................................................. 8-42-107(1)(a) .................................................................................. 25

scheduled injuries ........................................................................................ 8-42-107(2)....................................................................................... 25

whole person injuries (medical impairment) ................................................ 8-42-107(8)....................................................................................... 26

presumption, after 5 years ................................................................................ 8-41-206 ........................................................................................... 12

permanent total, defined, award ....................................................................... 8-40-201(16.5), 8-42-111(1)......................................................... 4, 30

previous ........................................................................................................... 8-42-104(1)....................................................................................... 23

subsequent injury ............................................................................................. 8-46-101(1)(a) .................................................................................. 72

temporary disability ......................................................................................... 8-42-105(1), 8-42-106(1) ........................................................... 24, 25

termination of............................................................................................... 8-42-105(3), 8-42-106(2), 8-42-107(3) ................................ 24, 25, 26

total, permanent ............................................................................................... 8-42-111(1)....................................................................................... 30

what constitutes

disfigurement ............................................................................................... 8-42-108(1)

....................................................................................... 30

permanent total award .................................................................................. 8-42-111(1)....................................................................................... 30

specific ......................................................................................................... 8-42-107(1)(a) .................................................................................. 25

subsequent injury ......................................................................................... 8-46-101(1)(a) .................................................................................. 72

temporary partial .......................................................................................... 8-42-106(1)....................................................................................... 25

temporary total ............................................................................................. 8-42-105(1)....................................................................................... 24

DISABILITY INSURANCE

offset ................................................................................................................ 8-42-103(1)(d)

.................................................................................. 22

notice to insurer ............................................................................................... 8-42-113.5(1).................................................................................... 31

DISCIPLINARY ACTION, mental condition................................................... 8-41-301(2).................................................................................. 13-14

DISCOVERY ..................................................................................................... 8-43-207(1)(e) .................................................................................. 40

DISEASE, defined .............................................................................................. 8-40-201(14)....................................................................................... 3

last employer .................................................................................................... 8-41-304(1)....................................................................................... 14

last exposure .................................................................................................... 8-41-304(1)....................................................................................... 14

Find what you were looking for?

DISFIGUREMENT ........................................................................................... 8-42-108(1) ....................................................................................... 30

DISTRICT ATTORNEY, act for director or

Industrial Claim Appeals Panel. ....................................................................... 8-43-401(1)

....................................................................................... 47

DIVISION IME (see INDEPENDENT MEDICAL EXAMINATION) ......... 8-42-107.2(1) .................................................................................... 28

DIVISION OF WORKERS’ COMPENSATION (see DIRECTOR)

creation ............................................................................................................ 8-47-101(1)

, 24-1-121(3)(d) ............................................................. 77

defined ............................................................................................................. 8-40-201(4) ......................................................................................... 3

disputes submitted to........................................................................................ 8-43-201(1) ....................................................................................... 36

duties ................................................................................................................ 8-47-101(1) ....................................................................................... 77

employees of

bonds ............................................................................................................ 8-47-206

........................................................................................... 80

how appointed .............................................................................................. 8-47-204 ........................................................................................... 80

qualifications ................................................................................................ 8-47-204 ........................................................................................... 80

salaries ......................................................................................................... 8-47-205 ........................................................................................... 80

employer shall furnish information .................................................................. 8-47-202 ........................................................................................... 79

employer to file admission or denial ................................................................ 8-43-203(1) ....................................................................................... 36

expenses of ....................................................................................................... 8-47-209 ........................................................................................... 80

files, access to .................................................................................................. 8-42-125, 8-47-203(1) ................................................................ 34, 79

gifts, grants and donations ............................................................................... 8-42-101(3.6)(q) ............................................................................... 20

insurer to file admission or denial .................................................................... 8-43-203(1) ....................................................................................... 36

retain original claim records ............................................................................ 8-43-203(2)(c) .................................................................................. 37

verify insurance compliance ............................................................................ 8-47-111 ........................................................................................... 79

website, to file a complaint .............................................................................. 8-47-112 ........................................................................................... 79

DOMESTIC EMPLOYEES .............................................................................. 8-40-302(4) ......................................................................................... 8

EARNINGS (see WAGES)

ELECTED OFFICIALS .................................................................................... 8-40-202(1)(a)(I)(A)

........................................................................... 4

ELECTION OF REMEDIES ............................................................................ 8-41-203(1)(a) .................................................................................. 10

ELECTION TO ACCEPT COMPENSATION ............................................... 8-41-104 ............................................................................................. 9

EMOTIONAL STRESS .................................................................................... 8-41-301(2) ....................................................................................... 13

impairment not combined ................................................................................ 8-42-107(7)(b) .................................................................................. 26

EMPLOYEE (see EMPLOYER)

acceptance of Act, surrender of other remedies ............................................... 8-41-104

............................................................................................. 9

action by, dependents not parties in interest ..................................................... 8-41-504 ........................................................................................... 18

alien ................................................................................................................. 8-40-202(1)(b) .................................................................................... 6

casual ............................................................................................................... 8-40-202(1)(b) .................................................................................... 6

compensation of, where employer not insured ................................................. 8-43-408(1) ....................................................................................... 52

contractor ......................................................................................................... 8-41-401(1), (2) .......................................................................... 14, 15

deductions ........................................................................................................ 8-42-124(7) ....................................................................................... 34

defined ............................................................................................................. 8-40-201(6), 8-40-202(1), 8-40-301(1) ....................................... 3, 4, 7

domestic employee........................................................................................... 8-40-302(4) ......................................................................................... 8

driver, under P.U.C. lease agreement ............................................................... 8-40-301(5) ......................................................................................... 8

elected or appointed official ............................................................................. 8-40-202(1)(a)(I)(B) ........................................................................ 4-5

farm labor ......................................................................................................... 8-40-302(3) ......................................................................................... 8

horse track........................................................................................................ 8-40-301(8) ......................................................................................... 8

host home services ........................................................................................... 8-40-301(7) ......................................................................................... 8

incompetent ...................................................................................................... 8-41-503(3) ....................................................................................... 18

independent truck driver .................................................................................. 8-41-401(6) ....................................................................................... 16

injured, submit to examination ......................................................................... 8-43-404(1)(a) .................................................................................. 48

injuries by third party, election ........................................................................ 8-41-203(1)(a) .................................................................................. 10

inmate exception .............................................................................................. 8-40-301(3)(a) .................................................................................... 7

interstate common carrier................................................................................. 8-41-201 ........................................................................................... 10

lessee ................................................................................................................ 8-41-401, 8-41-403(1) ................................................................ 14, 16

loaned by employer .......................................................................................... 8-40-202(1)(a)(III-IV), 8-41-303 .................................................. 4, 14

minors .............................................................................................................. 8-40-202(1)(b) .................................................................................... 6

nonprofit youth sports organization ................................................................. 8-40-202(2)(e)(I) ................................................................................ 7

participation in recreational activity ................................................................. 8-40-201(8) ......................................................................................... 3

payment of insurance ....................................................................................... 8-44-101(2) ....................................................................................... 58

property tax work-off program......................................................................... 8-40-202(3), 8-40-301(9), 8-41-210 ......................................... 7, 8, 12

race meet .......................................................................................................... 8-40-301(8) ......................................................................................... 8

railroad ............................................................................................................. 8-41-201 ........................................................................................... 10

real estate, agent or broker ............................................................................... 8-40-301(2) ......................................................................................... 7

report injury ..................................................................................................... 8-43-102(1)(a) .................................................................................. 34

ski area volunteers............................................................................................ 8-40-301(4) ......................................................................................... 8

volunteers ......................................................................................................... 8-40-202(1)(a)(I)(A) ........................................................................... 4

EMPLOYEES OF DIVISION OF WORKERS’ COMPENSATION ........... 8-47-204 ........................................................................................... 80

Find what you were looking for?

bonds................................................................................................................ 8-47-206 ........................................................................................... 80

salaries ............................................................................................................. 8-47-205 ........................................................................................... 80

EMPLOYER (see EMPLOYEE)

agricultural corporation officers....................................................................... 8-40-302(6)......................................................................................... 8

books and records, insurer may examine ......................................................... 8-44-107 ........................................................................................... 59

buyer of goods excluded .................................................................................. 8-41-401(1)(a)(II) ............................................................................. 15

charitable/fraternal/religious ............................................................................ 8-40-302(2)......................................................................................... 8

contractor ......................................................................................................... 8-41-401(1)(a)(II), 8-41-402(1) .................................................. 15, 16

defined ............................................................................................................. 8-40-201(7), 8-40-203(1) ................................................................ 3,7

display of notice ............................................................................................... 8-43-102(1)(b), (1.5) .................................................................. 34, 35

domestic employees ......................................................................................... 8-40-302(4)......................................................................................... 8

duty to offer case management or managed care ............................................. 8-42-101(3.6)(p)(II) .......................................................................... 20

farm or ranch ................................................................................................... 8-41-401(4)....................................................................................... 15

fine, no insurance ............................................................................................. 8-43-409(1)(b) .................................................................................. 53

furnish information to division ........................................................................ 8-47-202 ........................................................................................... 79

director may fix time in which to ................................................................. 8-47-201 ........................................................................................... 79

may require under oath ................................................................................ 8-47-201 ........................................................................................... 79

homeowner ...................................................................................................... 8-40-302(4)......................................................................................... 8

independent contractor, defined ....................................................................... 8-40-202(2), 8-41-401(3) ............................................................. 6, 15

information must furnish ................................................................................. 8-47-102 ........................................................................................... 78

insurance, failure to obtain

certified copy of order filed ......................................................................... 8-43-408(3)

....................................................................................... 52

enjoined from continuing business............................................................... 8-43-409(1)....................................................................................... 52

failure to pay judgment ................................................................................ 8-43-408(4)....................................................................................... 52

file bond ....................................................................................................... 8-43-408(2)....................................................................................... 52

fine ............................................................................................................... 8-43-409(1)(b) .................................................................................. 53

judgment ...................................................................................................... 8-43-408(3)....................................................................................... 52

monetary penalty ......................................................................................... 8-43-409(1)(b) .................................................................................. 53

penalty ......................................................................................................... 8-43-408(1)....................................................................................... 52

procedure ..................................................................................................... 8-43-408(2), (3) ................................................................................ 52

insurance requirements .................................................................................... 8-44-101(1)....................................................................................... 58

keep records of injuries .................................................................................... 8-43-101(1)....................................................................................... 34

lessee................................................................................................................ 8-41-401(1)(a)(I), 8-41-403(1) ................................................... 14, 16

liability of ........................................................................................................ 8-41-102 ............................................................................................. 9

loaned employee .......................................................................................... 8-41-303 ........................................................................................... 14

loaning services ........................................................................................... 8-41-303 ........................................................................................... 14

loaning ............................................................................................................. 8-41-303 ........................................................................................... 14

medical aid, etc. furnished by .......................................................................... 8-42-101(1)(a) .................................................................................. 18

insurance liability for ................................................................................... 8-44-101(1)....................................................................................... 58

misclassifications ............................................................................................. 8-44-108(2)....................................................................................... 60

not insured (see FAILURE TO INSURE)

notice to, of injury ............................................................................................ 8-43-102(1)(a)

.................................................................................. 34

notice to, of settlement ..................................................................................... 8-40-301(1)(b), 8-41-212 ............................................................. 7, 13

out of state ....................................................................................................... 8-41-212 ........................................................................................... 13

property owner contracting out ........................................................................ 8-41-402(1)....................................................................................... 16

exemptions of............................................................................................... 8-41-403(1)....................................................................................... 16

liable for insurance....................................................................................... 8-41-402(1)....................................................................................... 16

records of, open to inspection .......................................................................... 8-47-208 ........................................................................................... 80

self-insurance ................................................................................................... 8-44-201(1) thru 205 ................................................................... 62-63

pool .............................................................................................................. 8-44-205(1) thru (11) ................................................................... 63-64

rehabilitation ............................................................................................ 8-44-205(8)....................................................................................... 64

trade or professional association ...................................................................... 8-44-205(1)....................................................................................... 63

EMPLOYMENT, defined .................................................................................. 8-40-201(8)......................................................................................... 3

arising out of .................................................................................................... 8-41-301(1)(b) .................................................................................. 13

modified ........................................................................................................... 8-42-105(3)(d), 8-42-106(2)(b)(I) .............................................. 24, 25

temporary help contracting firm ...................................................................... 8-42-105(3)(d)(I), 8-42-106(2)(b)(II) ......................................... 24, 25

termination of, resulting wage loss .................................................................. 8-42-105(4)(a) .................................................................................. 24

EQUATIONS (see CALCULATIONS)

ERROR, reopening for ....................................................................................... 8-43-303(1)

....................................................................................... 44

EVIDENCE ........................................................................................................ 8-43-210 ........................................................................................... 41

EXAMINATION, by physicians ........................................................................ 8-43-404(1)(a) .................................................................................. 48

exchange .......................................................................................................... 8-43-210 ........................................................................................... 41

EXCLUSIVE REMEDY ................................................................................... 8-41-104 ............................................................................................. 9

EXECUTIVE DIRECTOR, Dept. of Labor and Employment

appoint employees ........................................................................................... 8-47-204

........................................................................................... 80

fix bond for custodian of funds ........................................................................ 8-45-119(2)....................................................................................... 70

Find what you were looking for?

XII

EXPENSES OF DIVISION OF WORKERS’ COMPENSATION ................ 8-47-209 ........................................................................................... 80

FAILURE TO INSURE

compensation (50% increased compensation).................................................. 8-43-408(1)

....................................................................................... 52

bond to secure .............................................................................................. 8-43-408(2) ....................................................................................... 52

deposit with trustee ...................................................................................... 8-43-408(2) ....................................................................................... 52

failure to pay judgment ................................................................................ 8-43-408(4) ....................................................................................... 52

procedure to secure judgment ...................................................................... 8-43-408(3) ....................................................................................... 52

fine . ................................................................................................................. 8-43-409(1)(b) .................................................................................. 53

injunction against carrying on business ........................................................... 8-43-409(1) ....................................................................................... 52

lien ................................................................................................................... 8-43-410(1) ....................................................................................... 54

monetary penalty .............................................................................................. 8-43-409(1)(b) .................................................................................. 53

trust fund for payment ...................................................................................... 8-47-105(1) ....................................................................................... 78

uninsured employer fund ................................................................................. 8-67-101 ........................................................................................... 83

FAILURE TO PROSECUTE ........................................................................... 8-43-207(1)(n) .................................................................................. 40

FAILURE TO REPORT INJURY ................................................................... 8-43-102(1)(a) .................................................................................. 34

FALSE STATEMENT ....................................................................................... 8-43-402 ........................................................................................... 48

willfully misleads employer ............................................................................. 8-42-112(1)(d) .................................................................................. 30

FARM AND RANCH LABOR ......................................................................... 8-40-302(3), 8-41-401(4) .............................................................. 8, 15

FATALITY

benefits ............................................................................................................. 8-41-501(1) ....................................................................................... 17

employer report ................................................................................................ 8-43-101(1) ....................................................................................... 34

FEES

attorney ............................................................................................................ 8-43-403(1) ....................................................................................... 48

chiropractic ...................................................................................................... 8-42-101(3)(a)(III) ............................................................................ 19

excess of fee schedule ...................................................................................... 8-42-101(3)(a)(I) .............................................................................. 19

expert witness, expert reviewer, expert evaluator ............................................ 8-42-101(3)(a)(I) .............................................................................. 19

medical and hospital ........................................................................................ 8-42-101(3)(a)(I) .............................................................................. 19

freeze on ....................................................................................................... 8-42-101(3)(a)(II) ............................................................................. 19

set aside as excessive or unnecessary ........................................................... 8-43-207(1)(o) .................................................................................. 40

transcripts ......................................................................................................... 8-43-213(2) ....................................................................................... 42

vocational rehabilitation ................................................................................... 8-42-101(3)(a)(I) .............................................................................. 19

witness ............................................................................................................. 8-43-315(1) ....................................................................................... 46

FEE SCHEDULE ............................................................................................... 8-42-101(3)(a)(I) .............................................................................. 19

FELLOW SERVANT, negligence of................................................................. 8-41-101(1)(b) .................................................................................... 9

FELONY

false statement.................................................................................................. 8-43-402 ........................................................................................... 48

FILES

inspection of ..................................................................................................... 8-42-125, 8-47-203(1) ................................................................ 34, 79

law enforcement ............................................................................................... 8-47-203.3 ........................................................................................ 80

FINAL ADMISSION ......................................................................................... 8-43-203(2)(b)(II)(A) ....................................................................... 37

FINES (see PENALTIES)

FINDINGS AND AWARD

action to set aside (see APPEAL)

administrative law judge’s ............................................................................... 8-43-215(1)

....................................................................................... 42

final, when ....................................................................................................... 8-43-215(1) ....................................................................................... 42

Industrial Claim Appeals Panel. ....................................................................... 8-43-301(8), (9), (10)........................................................................ 43

multiple employers........................................................................................... 8-43-301(13) ..................................................................................... 44

FIREFIGHTERS

cancer ............................................................................................................... 8-41-209 ........................................................................................... 12

cancer trust ....................................................................................................... 8-42-103(1)(h) .................................................................................. 23

coverage for occupational diseases .................................................................. 8-41-208(1), 209 ............................................................................... 12

hepatitis C ........................................................................................................ 8-42-101(1)(c) .................................................................................. 18

voluntary firefighter cancer program ............................................................... 8-41-209(4) ....................................................................................... 12

volunteer .......................................................................................................... 8-40-202(1)(a)(I)(A) ........................................................................... 4

FOR-HIRE TRANSPORTATION ................................................................... 8-41-401(6) ....................................................................................... 16

FRANCHISE HOLDER .................................................................................... 8-41-403(1) ....................................................................................... 16

FRAUD

offset benefits paid ........................................................................................... 8-43-304(2) ....................................................................................... 45

penalty ............................................................................................................. 8-43-402 ........................................................................................... 48

FRINGE BENEFIT

recalculation of wage within 15 days of termination ....................................... 8-42-103(2) ....................................................................................... 23

FULL DUTY RELEASE, ends temporary disability ......................................... 8-42-105(3)(c) .................................................................................. 24

FUNERAL EXPENSES ..................................................................................... 8-42-123 ........................................................................................... 33

accrued compensation ...................................................................................... 8-41-503(2) ....................................................................................... 17

Find what you were looking for?

XIII

GARNISHMENT ............................................................................................... 8-42-124(1), (6), 8-43-204(4) ............................................... 33, 34, 38

GENERAL PARTNER, coverage ..................................................................... 8-40-302(5)(b) .................................................................................... 8

GLASSES ........................................................................................................... 8-42-101(1)(b), 8-42-101(2) ............................................................. 18

GRATUITIES .................................................................................................... 8-40-201(19)(b) .................................................................................. 4

GUARANTY FUND .......................................................................................... 8-44-206(1)....................................................................................... 65

GUARDIAN AD LITEM, appoint..................................................................... 8-43-207(1)(l) ................................................................................... 40

HEALTH INSURANCE.................................................................................... 8-40-201(19)(b)

.................................................................................. 4

HEARING AIDS ................................................................................................ 8-42-101(1)(b) .................................................................................. 18

HEARINGS

adjournment of ................................................................................................. 8-43-207(1)(j) ................................................................................... 40

administrative law judge, conduct ................................................................... 8-43-207(1)....................................................................................... 40

order ............................................................................................................. 8-43-215(1)....................................................................................... 42

review by Industrial Claim Appeals Panel ................................................... 8-43-301(6-11) ................................................................................. 43

after Division independent medical examination report .................................. 8-42-107.2(4), 8-43-203(2) ........................................................ 29, 37

application of either party, on .......................................................................... 8-43-211(2)(b) .................................................................................. 41

award, appeal ................................................................................................... 8-43-301(1)....................................................................................... 43

before whom held ............................................................................................ 8-43-202 ........................................................................................... 36

commission of another state ......................................................................... 8-43-202 ........................................................................................... 36

conduct of ........................................................................................................ 8-43-207(1)(h) .................................................................................. 40

continuance ...................................................................................................... 8-43-209(3)....................................................................................... 41

depositions ....................................................................................................... 8-43-207.5(2), 8-43-210 ............................................................. 40, 41

director may hold ............................................................................................. 8-43-201(1)....................................................................................... 36

jurisdiction ................................................................................................... 8-43-103(2)....................................................................................... 36

during appeals .................................................................................................. 8-43-301(12)..................................................................................... 44

employer default insurance obligations ........................................................... 8-43-409(1)....................................................................................... 52

evidence ........................................................................................................... 8-43-210 ........................................................................................... 41

expedited .......................................................................................................... 8-42-105(2)(a), 8-43-203(1)(a), 8-43-211(2)(a) ................... 24, 36, 41

notice of contest ........................................................................................... 8-43-203(1)(a) .................................................................................. 37

physician choice ........................................................................................... 8-43-404(5)(a)(I)(D) ......................................................................... 49

safety rule .................................................................................................... 8-42-112(4)....................................................................................... 31

extension of hearing date ................................................................................. 8-43-209(1), (2) ................................................................................ 41

false statement ................................................................................................. 8-43-402 ........................................................................................... 48

issue ripe for adjudication ................................................................................ 8-43-211(2)(b) .................................................................................. 41

including selection of an IME ...................................................................... 8-43-203(2)....................................................................................... 37

limit for hearing date........................................................................................ 8-43-209(1)....................................................................................... 41

medical treatment guidelines ........................................................................... 8-43-201(3)....................................................................................... 36

notice of ........................................................................................................... 8-43-211(1)....................................................................................... 41

notice to set mailed .......................................................................................... 8-43-211(2)(c) .................................................................................. 41

orders, time limit .............................................................................................. 8-43-215(1)....................................................................................... 42

pending utilization review................................................................................ 8-43-501(2)(e) .................................................................................. 54

reporters ........................................................................................................... 8-43-213(2)....................................................................................... 42

time for completion .......................................................................................... 8-43-215(1)....................................................................................... 42

time schedule establishment ............................................................................ 8-43-209(1)....................................................................................... 41

transcript of proceedings .................................................................................. 8-43-213(1)....................................................................................... 42

time for filing ............................................................................................... 8-43-213(2)....................................................................................... 42

utilization review de novo ................................................................................ 8-43-501(5)....................................................................................... 55

witness

failure to appear at ....................................................................................... 8-43-212

........................................................................................... 41

fees ............................................................................................................... 8-43-315(1)....................................................................................... 46

HEART ATTACK ............................................................................................. 8-41-302(2)....................................................................................... 14

HEPATITIS C

baseline testing ................................................................................................ 8-41-208(1) (a), (b), 8-42-101(1)(c) ........................................... 12, 18

coverage for exposure, contraction .................................................................. 8-41-208(1)....................................................................................... 12

non-emergency provider exposure ................................................................... 8-41-208(2)....................................................................................... 12

HOMEOWNER ................................................................................................. 8-40-302(4), 8-41-402(1) ............................................................. 8, 16

home office ...................................................................................................... 8-40-302(3)......................................................................................... 8

HOSPITAL TREATMENT .............................................................................. 8-42-101(1)(a) .................................................................................. 18

HOST HOME SERVICES

employee .......................................................................................................... 8-40-301(7)......................................................................................... 8

statutory employ

ment exclusion .....................................................................

8-41-401(7)....................................................................................... 16

ILLEGITIMATE MINOR CHILDREN.......................................................... 8-41-505

........................................................................................... 18

IMMEDIATE PAYMENT FUND .................................................................... 8-44-206(1)....................................................................................... 65

Find what you were looking for?

XIV

IMMUNITY

employer .......................................................................................................... 8-41-102 ............................................................................................. 9

from suit ........................................................................................................... 8-41-104 ............................................................................................. 9

IMPAIRMENT RATINGS

basis ................................................................................................................. 8-42-101(3)(a)(I) .............................................................................. 19

chronic pain ..................................................................................................... 8-42-101(3.7) .................................................................................... 20

not combined.................................................................................................... 8-42-107(7) ....................................................................................... 26

not level II accredited ....................................................................................... 8-42-107(8)(b.5) ............................................................................... 27

who may provide ............................................................................................. 8-42-101(3.6)(b) ............................................................................... 19

IMPLANTABLE DEVICE ............................................................................... 8-42-101(1)(b) .................................................................................. 18

INCARCERATION

inmate as employee .......................................................................................... 8-40-301(3)

......................................................................................... 7

limitation on payments ..................................................................................... 8-42-113(1) ....................................................................................... 31

INCOME ASSIGNMENT ................................................................................. 8-42-124(6), 8-43-204(4) ............................................................ 34, 38

INCOMPETENT CLAIMANT OR DEPENDENT ........................................ 8-41-503(3) ....................................................................................... 18

INDEPENDENT CONTRACTOR, defined ..................................................... 8-40-202(2), 8-41-401(3) .............................................................. 6, 15

common carrier ................................................................................................ 8-40-301(5), (6) .................................................................................. 8

factors .............................................................................................................. 8-40-202(2)(b) .................................................................................... 6

nonprofit youth sports organization coach ....................................................... 8-40-202(2)(e)(I) ................................................................................ 7

rebuttable presumption ..................................................................................... 8-40-202(2)(a) .................................................................................... 6

INDEPENDENT MEDICAL EXAMINATION (IME)

Division IME (DIME) .................................................................................... 8-42-107(8)(b), (b.5), 8-43-502(1) ....................................... 26, 27, 55

after report file admission or request hearing ............................................... 8-42-107.2(4)(c), 8-43-203(2) .................................................... 29, 37

applicability ................................................................................................. 8-42-107.2(6) .................................................................................... 29

contact with treating physician ..................................................................... 8-42-107.2(3)(d)(I) ........................................................................... 29

cost ............................................................................................................... 8-42-107.2(5), 8-43-502(2) ......................................................... 29, 55

immunity from liability ................................................................................ 8-43-502(6) ....................................................................................... 56

indigency ...................................................................................................... 8-42-107.2(5) .................................................................................... 29

negotiate selection of ................................................................................... 8-42-107.2(3) .................................................................................... 28

medical records ............................................................................................ 8-42-107.2(3) .................................................................................... 28

mileage, travel cost reimbursement .............................................................. 8-43-404(1) ....................................................................................... 48

panel ............................................................................................................. 8-42-107.2(3) .................................................................................... 28

physician selection ....................................................................................... 8-43-502(2) ....................................................................................... 55

request for disclosure of information by a listed examiner ......................... 8-42-107.2(3.5)(a), (b) ...................................................................... 29

selection of examiner ................................................................................... 8-42-107.2(2) .................................................................................... 28

twenty-four months to request DIME to determine MMI ............................ 8-42-107(8)(b)(II) .......................................................................... 26

Non Division IME

audio recording ............................................................................................ 8-43-404(2)(a) .................................................................................. 48

evaluation ..................................................................................................... 8-43-404(1)(a) .................................................................................. 48

refusal of examination .................................................................................. 8-43-404(3) ....................................................................................... 49

transportation, mileage, food, hotel costs ..................................................... 8-43-404(1) ....................................................................................... 48

wage loss ...................................................................................................... 8-43-404(1)(b) .................................................................................. 48

written report ................................................................................................ 8-43-404(2)(a) .................................................................................. 48

INDIVIDUAL EMPLOYER, coverage ............................................................. 8-44-102(1) ....................................................................................... 58

INDUSTRIAL CLAIM APPEALS PANEL

appeal to court of appeals................................................................................. 8-43-301(10) ..................................................................................... 43

defined ............................................................................................................. 8-40-201(16) ....................................................................................... 4

examiner defined .............................................................................................. 8-40-201(9) ......................................................................................... 3

grounds ............................................................................................................ 8-43-301(8) ....................................................................................... 43

orders ............................................................................................................... 8-47-103 ........................................................................................... 78

error disregarded .......................................................................................... 8-43-310 ........................................................................................... 46

extend time for entry .................................................................................... 8-43-301(9) ....................................................................................... 43

failure to issue timely order.......................................................................... 8-43-301(11) ..................................................................................... 43

prima facie reasonable and valid .................................................................. 8-47-103 ........................................................................................... 78

procedural orders ......................................................................................... 8-43-301(9) ....................................................................................... 43

sixty days to enter order ............................................................................... 8-43-301(8) ....................................................................................... 43

technical objections ...................................................................................... 8-47-104 ........................................................................................... 78

INFORMATION, employers must furnish ........................................................ 8-47-102 ........................................................................................... 78

INJURIOUS PRACTICE .................................................................................. 8-43-404(3) ....................................................................................... 48

INJURY

arising out of employment ............................................................................... 8-41-301(1)

....................................................................................... 13

conditions of recovery for ................................................................................ 8-41-301(1) ....................................................................................... 13

defenses, abrogation of ................................................................................ 8-41-101(1) ......................................................................................... 9

defenses, available when .............................................................................. 8-41-103 ............................................................................................. 9

defined ............................................................................................................. 8-40-201(1), (2) .................................................................................. 3

emotional stress ................................................................................................ 8-41-301(1) ....................................................................................... 13

employee submit to examination ..................................................................... 8-43-404(1) ....................................................................................... 48

Find what you were looking for?

employer, keep record of ................................................................................. 8-43-101(1)....................................................................................... 34

report to division, time limit ........................................................................ 8-43-101(1)....................................................................................... 34

deaths ....................................................................................................... 8-43-101(1), 103 ......................................................................... 34, 35

liability of employer ........................................................................................ 8-41-102 ............................................................................................. 9

contractor ..................................................................................................... 8-41-401(1)(a)(I) .............................................................................. 14

lessor ............................................................................................................ 8-41-401(1)(a)(I), 403 ................................................................ 14, 16

owner ........................................................................................................... 8-41-402(1)....................................................................................... 16

loss of members, specific ................................................................................. 8-42-107(1)(a) .................................................................................. 25

mental, emotional, psychological..................................................................... 8-41-301(2)....................................................................................... 13

negligence of third party, election .................................................................... 8-41-203(1)(a) .................................................................................. 10

subrogation of insurer .................................................................................. 8-41-203(1)(a) .................................................................................. 10

out of state ....................................................................................................... 8-41-204 ........................................................................................... 12

reports to division ............................................................................................ 8-43-101(1)....................................................................................... 34

to employer .................................................................................................. 8-43-102(1)(a) .................................................................................. 34

INJURY BENEFITS (see BENEFITS)

INMATE

benefit payment to ........................................................................................... 8-42-113(1)

....................................................................................... 31

employee .......................................................................................................... 8-40-301(3)(a) .................................................................................... 7

inmate exception .............................................................................................. 8-40-301(3)(a), 8-42-113(4) ......................................................... 7, 31

repay benefits if ineligible ............................................................................... 8-42-113(1.5)(b) ............................................................................... 31

INSANE OR INCOMPETENT

determine competency of witnesses and parties............................................... 8-43-207(1)(m) ................................................................................. 40

payments .......................................................................................................... 8-41-503(3)....................................................................................... 18

INSPECTION

books, payrolls, records ................................................................................... 8-47-208 ........................................................................................... 80

workers’ compensation files ............................................................................ 8-42-125, 8-47-203(1) ................................................................ 34, 79

law enforcement............................................................................................... 8-47-203.3 ........................................................................................ 80

INSURANCE (see FAILURE TO INSURE)

annual report, policies ...................................................................................... 8-44-102(2)

....................................................................................... 58

cancellation, notice of ...................................................................................... 8-44-110 ........................................................................................... 60

classification, notice of appeal rights ............................................................... 8-44-109(2)....................................................................................... 60

classification, notice of change in rate ............................................................. 8-44-109(1)....................................................................................... 60

classification of risks filed with commissioner of insurance ............................ 8-44-103 ........................................................................................... 59

compensation exclusive remedy ...................................................................... 8-41-104 ............................................................................................. 9

contract for, subject to Act ............................................................................... 8-44-102(1)....................................................................................... 58

form of, commissioner of insurance prescribe ............................................. 8-44-102(1)....................................................................................... 58

void when .................................................................................................... 8-44-102(1)....................................................................................... 58

credit losses, overpayment repaid .................................................................... 8-42-113.5(1).................................................................................... 31

cutting or rebating rates, prohibited ................................................................. 8-44-104 ........................................................................................... 59

penalty ......................................................................................................... 8-44-104 ........................................................................................... 59

deductibles ....................................................................................................... 8-44-111(1)(a) .................................................................................. 60

employee payment of insurance ....................................................................... 8-44-101(2)....................................................................................... 58

employer, defaulting in, enjoined .................................................................... 8-43-409(1)....................................................................................... 52

compensation increased ............................................................................... 8-43-408(1)....................................................................................... 52

Federal Prison Industry Enhancement Certification Program .......................... 8-44-101(3)(a)(II) ............................................................................. 58

liability of lessor or contractor out ................................................................... 8-41-401(1)(a)(I) .............................................................................. 14

of owner contracting out .............................................................................. 8-41-402(1)....................................................................................... 16

medical aid ....................................................................................................... 8-42-101(1)(a) .................................................................................. 18

methods of

public entities pools ..................................................................................... 8-44-204(1)

....................................................................................... 62

self-insurance ............................................................................................... 8-44-101(1)....................................................................................... 58

self-insurance pools ..................................................................................... 8-44-205(1)....................................................................................... 63

state authority............................................................................................... 8-44-101(1)....................................................................................... 58

stock or mutual companies ........................................................................... 8-44-101(1)....................................................................................... 58

misclassifications, repayments for ................................................................... 8-44-108(1)....................................................................................... 59

non-insurance (see FAILURE TO INSURE)

notice of insurance ........................................................................................... 8-44-101(1)(b)

.................................................................................. 58

out of state exemption ...................................................................................... 8-41-212 ........................................................................................... 13

overpayment repaid, credit losses .................................................................... 8-42-113.5(1).................................................................................... 31

Pinnacol Assurance

cancellation of policy ................................................................................... 8-45-101(1); 8-45-112, 113

........................................................ 66, 69

shall not refuse to insure .............................................................................. 8-45-101(5)(f) ................................................................................... 67

policy

approve form ................................................................................................ 8-44-102(1)

....................................................................................... 58

cancellation .................................................................................................. 8-44-110 ........................................................................................... 60

Find what you were looking for?

XVI

essential provisions ...................................................................................... 8-44-105 ........................................................................................... 59

notice to division .......................................................................................... 8-44-101(1) ....................................................................................... 58

subject to Act ............................................................................................... 8-44-102(1) ....................................................................................... 58

premium dividend ............................................................................................ 8-42-107.6 ........................................................................................ 30

property tax work-off program......................................................................... 8-40-202(3), 8-40-301(9), 8-41-210 ......................................... 7, 8, 12

public entities ................................................................................................... 8-44-101(3) ....................................................................................... 58

rates

approved by commissioner of insurance ...................................................... 8-44-104 ........................................................................................... 59

cutting or rebating prohibited ....................................................................... 8-44-104 ........................................................................................... 59

not include penalties or damages ................................................................. 8-43-304.5 ........................................................................................ 45

rebating prohibited ....................................................................................... 8-44-104 ........................................................................................... 59

system of filed .............................................................................................. 8-44-103 ........................................................................................... 59

requirements .................................................................................................... 8-44-101(1) ....................................................................................... 58

revisionary interests prohibited ........................................................................ 8-44-116 ........................................................................................... 62

self-insurance ................................................................................................... 8-44-101(1), 8-44-201 thru 205 ............................................. 58, 62-63

bankruptcy or insufficient reserves .............................................................. 8-44-206(1) ....................................................................................... 65

definitions .................................................................................................... 8-44-204(1) ....................................................................................... 62

fund audit ..................................................................................................... 8-44-204(7), 8-44-205(6) ............................................................ 63, 64

guaranty fund ............................................................................................... 8-44-206(1) ....................................................................................... 65

guaranty fund assessment ............................................................................. 8-44-206(4) ....................................................................................... 65

initial application ......................................................................................... 8-44-202 ........................................................................................... 62

notice of injury to employer ......................................................................... 8-43-102(1.5) .................................................................................... 35

pools ............................................................................................................. 8-44-204(3) thru (7), 8-44-205(1) ..................................................... 63

approval ................................................................................................... 8-44-204(5), 8-44-205(5) ............................................................ 63, 64

other insurance ......................................................................................... 8-44-204(10) ............................................................................... 63, 64

public entities ............................................................................................... 8-44-204(1) ....................................................................................... 62

reserve fund.................................................................................................. 8-44-204(2) ....................................................................................... 62

revocation .................................................................................................... 8-44-204(8), 8-44-205(7) ............................................................ 63, 64

securities investment .................................................................................... 8-44-204(9) ....................................................................................... 63

trust fund, pools ........................................................................................... 8-44-205(11) ..................................................................................... 64

surcharge on premiums .................................................................................... 8-44-112(1)(a) .................................................................................. 60

uninsured (see FAILURE TO INSURE)

INSURER

annual report, policies ...................................................................................... 8-44-102(2)

....................................................................................... 58

classification, notice of appeal rights ............................................................... 8-44-109(2) ....................................................................................... 60

cutting rates, penalty ........................................................................................ 8-44-104 ........................................................................................... 59

deposits to secure future payments of

compensation ............................................................................................... 8-47-105(1)

....................................................................................... 78

duty to offer case management

or managed care ........................................................................................... 8-42-101(3.6)(p)(II)

.......................................................................... 20

file system of rating ......................................................................................... 8-44-103 ........................................................................................... 59

insurance filed with division ............................................................................ 8-44-101(1) ....................................................................................... 58

liability to employee ........................................................................................ 8-44-105 ........................................................................................... 59

mutual liability company, may be .................................................................... 8-44-101(1) ....................................................................................... 58

notice of injury to employer is notice to........................................................... 8-44-105 ........................................................................................... 59

rebates by, penalty ........................................................................................... 8-44-104 ........................................................................................... 59

revocation of license ........................................................................................ 8-44-106 ........................................................................................... 59

right to examine books of employer ................................................................. 8-44-107 ........................................................................................... 59

INTENT, legislative (see LEGISLATURE DECLARATION)

INTENTIONALLY SELF-INFLICTED INJURIES ...................................... 8-41-301(1)(c)

.................................................................................. 13

INTEREST ......................................................................................................... 8-43-410(2) ....................................................................................... 54

INTERN .............................................................................................................. 8-40-302(7)(a) .................................................................................... 8

INTERPRETATION OF ACT ......................................................................... 8-43-201(1) ....................................................................................... 36

INTERSTATE COMMERCE (see COMMON CARRIERS)

INTOXICATION OF EMPLOYEE ................................................................. 8-42-112.5(1)

.................................................................................... 31

INTRASTATE COMMERCE (see COMMON CARRIERS)

INVESTIGATIONS ........................................................................................... 8-43-208(1) ....................................................................................... 41

JAIL, payments to prisoners ............................................................................... 8-42-113(1)

....................................................................................... 31

JOB OFFER, ends temporary disability ............................................................. 8-42-105(3) ....................................................................................... 24

JOB TRAINING ................................................................................................ 8-40-202(1)(a)(IV) ............................................................................. 5

JUDGMENT ...................................................................................................... 8-43-408(3) ....................................................................................... 52

JURISDICTION, injury out of state .................................................................. 8-41-204 ........................................................................................... 12

LAST INJURIOUS EXPOSURE ...................................................................... 8-41-304(1)

....................................................................................... 14

Find what you were looking for?

XVII

LEASING OUT (see CONTRACTORS AND LESSEES)

LEGISLATIVE DECLARATION

claims management ......................................................................................... 8-43-217

........................................................................................... 42

cost containment .............................................................................................. 8-14.5-102 .......................................................................................... 1

employee defined ............................................................................................. 8-40-102(2)......................................................................................... 3

employers have insurance in effect .................................................................. 8-47-111 ........................................................................................... 79

settlement of subsequent injury and major medical insurance claims .............. 8-46-109 ........................................................................................... 74

utilization review ............................................................................................. 8-43-501(1)....................................................................................... 54

uninsured employer fund ................................................................................. 8-67-102 ........................................................................................... 83

Workers’ Compensation Act ............................................................................ 8-40-102(1)......................................................................................... 3

LESSEE (see CONTRACTORS AND LESSEES)

deemed employer, must insure, when .............................................................. 8-41-401 ........................................................................................... 14

LESSOR, statutory employer .............................................................................. 8-41-401 ........................................................................................... 14

LIEN AGAINST BENEFITS ............................................................................ 8-42-124(6), 8-43-204(4) ........................................................... 34, 38

LIEN AGAINST EMPLOYER OR INSURER ............................................... 8-43-410(1), 8-44-105, 8-67-109(5) ..................................... 54, 59, 85

LIMITATIONS (see TIME LIMITS)

claim for benefits ............................................................................................. 8-43-103(1)

....................................................................................... 35

LIMITED LIABILITY MEMBER .................................................................. 8-41-202(1)....................................................................................... 10

LOANED EMPLOYEE .................................................................................... 8-40-202(1)(a)(III).............................................................................. 5

LOANING SERVICES ..................................................................................... 8-41-303 ........................................................................................... 14

LUMP SUMS ..................................................................................................... 8-43-406(1)....................................................................................... 51

maximum ......................................................................................................... 8-43-406(2)....................................................................................... 52

may not be conditioned on waiver of permanent total benefits........................ 8-43-406(1)....................................................................................... 51

settlements, timely payment of ........................................................................ 8-43-204(7)....................................................................................... 39

$10,000 ............................................................................................................ 8-42-107(8)(d) .................................................................................. 28

MAJOR MEDICAL INSURANCE FUND ...................................................... 8-46-201 thru 212

........................................................................ 74-76

closure of fund ................................................................................................. 8-46-212 ........................................................................................... 76

MANAGED CARE, defined .............................................................................. 8-42-101(3.6)(p)(I) ........................................................................... 20

MAXIMUM MEDICAL IMPROVEMENT (MMI), defined ......................... 8-40-201(11.5) .................................................................................... 3

date determined by physician ........................................................................... 8-42-107(8)(b) .................................................................................. 26

independent medical examination .................................................................... 8-42-107(8)....................................................................................... 26

medical benefits after MMI ............................................................................. 8-42-107(8)(f) ................................................................................... 28

temporary partial terminates ............................................................................ 8-42-106(2)(a) .................................................................................. 25

temporary total terminates ............................................................................... 8-42-105(3)(a) .................................................................................. 24

MEDIATION

application procedures ..................................................................................... 8-43-205(1)....................................................................................... 39

defined ............................................................................................................. 8-40-201(12)....................................................................................... 3

representation of parties ................................................................................... 8-43-205(1)....................................................................................... 39

time limit for conference .................................................................................. 8-43-205(1)....................................................................................... 39

MEDIATORS, defined ....................................................................................... 8-40-201(13)....................................................................................... 3

MEDICAL BENEFITS ..................................................................................... 8-42-101(1)(a) .................................................................................. 18

after MMI ........................................................................................................ 8-42-107(8)(f) ................................................................................... 28

apparatus .......................................................................................................... 8-42-101(1)(a) .................................................................................. 18

bill for payment for services after

loss of accreditation ..................................................................................... 8-42-101(3.6)(h) ............................................................................... 20

change of physician ......................................................................................... 8-43-404(5)....................................................................................... 49

chiropractic treatments, limit ........................................................................... 8-42-101(3)(a)(III)............................................................................ 19

costs paid by claimant ...................................................................................... 8-42-101(4)....................................................................................... 21

deemed authorized for services provided ......................................................... 8-43-404(9)....................................................................................... 51

dental ............................................................................................................... 8-42-101(1)(b) .................................................................................. 18

dictating care .................................................................................................... 8-43-503(3)....................................................................................... 56

employee may change physicians .................................................................... 8-43-404(5)....................................................................................... 49

employer furnish .............................................................................................. 8-42-101(1)(a) .................................................................................. 18

at time of injury ........................................................................................... 8-43-404(5)....................................................................................... 49

examination rights, refusal ............................................................................... 8-43-404(3)....................................................................................... 48

fees, set aside ................................................................................................... 8-43-207(1)(o) .................................................................................. 40

fees, withheld ................................................................................................... 8-42-105(2)(d) .................................................................................. 24

full duty release................................................................................................ 8-42-105(3)(c) .................................................................................. 24

implantable devices ......................................................................................... 8-42-101(1)(b) .................................................................................. 18

independent medical examination .................................................................... 8-42-107(8), 8-43-502(1) ........................................................... 26, 55

liability for authorized ..................................................................................... 8-43-404(7)....................................................................................... 51

Major Medical Fund ........................................................................................ 8-46-201 thru 212 ........................................................................ 74-76

Medical Disaster Insurance Fund ..................................................................... 8-46-301 thru 309 ........................................................................ 76-77

Find what you were looking for?

XVIII

medical fees ..................................................................................................... 8-42-101(3) ....................................................................................... 19

missed appointment ......................................................................................... 8-42-105(2)(c) .................................................................................. 24

mutual plan of employer and employee ........................................................... 8-42-101(2) ....................................................................................... 18

no recovery from employee ............................................................................. 8-42-101(4) ....................................................................................... 21

privilege waived ............................................................................................... 8-43-404(6) ....................................................................................... 51

prosthetic device .............................................................................................. 8-42-101(1)(b) .................................................................................. 18

reasonably needed ............................................................................................ 8-42-101(1)(a) .................................................................................. 18

refusal .............................................................................................................. 8-43-404(3) ....................................................................................... 48

reimbursement of medical expenses ................................................................ 8-42-101(6) ....................................................................................... 21

reopening ......................................................................................................... 8-43-303(2) ....................................................................................... 44

reports, evidence .............................................................................................. 8-43-210 ........................................................................................... 41

schedule of fees ................................................................................................ 8-42-101(3) ....................................................................................... 19

suspension of compensation ............................................................................. 8-43-404(3) ....................................................................................... 48

utilization review process................................................................................. 8-43-501(1) ....................................................................................... 54

verification off work ........................................................................................ 8-42-105(2)(d) .................................................................................. 24

waiver of privilege ........................................................................................... 8-47-203(1) ....................................................................................... 79

willful delay of payment .................................................................................. 8-43-401(2)(a) .................................................................................. 47

MEDICAL DIRECTOR

advises on appointment of utilization review committees ................................ 8-43-501(3)(a) .................................................................................. 54

appointment ..................................................................................................... 8-42-101(3.6)(n) ............................................................................... 20

contracts for peer review .................................................................................. 8-42-101(3.6)(n) ............................................................................... 20

duties ................................................................................................................ 8-42-101(3.6)(n) ............................................................................... 20

qualifications .................................................................................................... 8-42-101(3.6)(n) ............................................................................... 20

MEDICAL DISASTER INSURANCE FUND ................................................. 8-46-301 thru 309 ........................................................................ 76-77

MEDICAL IMPAIRMENT (see DISABILITY)

MEDICAL IMPAIRMENT RATINGS (see IMPAIRMENT RATINGS)

MEDICAL TREATMENT GUIDELINES

administrative law judge consideration ............................................................ 8-43-201(3)

....................................................................................... 36

required use ...................................................................................................... 8-42-101(3)(b) .................................................................................. 19

MENTAL IMPAIRMENT

combined to determine cap .............................................................................. 8-41-301(2), 8-42-107(7)(b)(III), 8-42-107.5 ....................... 13, 26, 30

conditions of recovery ...................................................................................... 8-41-301(2) ....................................................................................... 13

crime of violence ............................................................................................. 8-41-301(2)(b) ............................................................................. 13-14

not combined with physical impairments ......................................................... 8-42-107(7)(b) .................................................................................. 26

MEDICAL MAINTENANCE

admitted but contested ..................................................................................... 8-42-101(5)

....................................................................................... 21

MINORS

average weekly wage, children ........................................................................ 8-42-102(4) ....................................................................................... 21

compensation rate ............................................................................................ 8-40-202(1)(a)(III), 8-42-102(4) ................................................... 5, 21

deceased, death benefits to ............................................................................... 8-46-102(1)(b) .................................................................................. 72

dependents

illegitimate ................................................................................................... 8-41-505

........................................................................................... 18

presumed ...................................................................................................... 8-41-501(1)(b), (c) ............................................................................ 17

employees ........................................................................................................ 8-40-202(1)(b) .................................................................................... 6

safeguarding payments of ................................................................................ 8-42-122 ........................................................................................... 33

students ............................................................................................................ 8-41-501(1)(c) .................................................................................. 17

termination of benefits ..................................................................................... 8-42-120 ........................................................................................... 32

MISTAKE, reopening claim ............................................................................... 8-43-303(1) ....................................................................................... 44

MODIFIED EMPLOYMENT .......................................................................... 8-42-105(3)(b), (d) and (4)(b) & (c), 8-42-106(2)(b)(I) .............. 24, 25

refusal .............................................................................................................. 8-42-105(4)(b) .................................................................................. 24

MORTALITY TABLES, setting reserves, use of .............................................. 8-45-107(2) ....................................................................................... 68

MOTION ............................................................................................................ 8-43-207(1)(g) .................................................................................. 40

MOTOR VEHICLE ACCIDENTS, calculation of premium ........................... 8-44-115(1) ....................................................................................... 62

MUTUAL LIABILITY COMPANY ................................................................ 8-44-101(1)(b) .................................................................................. 58

NEGLIGENCE

of employee ..................................................................................................... 8-41-101(1)

......................................................................................... 9

of stranger ........................................................................................................ 8-41-203(1)(a) .................................................................................. 10

NON-INSURANCE (see FAILURE TO INSURE)

NON-MEDICAL BENEFITS, defined .............................................................. 8-42-112.5(2)

.................................................................................... 31

NONRESIDENT DEPENDENT, applicability of appeal.................................. 8-42-118 ........................................................................................... 32

NOTICE

by employee, to employer, of injury ................................................................ 8-43-102(1)(a) .................................................................................. 34

by employer, to carrier, of injury ..................................................................... 8-43-103(1) ....................................................................................... 35

Find what you were looking for?

XIX

of hearing ......................................................................................................... 8-43-211(1)....................................................................................... 41

of issuance of policy ........................................................................................ 8-44-101(1)(b) .................................................................................. 58

of occupational disease .................................................................................... 8-43-102(2)....................................................................................... 35

of request for IME ........................................................................................... 8-42-107.2(2)(b) ............................................................................... 28

to employer of settlement ................................................................................ 8-43-204(2)....................................................................................... 38

to set................................................................................................................. 8-43-211(2)....................................................................................... 41

NOTICE OF CONTEST ................................................................................... 8-43-203(1)(a) .................................................................................. 36

OCCUPATIONAL DISEASE

aggravation ...................................................................................................... 8-41-304(1)

....................................................................................... 14

coverage for firefighters ................................................................................... 8-41-209(1)....................................................................................... 12

definition .......................................................................................................... 8-40-201(14)....................................................................................... 3

scope of term ................................................................................................... 8-41-302(1)....................................................................................... 14

OFFENSES, penalty ........................................................................................... 8-43-304(1)....................................................................................... 45

OFFICE OF ADMINISTRATIVE COURTS.................................................. 24-30-1001

OFFSET

age greater than 45 ........................................................................................... 8-42-103(1)(c)(IV)

........................................................................... 22

controlled substances ....................................................................................... 8-42-112.5(1).................................................................................... 31

disability plan/ insurance ................................................................................. 8-42-103(1)(d) .................................................................................. 22

firefighter cancer trust ...................................................................................... 8-42-103(1)(h) .................................................................................. 23

intoxication ...................................................................................................... 8-42-112.5(1).................................................................................... 31

misleads employer ........................................................................................... 8-42-112(1)(d) .................................................................................. 30

payroll deductions ............................................................................................ 8-42-124(7)....................................................................................... 34

pension plan ..................................................................................................... 8-42-103(1)(d) .................................................................................. 22

unemployment benefits .................................................................................... 8-42-103(1)(f) ................................................................................... 23

WC benefits other jurisdiction ......................................................................... 8-42-103(1)(e), 8-42-114 ............................................................ 23, 32

ORDER

administrative law judge issue ......................................................................... 8-43-207(1)(k), 8-43-215(1) ....................................................... 40, 42

corrected order ................................................................................................. 8-43-302(1)....................................................................................... 44

director issue .................................................................................................... 8-43-207(1)(k), 8-43-215(1) ....................................................... 40, 42

false statement, fraud ....................................................................................... 8-43-402 ........................................................................................... 48

final order, administrative law judge or director .............................................. 8-43-215(1)....................................................................................... 42

Industrial Claim Appeals Office ...................................................................... 8-43-301(8) thru (11) ........................................................................ 43

not enforceable................................................................................................. 8-43-301(12)..................................................................................... 44

prehearing ........................................................................................................ 8-43-207.5(3).................................................................................... 40

prima facie valid .............................................................................................. 8-47-103 ........................................................................................... 78

request for full order ........................................................................................ 8-43-215(1)....................................................................................... 42

summary order ................................................................................................. 8-43-215(1)....................................................................................... 42

time for issuing ................................................................................................ 8-43-215(1)....................................................................................... 42

written findings of fact ..................................................................................... 8-43-215(1)....................................................................................... 42

OTHER STATES............................................................................................... 8-41-212 ........................................................................................... 13

OVERPAYMENT

collection of ..................................................................................................... 8-43-306(1)....................................................................................... 45

defined ............................................................................................................. 8-40-201(15.5) .................................................................................... 4

hearing ............................................................................................................. 8-43-207(1)(q) .................................................................................. 40

inmate .............................................................................................................. 8-42-113(1.5)(b) ............................................................................... 31

notice of claimant obligations .......................................................................... 8-43-203(1)(a) .................................................................................. 36

recovery of ....................................................................................................... 8-42-113.5(1).................................................................................... 31

reopen for ......................................................................................................... 8-43-303(1)....................................................................................... 44

social security benefits ..................................................................................... 8-42-113.5(1).................................................................................... 31

OWNER, LEASING OR CONTRACTING

(see CONTRACTORS AND LESSEES)

PAIN, not render impairment rating based on ..................................................... 8-42-101(3.7)

.................................................................................... 20

PARALYSIS....................................................................................................... 8-42-107(4)....................................................................................... 26

PARENTS

deceased minor, death benefits to .................................................................... 8-46-102(1)(b)

.................................................................................. 72

PARTIAL DEPENDENTS ................................................................................ 8-42-119 ........................................................................................... 32

PARTIAL DISABILITY (see DISABILITY

Find what you were looking for?

PARTY IN INTEREST, dependent of employee .............................................. 8-41-504 ........................................................................................... 18

PAYROLLS OF EMPLOYER, examination by insurer, division .................... 8-44-107, 8-47-208 ..................................................................... 59, 80

PENALTIES

admission, failure to file................................................................................... 8-43-203(2)

....................................................................................... 37

application for hearing ..................................................................................... 8-43-304(4) ....................................................................................... 45

collection of ..................................................................................................... 8-43-306(1) ....................................................................................... 45

cure violation ................................................................................................... 8-43-304(4) ....................................................................................... 45

each day separate offense ................................................................................. 8-43-305 ........................................................................................... 45

failure to cooperate with claims management .................................................. 8-43-218(3) ....................................................................................... 42

failure to insure ................................................................................................ 8-43-408(1) ....................................................................................... 52

fine for ......................................................................................................... 8-43-409(1)(b) .................................................................................. 53

general ............................................................................................................. 8-43-304(1) ....................................................................................... 45

in rate making .................................................................................................. 8-43-304.5 ........................................................................................ 45

injurious practice .............................................................................................. 8-43-404(3) ....................................................................................... 48

injury, failure of employee to report ................................................................ 8-43-102(1)(a) .................................................................................. 34

insure, failure to ............................................................................................... 8-43-408(1) ....................................................................................... 52

judgment, failure to pay ................................................................................... 8-43-408(1) ....................................................................................... 52

notice of contest, failure to file ........................................................................ 8-43-203(2) ....................................................................................... 37

payable to ......................................................................................................... 8-43-306(2) ....................................................................................... 46

refusal of examination ...................................................................................... 8-43-404(3) ....................................................................................... 48

report on fine imposed ..................................................................................... 8-43-409(5) ....................................................................................... 53

report on penalties imposed ............................................................................. 8-43-304(3) ....................................................................................... 45

request for ........................................................................................................ 8-43-304(5) ....................................................................................... 45

subpoena, failure to obey ................................................................................. 8-47-102 ........................................................................................... 78

time limit .......................................................................................................... 8-43-304(5) ....................................................................................... 45

untimely payment after appeals ....................................................................... 8-43-401(2)(a) .................................................................................. 47

violation of Act ................................................................................................ 8-43-304(1) ....................................................................................... 45

willful or repeated violations ........................................................................... 8-43-304(1.5) .................................................................................... 45

PENSION PLAN, effect on compensation ......................................................... 8-42-103(1)(d) .................................................................................. 22

PER DIEM computation ..................................................................................... 8-42-102(2)(c) .................................................................................. 21

defined ............................................................................................................. 8-40-201(19)(c) .................................................................................. 4

premium ........................................................................................................... 8-44-114 ........................................................................................... 61

PERMANENT DISABILITY (see BENEFITS and DISABILITY)

additional injury ............................................................................................... 8-42-109

........................................................................................... 30

amputation ....................................................................................................... 8-42-107(5) ....................................................................................... 26

combining whole and scheduled impairments ................................................. 8-42-107(7)(b) .................................................................................. 26

death ................................................................................................................. 8-42-116(1), 8-42-117(1) .................................................................. 32

permanent partial disability

age factors .................................................................................................... 8-42-107(8)(e) .................................................................................. 28

assignability ................................................................................................. 8-42-124(6) ....................................................................................... 34

compensation rate modified ......................................................................... 8-42-107(6) ....................................................................................... 26

determination of ........................................................................................... 8-42-107(1)(a) .................................................................................. 25

limit .............................................................................................................. 8-42-107(6) ....................................................................................... 26

scheduled injuries......................................................................................... 8-42-107(1)(a) .................................................................................. 25

whole person impairments ........................................................................... 8-42-107(1)(b) .................................................................................. 25

cost of living increase .................................................................................. 8-42-111(4) ....................................................................................... 30

defined ......................................................................................................... 8-40-201(16.5) .................................................................................... 4

offset, age greater than 45 ............................................................................ 8-42-103(1)(c)(IV) ........................................................................... 22

rebuttable presumption ................................................................................. 8-40-201(16.5)(b) ............................................................................... 4

previous............................................................................................................ 8-42-104(5) ....................................................................................... 23

rate paid ........................................................................................................... 8-42-107(6) ....................................................................................... 26

PERMANENT IMPAIRMENT

benefits cap ...................................................................................................... 8-42-107.5 ........................................................................................ 30

mental .............................................................................................................. 8-41-301(2)(b) .................................................................................. 13

mental limitations ............................................................................................ 8-41-301(2)(b) .................................................................................. 13

out of state ........................................................................................................ 8-42-107(8)(b.5)(I) ........................................................................... 27

PETITION TO REVIEW (see APPEAL)

briefs ................................................................................................................ 8-43-301(4) ....................................................................................... 43

to Court of Appeals .......................................................................................... 8-43-301(10) ..................................................................................... 43

supplemental order ........................................................................................... 8-43-301(5) ....................................................................................... 43

Find what you were looking for?

XXI

time to file ........................................................................................................ 8-43-301(2)....................................................................................... 43

to Industrial Claim Appeals Panel. .................................................................. 8-43-301(6)....................................................................................... 43

PHYSICIANS

accreditation (see accreditation)....................................................................... 8-42-101(3.6)

.................................................................................... 19

attending, required to testify ............................................................................ 8-43-404(4)....................................................................................... 49

change of physician ......................................................................................... 8-43-404(5)(a)(III) thru (VI) ............................................................ 50

utilization review ......................................................................................... 8-43-501(4)....................................................................................... 55

claims for routine loss injuries ......................................................................... 8-42-101(3.6)(a)(I) ........................................................................... 19

claims for services, after revocation................................................................. 8-42-101(3.6)(h) ............................................................................... 20

communication with employer ........................................................................ 8-43-404(5)(c) .................................................................................. 51

defined ............................................................................................................. 8-42-101(3.5)(a)(I)(A) ...................................................................... 19

expedited hearing ............................................................................................. 8-43-404(5)(a)(1)(D) ........................................................................ 49

insurer not liable for unauthorized treatment ................................................... 8-43-404(7)....................................................................................... 51

level I

change of physician ..................................................................................... 8-43-404(8)

....................................................................................... 51

moves to another facility .................................................................................. 8-43-404(5)(a)(V) ............................................................................. 50

one-time change notification ............................................................................ 8-43-404(5)(a)(III)............................................................................ 50

on-site facility .................................................................................................. 8-43-404(5)(a)(II)(B) ........................................................................ 50

refusal to provide treatment ............................................................................. 8-43-404(10)..................................................................................... 51

revocation of accreditation ............................................................................... 8-42-101(3.6)(g) ............................................................................... 20

selection ........................................................................................................... 8-43-404(5)(a)(I)(A) ......................................................................... 49

PINNACOL ASSURANCE

annual report .................................................................................................... 8-45-122(1)

....................................................................................... 71

audit and examination of .................................................................................. 8-45-121(2)....................................................................................... 71

board

defined ......................................................................................................... 8-40-201(3)

......................................................................................... 3

fix rates ........................................................................................................ 8-45-103(1)....................................................................................... 68

members....................................................................................................... 8-45-101(2)....................................................................................... 66

per diem compensation ................................................................................ 8-45-101(3)....................................................................................... 66

powers, rights, duties ................................................................................... 8-45-101(2)(c), 8-45-101(5) ........................................................ 65-66

cancellation of policy ....................................................................................... 8-45-112, 113 ................................................................................... 69

chief executive officer, defined ........................................................................ 8-40-201(3.4)...................................................................................... 3

contracts of insurance .................................................................................. 8-45-103(2)....................................................................................... 68

contracts of insurance ...................................................................................... 8-44-101(1)(b), 8-44-102(1), 8-44-104, 8-45-103(2)(b) 58, 58, 59, 68

custodian of, State Treasurer ............................................................................ 8-45-118(1)....................................................................................... 70

invest funds .................................................................................................. 8-45-120(1)....................................................................................... 70

defined ............................................................................................................. 8-45-102(1)....................................................................................... 67

disbursements .................................................................................................. 8-45-118(1)....................................................................................... 70

employees ........................................................................................................ 8-45-101(8)....................................................................................... 67

established ....................................................................................................... 8-45-102(1)....................................................................................... 67

insurance at cost ............................................................................................... 8-45-106(1)....................................................................................... 68

rates charged ................................................................................................ 8-45-107(1)....................................................................................... 68

investment of funds .......................................................................................... 8-45-120(1)....................................................................................... 70

office and employees ....................................................................................... 8-45-102(1)....................................................................................... 67

on discontinuing business ................................................................................ 8-45-112 ........................................................................................... 69

places of employment, classification of ........................................................... 8-45-105(1)....................................................................................... 68

policy, new....................................................................................................... 8-45-113 ........................................................................................... 69

premiums

classification of employment ....................................................................... 8-45-105(1)

....................................................................................... 68

manner of payment ...................................................................................... 8-45-105(1)....................................................................................... 68

rates, amendment of ..................................................................................... 8-45-112 ........................................................................................... 69

basis of ..................................................................................................... 8-45-107(1)....................................................................................... 68

surcharge .................................................................................................. 8-45-106(1)....................................................................................... 68

refuse to insure, shall not ................................................................................. 8-45-101(5)(f) ................................................................................... 67

regulation by commissioner of insurance ........................................................ 8-45-117(1)....................................................................................... 69

suits as to ......................................................................................................... 8-45-103(2)....................................................................................... 68

surplus.............................................................................................................. 8-45-107(1)....................................................................................... 68

amount of ..................................................................................................... 8-45-111 ........................................................................................... 69

credit balance to policyholder ...................................................................... 8-45-112 ........................................................................................... 69

plan for ......................................................................................................... 8-45-111 ........................................................................................... 69

portions of premiums set aside..................................................................... 8-45-111 ........................................................................................... 69

transfer of moneys to board ......................................................................... 8-45-117(6)....................................................................................... 69

PLACE OF EMPLOYMENT

classification .................................................................................................... 8-45-105(1)

....................................................................................... 68

defined ............................................................................................................. 8-40-201(17)....................................................................................... 4

PODIATRIST .................................................................................................... 8-42-101(3.5)(a)(I)(A) ...................................................................... 19

Find what you were looking for?

XXII

POLICY (see INSURANCE)

POSSES, sheriff’s ............................................................................................... 8-40-202(1)(a)(I)(A)

........................................................................... 4

POSTHUMOUS CHILDREN ........................................................................... 8-41-501(1)(b) .................................................................................. 17

POWER OF ATTORNEY

distributing funds ............................................................................................. 8-42-124(2)(b) .................................................................................. 33

void ................................................................................................................. 8-42-124(2) ....................................................................................... 33

PREHEARING CONFERENCES

administrative law judge, authority .................................................................. 8-43-207.5(2)

.................................................................................... 40

default of insurance obligation issue ................................................................ 8-43-409(1) ....................................................................................... 52

issues ................................................................................................................ 8-43-207.5(1) .................................................................................... 40

jurisdiction ....................................................................................................... 8-43-207.5(1) .................................................................................... 40

order ................................................................................................................. 8-43-207.5(3) .................................................................................... 40

procedure ......................................................................................................... 8-43-207.5(1) .................................................................................... 40

record of ........................................................................................................... 8-43-207.5(3) .................................................................................... 40

settlements ....................................................................................................... 8-43-206(1) ....................................................................................... 39

time limits ........................................................................................................ 8-43-207.5(1) .................................................................................... 40

PREMIUM COST CONTAINMENT (see COST CONTAINMENT) .......... 8-14.5-101 thru 109 ......................................................................... 1-2

PREMIUMS

approved by Commissioner ............................................................................. 8-44-104

........................................................................................... 59

based on payroll ............................................................................................... 8-45-107(1) ....................................................................................... 68

calculation for motor vehicle accidents ............................................................ 8-44-115(1) ....................................................................................... 62

calculation for occupations disease .................................................................. 8-46-105(2) ....................................................................................... 74

calculation for permanent total disability ......................................................... 8-46-105(1) ....................................................................................... 74

classification, notice of change

in rate ........................................................................................................... 8-44-109(1)

....................................................................................... 60

misclassifications, repayments for ................................................................... 8-44-108(1) ....................................................................................... 59

multiple injuries, calculation ............................................................................ 8-46-105(1) ....................................................................................... 74

occupational disease, calculation ..................................................................... 8-46-105(2) ....................................................................................... 74

per diem consideration ..................................................................................... 8-44-114 ........................................................................................... 61

places of employment, classification of ........................................................... 8-45-105(1) ....................................................................................... 68

premium cost containment program ................................................................. 8-44-112(1)(b) .................................................................................. 61

report and payment timeframes ........................................................................ 8-44-112(2) thru (3) .......................................................................... 61

surcharge .......................................................................................................... 8-44-112(1)(a) .................................................................................. 60

PREPONDERANCE OF EVIDENCE

conditions of independent trade ....................................................................... 8-40-202(2)(b)

.................................................................................... 6

credit for reduced disability ............................................................................. 8-46-307(1) ....................................................................................... 77

entitlement to benefits ...................................................................................... 8-43-201(1) ....................................................................................... 36

final disposition of utilization review. .............................................................. 8-43-501(2) ....................................................................................... 54

PRESUMPTION (see REBUTTABLE PRESUMPTION)

PREVIOUS DISABILITY OR IMPAIRMENT

AFFECTING COMPENSATION ................................................................ 8-42-104(1)

....................................................................................... 23

PRIMA FACIE

cease and desist order ....................................................................................... 8-43-409(3)

....................................................................................... 53

death after 2 years ............................................................................................ 8-41-207 ........................................................................................... 12

employee .......................................................................................................... 8-40-301(3) ......................................................................................... 7

independent contractor ..................................................................................... 8-40-202(2)(b) .................................................................................... 6

limitations on payments ................................................................................... 8-42-113(1) ....................................................................................... 31

repay benefits if ineligible ................................................................................ 8-42-113(1.5)(b) ............................................................................... 31

PROSTHETIC DEVICE

damage to ......................................................................................................... 8-42-101(1)(b)

.................................................................................. 18

petition for additional device ........................................................................... 8-42-101(1)(b) .................................................................................. 18

PROVIDER REVIEW AND DISCLOSURE ACT

definitions ........................................................................................................ 8-43-603(1) ....................................................................................... 56

due process ....................................................................................................... 8-43-605 ........................................................................................... 57

enforcement ..................................................................................................... 8-43-606 ........................................................................................... 57

filling with director .......................................................................................... 8-43-607 ........................................................................................... 57

legislative declaration ...................................................................................... 8-43-602 ........................................................................................... 56

performance programs ..................................................................................... 8-43-604(1) ....................................................................................... 56

QUALIFIED RESIDENCE ............................................................................... 8-41-402(1)

....................................................................................... 16

RADIOACTIVE MATERIALS

Find what you were looking for?

XXIII

disabled from exposure to ................................................................................ 8-41-304(2)....................................................................................... 14

time limits ........................................................................................................ 8-41-206 ........................................................................................... 12

RAILROADS ..................................................................................................... 8-41-201 ........................................................................................... 10

RATED AGE...................................................................................................... 8-43-204(6)....................................................................................... 39

RATES OF INSURANCE (see INSURANCE)

approved by commissioner of insurance .......................................................... 8-44-104

........................................................................................... 59

basis of for premiums of Pinnacol Assurance. ................................................. 8-45-107(1)....................................................................................... 68

not include penalties or damages ..................................................................... 8-43-304.5 ........................................................................................ 45

REAL ESTATE, agent or broker ....................................................................... 8-40-301(2), 8-41-401(5) ............................................................. 7, 15

REAL PROPERTY, repairs............................................................................... 8-41-402(1)....................................................................................... 16

REASONABLE AND NECESSARY MEDICAL TREATMENT ................. 8-42-101(1)(a) .................................................................................. 18

REBATES .......................................................................................................... 8-44-104 ........................................................................................... 59

REBUTTABLE PRESUMPTION

attorney fee agreement, violation of Code of Professional Responsibility ....... 8-43-403(2)....................................................................................... 48

attorneys fee, unreasonable .............................................................................. 8-43-403(1)....................................................................................... 48

cancer, firefighter ............................................................................................. 8-41-209(1)....................................................................................... 12

death, after two years ....................................................................................... 8-41-207 ........................................................................................... 12

deliverer of goods ............................................................................................ 8-41-401(1)(a)(II) ............................................................................. 15

dependents ....................................................................................................... 8-41-501(1)....................................................................................... 17

disability, after five years ................................................................................. 8-41-206 ........................................................................................... 12

hepatitis C ........................................................................................................ 8-41-208(1)....................................................................................... 12

independent contractor relationship ................................................................. 8-40-202(2)(a) .................................................................................... 6

occupational disease, firefighter ...................................................................... 8-41-209(1)....................................................................................... 12

permanent total disability ................................................................................. 8-40-201(16.5)(b) ............................................................................... 4

physician consent to treat employee ................................................................ 8-43-404(5)(a)(I)(B), 8-43-404(5)(a)(IV)(E) .............................. 49, 50

youth sports coach ........................................................................................... 8-40-202(2)(e)(1)................................................................................ 7

RECIPROCITY ................................................................................................. 8-41-212 ........................................................................................... 13

RECORDS

access to workers’ compensation files ............................................................. 8-42-125, 8-47-203(1) ................................................................ 34, 79

employer .......................................................................................................... 8-44-107, 8-47-208 ..................................................................... 59, 80

retention of claim records ................................................................................ 8-43-203(2)(c) .................................................................................. 37

RECORDS OF PROCEEDINGS ..................................................................... 8-43-311 ........................................................................................... 46

transcribed ....................................................................................................... 8-43-213(1)....................................................................................... 41

RECOVERY OF OVERPAYMENT ............................................................... 8-42-113.5(1).................................................................................... 31

collection of overpayment................................................................................ 8-43-306(1)....................................................................................... 45

notice to claimant of obligations ...................................................................... 8-43-203(1)(a) .................................................................................. 36

reopen award .................................................................................................... 8-43-303(1)....................................................................................... 44

RECREATIONAL ACTIVITY, of employee .................................................. 8-40-201(8), 8-40-301(1) ............................................................... 3, 7

REEMPLOYMENT OF WORKERS, premium dividend ............................... 8-42-107.6 ........................................................................................ 30

REFEREE (see ADMINISTRATIVE LAW JUDGE)

REHABILITATION (see VOCATIONAL REHABILITATION)

REJECTION OF ACT

agricultural corporations .................................................................................. 8-40-302(6)

......................................................................................... 8

appointed official ............................................................................................. 8-40-202(1)(a)(I)(B) ........................................................................... 4

corporate officers ............................................................................................. 8-41-202(1)....................................................................................... 10

limited liability member ................................................................................... 8-41-202(1)....................................................................................... 10

RELEASE OF CLAIM ..................................................................................... 8-42-124(1), 8-43-204(1) ........................................................... 33, 38

REMEDIES, surrender of ................................................................................... 8-41-104 ............................................................................................. 9

REMARRIAGE ................................................................................................. 8-42-120 ........................................................................................... 32

REOPEN ............................................................................................................ 8-43-303(1)....................................................................................... 44

burden of proof ................................................................................................ 8-43-303(4)....................................................................................... 45

medical benefits ............................................................................................... 8-43-303(2)(b) .................................................................................. 44

overpayments ................................................................................................... 8-43-303(1)....................................................................................... 44

permanent total ................................................................................................ 8-43-303(3)....................................................................................... 44

settlement ......................................................................................................... 8-43-204(1)....................................................................................... 38

REPORTS

employee report injury to employer ................................................................. 8-43-102(1)(a) .................................................................................. 34

employer report injury to division ................................................................... 8-43-101(1)....................................................................................... 34

of penalties imposed ........................................................................................ 8-43-304(3)....................................................................................... 45

of physicians, etc., as evidence ........................................................................ 8-43-210 ........................................................................................... 41

REQUIREMENT TO HAVE INSURANCE ................................................... 8-44-101(1)....................................................................................... 58

REVIEW OF AWARD (see APPEAL and PETITION TO REVIEW)

RESIDENTIAL REAL PROPERTY ............................................................... 8-41-402(1)....................................................................................... 16

RESPONSIBLE FOR TERMINATION .......................................................... 8-42-103(1)(g), 8-42-105(4)(a) .................................................. 23, 24

RETIREMENT BENEFITS

Find what you were looking for?

XXIV

offset ................................................................................................................ 8-42-103(1)(c)(II) ............................................................................. 22

notice to insurer ............................................................................................... 8-42-113.5(1) .................................................................................... 31

PERA ............................................................................................................... 8-42-103(1)(c)(II.5) .......................................................................... 22

received through collective bargaining agreement ........................................... 8-42-103(1)(c)(II)(B) ........................................................................ 22

REVERSIONARY INTERESTS ...................................................................... 8-44-116 ........................................................................................... 62

REVOCATION

bills for payment ............................................................................................... 8-42-101(3.6)(h) ............................................................................... 20

certificate of authority

public entity ................................................................................................. 8-44-204(8)

....................................................................................... 63

self-insurance pool ....................................................................................... 8-44-205(7) ....................................................................................... 64

corporate officer or member election to reject ................................................. 8-41-202(2) ....................................................................................... 10

license of insurer .............................................................................................. 8-44-106 ........................................................................................... 59

orders valid until .............................................................................................. 8-47-103 ........................................................................................... 78

payroll deduction ............................................................................................. 8-42-124(7) ....................................................................................... 34

physician accreditation ..................................................................................... 8-42-101(3.6)(g) ............................................................................... 20

utilization review committee recommend .................................................... 8-43-501(3)(c)(III) ............................................................................ 55

self-insurance permit ........................................................................................ 8-44-201(1) ....................................................................................... 62

REWARD TO SHERIFF .................................................................................. 8-42-113(1.5)(a) ............................................................................... 31

RIDESHARING, employment ........................................................................... 8-40-201(8) ......................................................................................... 3

RISKS, classification of ...................................................................................... 8-44-103 ........................................................................................... 59

RULES AND REGULATIONS

director adopts.................................................................................................. 8-47-107 ........................................................................................... 78

for medical treatment guidelines and impairment ratings ................................ 8-42-101(3.5)(a)(II) .......................................................................... 19

SAFETY DEVICE, failure to use ....................................................................... 8-42-112(1)(a)

.................................................................................. 30

SAFETY RULE

employer statement .......................................................................................... 8-42-112(3)

....................................................................................... 30

expedited hearing ............................................................................................. 8-42-112(4) ....................................................................................... 31

reduction computed .......................................................................................... 8-42-112(2) ....................................................................................... 30

violation of ....................................................................................................... 8-42-112(1)(b) .................................................................................. 30

SALARY CONTINUATION ............................................................................ 8-42-124(2)(a), (3), (4), (8).......................................................... 33-34

SANCTIONS ...................................................................................................... 8-43-207(1)(p) .................................................................................. 40

SCHEDULE OF SPECIFIC INJURIES .......................................................... 8-42-107(1)(b) .................................................................................. 25

SECOND INJURY (see SUBSEQUENT INJURY FUND)

SELECTION OF AN IME ................................................................................ 8-42-107.2(1)

.................................................................................... 28

procedural ........................................................................................................ 8-42-107.2(6) .................................................................................... 29

SELF-INFLICTED INJURIES......................................................................... 8-41-301(1)(c) .................................................................................. 13

SELF-INSURANCE (see INSURANCE)

SERVICE OF DOCUMENTS .......................................................................... 8-43-317

........................................................................................... 47

SERVICE OF PROCESS .................................................................................. 8-43-315(1) ....................................................................................... 46

SERVICES, loaning ........................................................................................... 8-41-303 ........................................................................................... 14

SETTLEMENT .................................................................................................. 8-43-204(1) ....................................................................................... 38

competency determination ............................................................................... 8-43-207(1)(m) ................................................................................. 40

conference procedures ..................................................................................... 8-43-206(1) ....................................................................................... 39

garnishment or administrative lien ................................................................... 8-43-204(4) ....................................................................................... 38

notice of, to employer ...................................................................................... 8-43-204(2) ....................................................................................... 38

reopen, fraud or mutual mistake of material fact ............................................. 8-43-204(1), 8-43-303(1) ............................................................ 38, 44

timely payment ................................................................................................ 8-43-204(7) ....................................................................................... 39

use of mortality tables ...................................................................................... 8-43-204(6) ....................................................................................... 39

SHERIFFS

as employees .................................................................................................... 8-40-202(1)(a)(I)(A) ........................................................................... 4

reward to .......................................................................................................... 8-42-113(1.5)(a) ............................................................................... 31

serve subpoena ................................................................................................. 8-43-315(1) ....................................................................................... 46

SILICOSIS ......................................................................................................... 8-41-304(1) ....................................................................................... 14

SKI AREA VOLUNTEER ................................................................................ 8-40-301(4) ......................................................................................... 8

SOCIAL SECURITY BENEFITS

effect on compensation .................................................................................... 8-42-103(1)(c)(I), 8-42-114 ........................................................ 22, 32

notice to insurer ............................................................................................... 8-42-113.5(1) .................................................................................... 31

SOLE PROPRIETOR, coverage ....................................................................... 8-40-302(5) ......................................................................................... 8

SPECIFIC FINDINGS ...................................................................................... 8-43-215(1) ....................................................................................... 42

SPECIAL FUNDS BOARD, creation, duties .................................................... 8-44-206(2) ....................................................................................... 65

STATE AVERAGE WEEKLY WAGE ........................................................... 8-47-106 ........................................................................................... 78

max. TTD, TPD, and PTD rate cannot exceed 91% of SAWW ....................... 8-42-105(1), 8-42-106(1), 8-42-111(1) ................................. 24, 25, 30

used to modify disfigurement rate .................................................................... 8-42-108(3) ....................................................................................... 30

Find what you were looking for?

XXV

used to modify scheduled compensation rate ................................................... 8-42-107(6)(b) .................................................................................. 26

used to set limit on combined temporary and perm. partial awards ................. 8-42-107.5 ........................................................................................ 30

STATE COMPENSATION INSURANCE AUTHORITY

(see COLORADO COMPENSATION INSURANCE AUTHORITY and PINNACOL ASSURANCE)

STATE TREASURER

bonds................................................................................................................ 8-45-119(1)

....................................................................................... 70

invest funds ...................................................................................................... 8-45-120, 8-46-103, 210, 308 ......................................... 70, 74, 76, 77

STATUTE OF LIMITATIONS

claim within 2 years ......................................................................................... 8-43-103(2)....................................................................................... 36

disability after 5 years ...................................................................................... 8-41-206 ........................................................................................... 12

exposure, 5 years ............................................................................................. 8-43-103(3)....................................................................................... 36

filing of penalty request ................................................................................... 8-43-203(2)(c) .................................................................................. 37

reasonable excuse, 3 years ............................................................................... 8-43-103(2)....................................................................................... 36

reopen .............................................................................................................. 8-43-303(1)....................................................................................... 44

STATUTORY EMPLOYER............................................................................. 8-41-401(1)(a)(I) .............................................................................. 14

cost of insurance .............................................................................................. 8-41-401(1)(b) .................................................................................. 15

exclusion for independent contractor ............................................................... 8-41-401(3)....................................................................................... 15

STRESS (see MENTAL IMPAIRMENT)

STUDENT

compensation rate ............................................................................................ 8-40-202(1)(a)(VI)

.......................................................................... 5-6

contract capacity .............................................................................................. 8-40-202(1)(a)(VI)(b) ......................................................................... 6

dependent ......................................................................................................... 8-41-501(1)(c) .................................................................................. 17

intern program ................................................................................................. 8-40-302(7)(a) .................................................................................... 8

work study ....................................................................................................... 8-40-202(1)(a)(IV) thru (V)................................................................ 5

SUBCONTRACTOR (see CONTRACTORS AND LESSEES)

SUBLESSEE (see CONTRACTORS AND LESSEES)

SUBPOENA

director issue .................................................................................................... 8-43-207(1)(a)

.................................................................................. 40

fee for service of .............................................................................................. 8-43-315(1)....................................................................................... 46

issuance of ....................................................................................................... 8-43-315(1)....................................................................................... 46

penalty for failure to appear ............................................................................. 8-43-315(3)....................................................................................... 47

service of ......................................................................................................... 8-43-315(1)....................................................................................... 46

witness, failure to appear ................................................................................. 8-43-212 ........................................................................................... 41

witness fees and mileage .................................................................................. 8-43-315(1)....................................................................................... 46

SUBROGATION ............................................................................................... 8-41-203(1)(a) .................................................................................. 10

attorney fees ..................................................................................................... 8-41-203(1)(e), 8-41-203(4)(d) .................................................. 10, 11

future benefits .................................................................................................. 8-41-203(1)(d) .................................................................................. 10

litigation notice ................................................................................................ 8-41-203(4)(a) ............................................................................. 11-12

non-economic damages .................................................................................... 8-41-203(1)(d) .................................................................................. 10

recovery ........................................................................................................... 8-41-203(1) thru (4) ..................................................................... 10-11

settlement demand notice ................................................................................. 8-41-203(4)(a) ............................................................................. 11-12

SUBSEQUENT INJURY .................................................................................. 8-42-104(5)....................................................................................... 23

SUBSEQUENT INJURY FUND

abatement of taxes ........................................................................................... 8-46-106

........................................................................................... 74

closure of fund ................................................................................................. 8-46-104 ........................................................................................... 74

SUPPLEMENTAL ORDER ............................................................................. 8-43-301(5)....................................................................................... 43

SUPPORT PAYMENTS ................................................................................... 8-42-124(1), (6), 8-43-204(4) ............................................... 33, 34, 38

SUPREME COURT, review Court of Appeals decision ................................... 8-43-313 ........................................................................................... 46

SURCHARGE

allocation to subsequent injury and major medical insurance funds ................ 8-46-102(2)(a)(I) .............................................................................. 72

failure to pay ...... ............................................................................................. 8-44-112(4) thru (6) .......................................................................... 61

premium cost containment ............................................................................... 8-44-112(1)(b)(I) .............................................................................. 61

purpose ............................................................................................................ 8-44-112(1)(a) .................................................................................. 60

report and payment timeframes ...................................................................... 8-44-112(2) thru (3) .......................................................................... 61

SURGEONS (see PHYSICIANS)

SURGICAL SUPPLIES .................................................................................... 8-42-101(1)(a) .................................................................................. 18

SURRENDER OF REMEDIES ........................................................................ 8-41-104 ............................................................................................. 9

SURVEY upon closure of claim ......................................................................... 8-43-220(1)....................................................................................... 42

SUSPENSION OF LICENSE, insurer .............................................................. 8-44-106 ........................................................................................... 59

TECHNICALITIES, orders not void ................................................................. 8-47-104

........................................................................................... 78

TEMPORARY DISABILITY ........................................................................... 8-42-103(1), 105(1) thru 106(1) ............................................ 22, 24-25

(see BENEFITS and DISABILITY)

TEMPORARY PARTIAL DISABILITY (see BENEFITS and DISABILITY)

TEMPORARY HELP CONTRACTING FIRM

Find what you were looking for?

XXVI

definition .......................................................................................................... 8-40-201(18.5) .................................................................................... 4

termination of temporary total ......................................................................... 8-42-105(3)(d)(I) .............................................................................. 24

termination of temporary partial ...................................................................... 8-42-106(2)(b)(II) ............................................................................. 25

TERMINATION

death benefits ................................................................................................... 8-42-120 ........................................................................................... 32

employment, resulting wage loss ..................................................................... 8-42-103(1)(g), 8-42-105(4) ....................................................... 23, 24

for cause ........................................................................................................... 8-42-103(1)(g), 8-42-105(4) ....................................................... 23, 24

temporary disability ......................................................................................... 8-42-105(3) ....................................................................................... 24

vocational rehabilitation ................................................................................... 8-42-105(1) ....................................................................................... 24

THIRD PERSON LIABILITY ......................................................................... 8-41-203(1)(a) .................................................................................. 10

limit damages ................................................................................................... 8-41-401(3) ....................................................................................... 15

TIME LIMITS (see TIME REQUIREMENTS)

admit or contest liability .................................................................................. 8-43-203(1)(a)

.................................................................................. 36

appeal (see APPEAL)

C.C.I.A. cancellation of policy......................................................................... 8-45-113

........................................................................................... 69

claim for compensation .................................................................................... 8-43-103(2) ....................................................................................... 36

compensation, commencement ........................................................................ 8-42-103(1) ....................................................................................... 22

contest or admit liability .................................................................................. 8-43-203(1)(a) .................................................................................. 36

death, after two years, presumption ................................................................. 8-41-207 ........................................................................................... 12

dependency, when rights determined ............................................................... 8-41-503(1) ....................................................................................... 17

dependent make claim ...................................................................................... 8-43-103(1) ....................................................................................... 35

disability after five years, presumption ............................................................ 8-41-206 ........................................................................................... 12

employee claim compensation ......................................................................... 8-43-103(2) ....................................................................................... 36

employee report injury ..................................................................................... 8-43-102(1)(a) .................................................................................. 34

employer, defaulting, file bond ........................................................................ 8-43-408(2) ....................................................................................... 52

report injury ................................................................................................. 8-43-101(1) ....................................................................................... 34

other information ..................................................................................... 8-43-103(1) ....................................................................................... 35

failure to admit or contest ................................................................................ 8-43-203(2) ....................................................................................... 37

injury

reported by employee ................................................................................... 8-43-102(1)(a) .................................................................................. 34

penalty ...................................................................................................... 8-43-102(1)(a) .................................................................................. 34

reported by employer ................................................................................... 8-43-101(1) ....................................................................................... 34

insurer, admit or contest liability ..................................................................... 8-43-203(1)(a) .................................................................................. 36

file notice of insurance ................................................................................. 8-44-101(1)(b) .................................................................................. 58

lump sums, application for ............................................................................... 8-43-406(1) ....................................................................................... 51

notice to insurer of award................................................................................. 8-42-113.5(1) .................................................................................... 31

request for penalties ......................................................................................... 8-43-304(5) ....................................................................................... 45

request selection of an IME ............................................................................. 8-42-107.2(2)(b) ............................................................................... 28

waiting period, commencement of benefits ..................................................... 8-42-103(1)(a), (b) ............................................................................ 22

TIME REQUIREMENTS (see TIME LIMITS)

amendment of compensation rates ................................................................... 8-45-112

........................................................................................... 69

information or reports from employer .............................................................. 8-47-201 ........................................................................................... 79

immediate

Court of Appeals transmit record ................................................................... 8-43-311

........................................................................................... 46

employer notify director of fatal injury .......................................................... 8-43-103(1) ....................................................................................... 35

employer notify director of injury of 3 or more ............................................. 8-43-103(1) ....................................................................................... 35

four days

employee report injury to employer ............................................................... 8-43-102(1)(a)

.................................................................................. 34

five days

division review of IME .................................................................................. 8-42-107.2(4)(a)

............................................................................... 29

notice to parties of application for lump sum ................................................. 8-43-406(1) ....................................................................................... 51

upon showing to District Court of refusal to comply with

order or testify, show cause order returnable ............................................ 8-47-102

........................................................................................... 78

ten days

advance cost of IME ...................................................................................... 8-42-107.2(5) .................................................................................... 29

director may extend time for filing admission or denial ................................ 8-43-203(2)(d) .................................................................................. 37

employers notify division of compensable injury .......................................... 8-43-101(1), 8-43-103(1) ............................................................ 34, 35

non-insured employer’s bond for compensation filed .................................... 8-43-408(2) ....................................................................................... 52

notice to set mailed ........................................................................................ 8-43-211(2)(c) .................................................................................. 41

prehearing jurisdiction prior formal adjudication ........................................... 8-43-207.5(1) .................................................................................... 40

fourteen days

disability indemnity payable from the date of loss ......................................... 8-42-103(1)(b)

.................................................................................. 22

terminate vocational rehabilitation ................................................................. 8-42-105(1) ....................................................................................... 24

fifteen days

division transmit record ................................................................................. 8-43-301(7)

....................................................................................... 43

Find what you were looking for?

XXVII

insurer provide copy of claim file .................................................................. 8-43-203(4)....................................................................................... 38

lump sum settlement payable ......................................................................... 8-43-204(7)....................................................................................... 39

public entity show cause ................................................................................ 8-44-204(8)....................................................................................... 63

recalculate AWW and pay at adjusted rate .................................................... 8-42-103(2)....................................................................................... 23

self-insured pools show cause ........................................................................ 8-44-205(7)....................................................................................... 64

twenty days

admit or deny liability .................................................................................... 8-43-203(1)(a)

.................................................................................. 36

admission for contested medical maintenance < 20 days before hearing ....... 8-42-101(5)....................................................................................... 21

cure violation ................................................................................................. 8-43-304(4)....................................................................................... 45

determine permanent impairment .................................................................. 8-42-107(8)(b.5)(I)(A)...................................................................... 27

evidence exchange ......................................................................................... 8-43-210 ........................................................................................... 41

extension hearing date in certain cases .......................................................... 8-43-209(2)....................................................................................... 41

extension of hearing date ............................................................................... 8-43-209(2)....................................................................................... 41

file admission or request hearing after IME ................................................... 8-42-107.2(4)(c) ............................................................................... 29

file briefs ........................................................................................................ 8-43-301(4)....................................................................................... 43

first installment paid ...................................................................................... 8-42-105(2)(a) .................................................................................. 24

notice to insurer of award .............................................................................. 8-42-113.5(1)(a) ............................................................................... 31

petition to review ........................................................................................... 8-43-301(6)....................................................................................... 43

request change of physician ........................................................................... 8-43-404(5)....................................................................................... 49

revision of deficiencies in Division independent

medical examination report .......................................................................... 8-42-107.2(4)

.................................................................................... 29

twenty-one days

Court of Appeals action commenced ............................................................. 8-43-301(10)

..................................................................................... 43

twenty-five days

Court of Appeals return Industrial Claim Appeals Panel records .................. 8-43-311

........................................................................................... 46

filing of transcript .......................................................................................... 8-43-213(2)....................................................................................... 42

thirty days

contest final admission................................................................................... 8-43-203(2)(b)(II) ............................................................................. 37

corrected order ............................................................................................... 8-43-302(1)....................................................................................... 44

funeral benefits paid....................................................................................... 8-42-123 ........................................................................................... 33

heard by Court of Appeals ............................................................................. 8-43-309 ........................................................................................... 46

Industrial Claim Appeals Panel extend order entry........................................ 8-43-301(9)....................................................................................... 43

negotiate selection of an IME ........................................................................ 8-42-107.2(3).................................................................................... 28

notice of cancellation of policy ...................................................................... 8-44-110 ........................................................................................... 60

notice of cancellation of warrant .................................................................... 8-45-118(2)....................................................................................... 70

notice of failure to prosecute .......................................................................... 8-43-207(1)(n) .................................................................................. 40

notice of hearing ............................................................................................ 8-43-211(1)....................................................................................... 41

notice of occupational disease

or death from occupational disease ............................................................ 8-43-102(2)

....................................................................................... 35

mediation conference ..................................................................................... 8-43-205(1)....................................................................................... 39

payment of benefits after appeals ................................................................... 8-43-401(2)(a) .................................................................................. 47

request selection of an IME ........................................................................... 8-42-107.2(2)(b) ............................................................................... 28

supplemental order ......................................................................................... 8-43-301(4)....................................................................................... 43

written order .................................................................................................. 8-43-215(1)....................................................................................... 42

thirty-five days

to commence action for review absent panel order ........................................ 8-43-301(11)

..................................................................................... 43

forty days

utilization review appeal ................................................................................ 8-43-501(5)(c)

.................................................................................. 55

forty-five days

request expedited hearing .............................................................................. 8-42-105(2)(a), 8-43-203(1)(a)

................................................... 24, 36

sixty days

Industrial Claim Appeals Panel .................................................................... 8-43-301(8), (11)

.............................................................................. 43

exposure to harmful quantities ..................................................................... 8-41-304(1)....................................................................................... 14

extension hearing date in certain cases ........................................................ 8-43-209(1)....................................................................................... 41

set expedited hearing ................................................................................... 8-43-203(1)(a) .................................................................................. 36

Supreme Court final decision ....................................................................... 8-43-313 ........................................................................................... 46

ninety days

chiropractic treatments ................................................................................. 8-42-101(3)(a)(III)

............................................................................ 19

one-time change in designated physician ..................................................... 8-43-404(5)(a)(III)(A) ...................................................................... 50

waiver of release of information .................................................................. 8-47-203(1)(e) .................................................................................. 80

one hundred twenty days

hearing completed ........................................................................................ 8-43-209(1)

....................................................................................... 41

six months

extraterritorial provisions apply

unless extended ........................................................................................ 8-41-204

........................................................................................... 12

failure to prosecute....................................................................................... 8-43-207(1)(n) .................................................................................. 40

offer lump sum after .................................................................................... 8-43-406(1)....................................................................................... 51

Find what you were looking for?

XXVIII

unclaimed warrant canceled ......................................................................... 8-45-118(1) ....................................................................................... 70

twenty-four months

request Division independent medical examination to determine MMI ....... 8-42-107(8)(b)(II), (III

) .................................................................... 26

one year

manager tabulate earned premiums and losses ............................................. 8-45-112

........................................................................................... 69

recovery of overpayment ............................................................................. 8-42-113.5(1) .................................................................................... 31

request for penalties filed ............................................................................. 8-43-304(5) ....................................................................................... 45

two years

claim barred unless filed within ................................................................... 8-43-103(2)

....................................................................................... 36

death, prima facie not due to injury .............................................................. 8-41-207 ........................................................................................... 12

death benefits, remarriage, no dependents ................................................... 8-42-120 ........................................................................................... 32

reopen after date of last payment ................................................................. 8-43-303(2)(a) .................................................................................. 44

reopen after last medical benefit .................................................................. 8-43-303(2)(b) .................................................................................. 44

three years

accreditation of physicians ........................................................................... 8-42-101(3.6)(f)

................................................................................ 20

fund audited ................................................................................................. 8-45-121(4) ....................................................................................... 71

reasonable excuse or claim barred ............................................................... 8-43-103(2) ....................................................................................... 36

five years

disability conclusively presumed not due to

accident, except radioactive materials ...................................................... 8-41-206

........................................................................................... 12

notice claiming compensation for exposure ................................................. 8-43-103(3) ....................................................................................... 36

six years

director reopen after date of injury ............................................................... 8-43-303(1)

....................................................................................... 44

permanent total – death not a proximate result............................................. 8-42-116(1)(a) .................................................................................. 32

termination of right to benefits, death .......................................................... 8-42-120 ........................................................................................... 32

seven years

request for penalty filed ............................................................................... 8-43-203(2)(c)

.................................................................................. 37

retention of division claim records ............................................................... 8-43-203(2)(c) .................................................................................. 37

TIPS ................................................................................................................. 8-40-201(19)(a) .................................................................................. 4

TRAINING PROGRAM

as employer ...................................................................................................... 8-40-302(7)(b) .................................................................................... 9

of government, employee ................................................................................. 8-40-202(1)(a)(III) .............................................................................. 5

TRANSCRIPTS ................................................................................................. 8-43-213(1) ....................................................................................... 42

appeal ............................................................................................................... 8-43-301(2) ....................................................................................... 43

received in evidence when ............................................................................... 8-43-214 ........................................................................................... 42

TREASURER, invest funds................................................................................ 8-45-120(1), 8-46-103(1), 210(1), 308(1) ....................... 70, 74, 76, 77

TREATING PHYSICIAN (AUTHORIZED)

change of physician

one time change ........................................................................................... 8-43-404(5)(a)(III)

............................................................................ 50

request in writing ......................................................................................... 8-43-404(5)(a)(VI) ........................................................................... 50

communication with employer ......................................................................... 8-43-404(5)(c) .................................................................................. 51

determine maximum medical improvement (MMI) ......................................... 8-42-107(8)(b)(I) .............................................................................. 26

determine medical impairment ......................................................................... 8-42-107(8)(c) .................................................................................. 27

determine no impairment ................................................................................. 8-42-101(3.6)(b), 8-42-107(8)(c) ................................................ 19, 27

dispute maximum medical improvement determination by ............................. 8-42-107(8)(b)(II) ............................................................................. 26

dispute medical impairment determination by ................................................. 8-42-107(8)(c) .................................................................................. 27

dispute non-determination of MMI by ............................................................. 8-42-107(8)(b)(II) ............................................................................. 26

insurer not liable for unauthorized treatment ................................................... 8-43-404(7) ....................................................................................... 51

recommend medical benefits after MMI .......................................................... 8-42-107(8)(f) ................................................................................... 28

TRUCK DRIVERS ............................................................................................ 8-41-401(6) ....................................................................................... 16

TRUST FUND

minor dependents ............................................................................................. 8-42-122

........................................................................................... 33

self-insured pools ............................................................................................. 8-44-205(11) ..................................................................................... 64

set expedited hearing ........................................................................................ 8-43-203(1)(a) .................................................................................. 36

when unpaid compensation threatened ............................................................ 8-47-105(1) ....................................................................................... 78

UNACCRUED COMPENSATION .................................................................. 8-42-116(1), 8-42-117(1)

.................................................................. 32

UNEMPLOYMENT COMPENSATION OFFSET ........................................ 8-42-103(1)(f) ................................................................................... 23

UNINSURED (see FAILURE TO INSURE)

UNINSURED EMPLOYER FUND .................................................................. 8-67-105

........................................................................................... 83

adopted rules .................................................................................................... 8-67-107(1)(f) ................................................................................... 84

application to fund ........................................................................................... 8-67-109(2) ....................................................................................... 84

assigned his or her rights .................................................................................. 8-67-109(1) ....................................................................................... 84

benefit rates ...................................................................................................... 8-67-107(1)(b) .................................................................................. 84

disfigurement ............................................................................................... 8-67-107(1)(b)(VII) ......................................................................... 84\

Find what you were looking for?

XXIX

death benefits ............................................................................................... 8-67-107(1)(b)(IV) ........................................................................... 84

funeral benefits ............................................................................................ 8-67-107(1)(b)(II) ............................................................................. 84

medical benefits ........................................................................................... 8-67-107(1)(b)(I) .............................................................................. 84

permanent total disability ............................................................................. 8-67-107(1)(b)(V) ............................................................................ 84

temporary disability ..................................................................................... 8-67-107(1)(b)(III) ........................................................................... 84

benefits ............................................................................................................ 8-67-109 ........................................................................................... 84

board ................................................................................................................ 8-67-103(1), 8-67-106 ...................................................................... 83

cooperate with the board .................................................................................. 8-67-109(1)....................................................................................... 84

covered claim ................................................................................................... 8-67-103(2)....................................................................................... 83

creditor in a bankruptcy ................................................................................... 8-67-109(3)....................................................................................... 84

death, payment to ............................................................................................. 8-46-102(1)(a) ................................................................................. 72

definitions ........................................................................................................ 8-67-103 ........................................................................................... 83

deny entry ........................................................................................................ 8-67-107(2)(f) ................................................................................... 84

designate a new authorized treating physician ................................................. 8-67-112(2)....................................................................................... 85

do not include any penalties ............................................................................. 8-67-109(2)....................................................................................... 84

exclusions ........................................................................................................ 8-67-104 ........................................................................................... 82

fraudulent activity ............................................................................................ 8-67-107(2)(f) ................................................................................... 84

funding ............................................................................................................. 8-67-105(2)....................................................................................... 83

individual who is responsible for obtaining ..................................................... 8-67-104(1)(d) .................................................................................. 83

insolvent employer ........................................................................................... 8-67-109(7)....................................................................................... 85

intervene as a party .......................................................................................... 8-67-107(2)(b), 8-67-113(2) ....................................................... 84, 85

multiple employers .......................................................................................... 8-67-111(2)....................................................................................... 85

notification of uninsured claims ....................................................................... 8-67-113(2)....................................................................................... 85

obligation of the employer ............................................................................... 8-67-109(8)....................................................................................... 85

opportunity to join the claim ............................................................................ 8-67-113(3)....................................................................................... 86

powers of the board ......................................................................................... 8-67-107 ........................................................................................... 84

reduction of benefits ........................................................................................ 8-67-111(3), (4) ................................................................................ 85

treated as benefits paid by an insurer or self-insured employer ....................... 8-67-111(1)....................................................................................... 85

Uninsured Employer Act ................................................................................. 8-67-101 ........................................................................................... 83

uninsured employer penalty ............................................................................. 8-43-408(5)....................................................................................... 52

voluntarily rejected .......................................................................................... 8-67-104(1)(e) .................................................................................. 83

UTILIZATION REVIEW

administrative law judge give great weight...................................................... 8-43-501(5)....................................................................................... 55

appeal from ...................................................................................................... 8-43-501(5)....................................................................................... 55

committee recommendations ........................................................................... 8-43-501(3)(c)(I) .............................................................................. 55

de novo hearing................................................................................................ 8-43-501(5)....................................................................................... 55

director give great weight ................................................................................ 8-43-501(3)(d) .................................................................................. 55

fees, costs ......................................................................................................... 8-43-501(2)(a) .................................................................................. 54

medical record defined ..................................................................................... 8-43-501(2)(d) .................................................................................. 54

new provider .................................................................................................... 8-43-501(4)....................................................................................... 55

no hearing request until final ........................................................................... 8-43-501(2)(e) .................................................................................. 54

physician accreditation revocation ................................................................... 8-43-501(3)(c)(III)............................................................................ 55

privilege waived............................................................................................... 8-43-404(6)....................................................................................... 51

provider removed for 3 years ........................................................................... 8-43-501(3)(e) .................................................................................. 55

purpose ............................................................................................................ 8-43-501(1), 8-43-503(1) ........................................................... 54, 56

UTILIZATION REVIEW COMMITTEES

appointment to ................................................................................................. 8-43-501(3)(a) .................................................................................. 54

recommendations ............................................................................................. 8-43-501(3)(c)(I) .............................................................................. 55

retroactive denial of payment ........................................................................... 8-43-501(3)(c)(II) ............................................................................. 55

revocation of accreditation ............................................................................... 8-43-501(4), 8-43-503(2) ........................................................... 55, 56

VIOLATIONS OF ACT

construction work proof of coverage .............................................................. 8-41-404(1)(a)

.................................................................................. 16

defaulting employers........................................................................................ 8-43-409(1)....................................................................................... 52

each day separate offense................................................................................. 8-43-305 ........................................................................................... 45

failure to timely admit or deny liability ........................................................... 8-43-203(2)(a) .................................................................................. 37

failure to timely pay or challenge a medical billing ......................................... 8-43-401(2)(a) .................................................................................. 47

failure to timely pay permanent partial disability benefits ............................... 8-43-401(2)(a) .................................................................................. 47

financial incentives to deny or delay claim ...................................................... 8-43-401.5(1).................................................................................... 47

repeated violation of the act ............................................................................. 8-43-304(1.5).................................................................................... 45

suspension or revocation of license of insurer ................................................ 8-44-106 ........................................................................................... 59

violation where no penalty specifically provided ........................................... 8-43-304(1)....................................................................................... 45

VOCATIONAL REHABILITATION

election to waive .............................................................................................. 8-43-407 ........................................................................................... 52

evaluation......................................................................................................... 8-43-404(1)(a), (3)...................................................................... 48, 49

Find what you were looking for?

XXX

refuse offer ....................................................................................................... 8-42-111(3) ....................................................................................... 30

report as evidence ............................................................................................ 8-43-210 ........................................................................................... 41

termination ....................................................................................................... 8-42-105(1) ....................................................................................... 24

VOLUNTEER .................................................................................................... 8-40-202(1)(a)(I)(A) ........................................................................... 4

boards ............................................................................................................... 8-40-302(2) ......................................................................................... 8

compensation ................................................................................................... 8-40-202(1)(a)(II) ............................................................................... 5

compensation rate ............................................................................................ 8-40-202(1)(a)(VI)(b) ......................................................................... 6

employee status ................................................................................................ 8-40-202(1)(a)(I)(A) ........................................................................... 4

fire department ................................................................................................. 8-40-202(1)(a)(I)(A) ........................................................................... 4

rescue teams ..................................................................................................... 8-40-202(1)(a)(I)(A) ........................................................................... 4

ski area ............................................................................................................. 8-40-301(4) ......................................................................................... 8

WAITING PERIOD AFTER LEAVING WORK ........................................... 8-42-103(1)(a), (b)

............................................................................ 22

WAGES

“at the time of injury” ...................................................................................... 8-42-102(5)(a)

.................................................................................. 22

average weekly computation ............................................................................ 8-42-102(2) ....................................................................................... 21

assignment, attachment .................................................................................... 8-42-124(1), 8-43-204(4) ............................................................ 33, 38

board and lodging included .............................................................................. 8-40-201(19)(b) .................................................................................. 4

continuation by employer................................................................................. 8-42-124(2)(a), (3), (4), (8).......................................................... 33-34

defined ............................................................................................................. 8-40-201(19)(a) .................................................................................. 4

hourly, computation ......................................................................................... 8-42-102(2)(d) .................................................................................. 21

items excluded ................................................................................................. 8-40-201(19)(b) .................................................................................. 4

included............................................................................................................ 8-40-201(19)(b) .................................................................................. 4

monthly computation ....................................................................................... 8-42-102(2)(a) .................................................................................. 21

payroll deductions ............................................................................................ 8-42-124(7) ....................................................................................... 34

per diem, computation ..................................................................................... 8-42-102(2)(c) .................................................................................. 21

per diem, defined ............................................................................................. 8-40-201(19)(c) .................................................................................. 4

per mile, computation ...................................................................................... 8-42-102(2)(f) ................................................................................... 21

piecework, commission .................................................................................... 8-42-102(2)(e) .................................................................................. 21

used as basis for computation .......................................................................... 8-42-102(1) ....................................................................................... 21

weekly computation ......................................................................................... 8-42-102(2)(b) .................................................................................. 21

other method ................................................................................................ 8-42-102(3) ....................................................................................... 21

minors .......................................................................................................... 8-42-102(4) ....................................................................................... 21

WAIVER

compensation ................................................................................................... 8-41-205 ........................................................................................... 12

doctor-patient privilege .................................................................................... 8-47-203(1) ....................................................................................... 79

medical issues raised by claim ......................................................................... 8-43-404(6) ....................................................................................... 51

release of information ...................................................................................... 8-47-203(1)(e) .................................................................................. 80

WARRANTS, state treasurer .............................................................................. 8-45-118(1) ....................................................................................... 70

WHOLE PERSON IMPAIRMENT ................................................................. 8-42-107(8) ....................................................................................... 26

calculation ........................................................................................................ 8-42-107(8)(d) .................................................................................. 28

WIDOW OR WIDOWER, presumed wholly dependent .................................. 8-41-501(1) ....................................................................................... 17

WITNESSES

competency determination ............................................................................... 8-43-207(1)(m)

................................................................................. 40

costs assessed ................................................................................................... 8-43-315(1) ....................................................................................... 46

failure to appear ............................................................................................... 8-43-212 ........................................................................................... 41

mileage ............................................................................................................. 8-43-315(1) ....................................................................................... 46

subpoena .......................................................................................................... 8-43-315(1) ....................................................................................... 46

WORKER’S CLAIM......................................................................................... 8-43-103(1) ....................................................................................... 35

WORKERS’ COMPENSATION CASH FUND

accept monies ................................................................................................... 8-42-101(3.6)(q) ............................................................................... 20

creation ............................................................................................................ 8-44-112(7)(a) .................................................................................. 61

construction work proof of coverage violation ................................................ 8-41-404(3) ....................................................................................... 16

defaulting employers, fines collected ............................................................. 8-43-409(7) ....................................................................................... 53

discretionary apportionment of fines................................................................ 8-43-304(1), 8-43-401(2)(a) ....................................................... 45, 47

repeated violations, fines imposed ................................................................... 8-43-304(1.5)(b) ............................................................................... 45

WORKERS’ COMPENSATION CLASSIFICATION APPEALS BOARD

creation ............................................................................................................ 8-55-101(1) ....................................................................................... 81

expenses ........................................................................................................... 8-55-101(5) ....................................................................................... 81

hearings ............................................................................................................ 8-55-103(1) ....................................................................................... 81

immunity .......................................................................................................... 8-55-101(6) ....................................................................................... 81

notice of appeal procedures .............................................................................. 8-55-102 ........................................................................................... 81

repeal ............................................................................................................... 8-55-105(1) ....................................................................................... 82

review of board decisions ................................................................................ 8-55-104(1) ....................................................................................... 82

secretary, duties ............................................................................................... 8-55-103(4) ....................................................................................... 82

terms ................................................................................................................ 8-55-101(3) ....................................................................................... 81

Find what you were looking for?

XXXI

vacancy ............................................................................................................ 8-55-101(4)....................................................................................... 81

WORK EXPERIENCE ASSIGNMENT .......................................................... 8-40-202(1)(a)(III) thru (IV) .............................................................. 5

WORKING PARTNER, coverage .................................................................... 8-44-102(1)....................................................................................... 58

WORK PLACE SAFETY STUDY ................................................................... 8-14.5-107.5(1) ................................................................................... 2

WORK STUDY .................................................................................................. 8-40-202(1)(a)(IV) thru (V)................................................................ 5

employer .......................................................................................................... 8-40-302(7)(b) .................................................................................... 9

liability ............................................................................................................. 8-40-302(7)(a) .................................................................................... 8

Find what you were looking for?