When will they pay him?

My son got hurt at work, filed a work comp claim, decided to hire an attorney, atty involved but still no payment from the insurance work comp people.  He finally got to stop therapy and does not need surgery.  Cortisone/therapy took care of his problem. 

He still has not received any payment.  It's been over 90 days since he filed his work comp claim.  Does anyone here know?  Thanks.

Some of this stuff take a very long time and  employers side may like to stall it out  .

And as a practical matter a smaller claim may have less urgency with his own attorney

Odds are if he was injured on the job his coverage will come thru .

What is he doing now--is he back at work?

Yes, he's working in another job for another company doing something completely different.  It's a better job but it pays less than the job he got hurt at.  He doesn't even want to go back to the job he got hurt at because it was just a seasonal job and it was very physically demanding.  He got released by the specialist and now he just has one more appointment with the work comp doctor, who I'm sure will release him too. 

So, hopefully after he's released the work comp will finally pay him for all his lost wages.  If he lived on his own he would be out on the street under a bridge, waiting for these jerks to pay him.  It's awful they can get away with this and treat people like this.  He's just fortunate he still lives at home. 

I tried posting a reply yesterday, but I guess the moderator didn't like what I wrote.  Yes, my son is working again in a different job with less pay, but he likes the job and it's not so physically demanding.  Plus the job he got hurt at was a seasonal job and probably gonna end in Nov/Dec, but the boss said when he first got hired for them that he would probably be hired as a permanent employee.  But, then he got hurt from the repetitive duties.  So, he's better off not working for the slave drivers.

Wouldn't the work comp ins. company pay him for loss wages once the work comp doctor releases him?  All the doctors, theirs included, said it was a work related injury due to repetitive duties. 

(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

There is some information missing here... you did not say how long he was off work due to the injury.  There is a 3 day waiting period where no benefits are due,  There is no money in WC for total lost wages.

You can find more on Disablitiy Benefits in CO WC here http://www.colorado.gov/cs/Satellite?c=Page&childpagename=CDLE-WorkComp%2FCDLELayout&cid=1251567599426&pagename=CDLEWrapper#Temporary_total_disability. You may want to pay special attention to Scheduled Loss impairment benefits... once he is rated for PPD, a number of weeks indemnity beneftis will be determined.  IF there is no PPD, there will be no award.

The carrier could and likely will make an offer to cash out his claim... just know that if he take money for future medical care...HE will be responsible for any treatment to this injured body part. He cannot use his own health ins coverage to pay for treatment. HE would be responsible out of his pocket.

He's been out of work for 4 months.  They have never paid him anything for his wage losses.  He won't have any perm. partial disability from his injury.  He says he is fully healed. 

You wrote that he cannot use his health insurance to pay for future treatment, if any is ever needed for his injured body part, is that true even if he gets back to normal now? 

So, even if he feels fine, should he continue to see their work comp doctor at least once per year to keep his claim open for any future problems if they should arise?

Steve - How does my son keep his medical benefits open in case his arm acts up again?  Thanks.

The underlying premise in WC is liability... the employers, you can't claim industrial injury, recover, and then say it's not industrial. That's why you don't use your own insurance... same premise....if you are injured on your own...you are responsible for the cost of treatment, you have insurance, just like your ER, to limit your out of pocket costs.

If he is completely recovered and returns to work there won't be any "settlement" money... for indemnity. The carrier will probably make an offer to close out the claim...including medical.

He can leave the claim open...with access to future medical care. You'd have to read the CO statutes to see how long. And/or if he needs to continue to see a Dr.

Some states allow a claim to administratively close after a year or two from the last payment of benefits. Indemnity or medical care.

Steve - I can't find the info in the CO statutes.  If he accepts an offer to close out the claim, including medical, if he has future medical problems with that arm does he pay out of his own pocket? Thanks.

The link to CO WC statutes is in the 4th reply to your org post.

If he accepts money for future medical... yes, he'd pay out of his pocket, that's what the money is for.  There are a couple ways to settle a comp claim, Stipulations...where the parties agree on the outstanding issues, ie PPD indemenity due, and access to future medical care.     A court ordered award, basically a stipulation, a judge makes the decision because the parties can't... or a C&R/Compromise and Release, the IW "compromises" on the outstanding issues, ie a "todays dollars'' on indemnity due, and a cash payment for anticiapted medical care. The IW is agreeing to accept liability, out of pocket for medical. There no entitlement for future medical dollars. But you are still claming industrial injury, and cannot use your own ins. It would be double dipping.

Thanks Steve.  So even if he gets cleared now by his doctors, he may still get offered the above stipulations?  That's good to know.  When the time comes, we will talk to his attorney about this stuff, cuz his arm injury may act up in the future, you never know.  You've been very helpful.

Ya, when I looked at the CE WC statutes you put in reply 4 I still couldn't find the medical provisions, I must be blind.....  Can you please tell me where exactly it is on that?  Thanks again.

When you take money to close a claim, it is closed. There are few if any states that permit a C&Rd claim to be reopened... that is why it's called a "Compromise and Release"...

Only with a stipulated agreement would be medical remain open.

There is no law that say 'pay out of pocket'...but a GHP will not accept or pay for a industrial injury, the reason is the employer carries the liability...until you take cash. You aren't going to find what you are looking for in the statutes. You're not blind.  However, if you look under "settlements" instead...you may find info on C&R.

Steve, Thanks for your reply.  Would you please tell me the statute number to look under because I looked that over again and didn't see anything on settlements except one sentence which didn't say too much.  I even typed in settlements in their search engine and nothing hardly came up.

I'd appreciate it.  Thanks alot.

Before you can determine how many weeks indemnity benefits are due, -you must reach MMI, and be rated for medical impairment...

(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.

Im not sure what you are looking for. Neither party can force a C&R, cash lump sum settlement. If the ER/IC decide to leave the medical open, see just what future medical may be necessary, thats' their option.

A C&R is a negotiated settlement between the parties for the IW consideration to drop the claim. There is no statute that says there must be a C&R, or that there cannot be a C&R.  The ultimate goal for the IW is a return to work, the ultimate goal for the ER/IC is a closed file. Of couse they would like the IW to take a cash payment, and drop the claim for future benefits to this injury.

WC is all about the ER liability for injury in the workplace. That means paying for treatment, and wage replacement while treating/recovering. Only if there is medical impairment would there be what most people would consider a "settlement".

Steve, Thanks.  Okay, my worry for my son is if he reaches MMI back to 100% normal,which is good, but in the future he aggravates that same injury again, then he's screwed if his own insurance company won't cover his aggravation in the future if he closes his claim.  Right?  Or will his own health insurance cover his future injury should he have an aggravation of that arm in the future?   

If the work comp doctor says he's 100% back to normal MMI, does that release the Work Comp Insurance company from providing medical benefits for him in the future in case his arm gets aggravated or hurt again?  Or can the doctor put in his report that he may need medical care?  This is a real concern for me.

His lawyer doesn't really care, all she cares about his how much money she's gonna get.  The lawyer wants to meet soon and she is not explaining any of this to us.  That's why I have to find out here.  Thanks for your help.