Understand Potential Benefits

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Lost Wages

If your claim has been accepted (or admitted) by the respondents and you are losing time from work because of your injury, you may be entitled to either Temporary Total or Temporary Partial Disability benefits. The respondents will not pay lost wage benefits until you have missed three shifts from work. This “waiting period” will be reimbursed if you miss more than two weeks as a result of your injury.

Temporary Total Disability (TTD)

Temporary Total Disability (TTD) is paid at two-thirds of your average weekly wage every two weeks. TTD is due if the doctor takes you completely off of work or if the doctor gives you restrictions that your employer cannot accommodate. If you are having difficulty performing your duties, contact your doctor immediately. You cannot take yourself off of work. If you stop working without your doctor’s approval, you may not receive benefits for this lost time.

Temporary Partial Disability (TPD)

Temporary Partial Disability (TPD) is paid when you return to work but you are not earning your normal pay or working your regular hours due to your injury (including missed work for medical appointments). The amount of TPD you will receive is determined by subtracting the amount you were paid from the amount you would have been paid if you hadn’t been injured. Contact your adjuster to let them know you are not earning your pre-injury wages.

Temporary disability benefits will end when:

• You return to work at your pre-injury wage
• You are given a release to return to regular work by the authorized treating physician
• You are given a written release by the authorized treating physician to return to modified work
• You fail to appear at a rescheduled medical appointment with knowledge that absence will result in the suspension of temporary disability benefits
• Your authorized treating physician determines that you have reached maximum medical improvement (MMI), meaning that your injury or illness has become stable and no further medical treatment will improve your condition
• The insurer requests to modify, terminate, or suspend benefits for reasons other than those listed above

Permanent Disability

Once you have been placed at Maximum Medical Improvement (MMI), your doctor determines the amount of loss in the form of a percentage. If your doctor is unable to do this, they may refer you to another doctor who can. Impairment is a permanent loss of function of a body part or system. For instance, you may no longer be able to use your hand the same way you did prior to being injured. Your doctor determines the amount of impairment you should receive.

There are two types of disability awards:

1. For loss of function to your toes, feet, legs, fingers, hands, arms, eyes, vision or hearing, you would receive a “scheduled” impairment.
2. For loss of function to your spine, lungs, or mental function, you would receive a “Non-Scheduled” (whole person) impairment.

Permanent Partial Disability (PPD)

Permanent Partial Disability (PPD) or medical impairment benefits are those benefits that compensate a claimant for permanent loss of function or impairment to a particular body part. The amount of PPD you will receive will be calculated using the percentage of loss determined by the doctor and the Colorado State statute.

Permanent Total Disability (PTD)

Permanent Total Disability (PTD) means you are unable to earn any wages for the rest of your life. Benefits for PTD are paid at the same amount as Temporary Total Disability (TTD).

Potential Offsets

Benefits received under workers’ compensation are not taxable.

You must inform your adjuster of benefits you receive outside of workers’ compensation. This may include, but is not limited to the following:

• Unemployment Insurance benefits
• Social Security Disability Insurance benefits
• Employer-paid short-term disability benefits
• Employer-paid long-term disability benefits

If you disagree with the amount you are being paid, notify your adjuster. If you lose your health insurance benefits, notify your adjuster. This could increase the amount of benefits you receive.

Your benefits may be reduced or terminated based on the following reasons:

• If you are injured because you violated a safety rule. (For example, if you are required to wear a safety device such as a hard hat, a harness, or safety glasses but fail to do so and are injured.) Your non-medical benefits may be reduced by 50%
• If you intentionally mislead your employer about your ability to perform a job and then are injured
  • You could be fired from your job for this reason and lose all temporary disability benefits
• If you test positive for unauthorized medications, drugs, and/or alcohol
  • Some employers have policies that require drug testing if you are injured
    • If the results come back positive, your non-medical benefits may be reduced by 50%
• Child support judgment

Mileage Reimbursement

You can request reimbursement for mileage and parking related to medical visits and to pick up medications or supplies related to the injury. You must request reimbursement within 120 days of travel. The insurance carrier must pay you within 30 days, or they must provide written notice stating why the reimbursement was denied. You may view a sample reimbursement form in the Claimant Brochure and get help determining the amount of repayment with our new online mileage calculator.

Injured Worker Guides