National Health Care?

Health coverage under workers comp is variable. One plus is that for covered and reasonable care the benefit is 100% coverage as long as necessary. The problem is that insurers often deny coverage for one reason or another and this can slow down or eliminate needed medical care. Also you go to one doctor for your injury, another for your overall health and must deal with varying coverages. VA, Medicare, Medicaid, perhaps even coverage under auto policies and a great array of insurance companies all with their own set of rules and payment plans make our current health care system terribly inefficient. To limit benefits is to ration them so the cry that we have the best health care system is questionable. Lately I've come around to accept that drastic change is called for and so have others. Even physicians have a website that promotes a national plan. While I strongly believe in free enterprise I realize the current hodgepodge is not working. One recent proposed law to allow Medicare to negotiate drug prices like the VA does failed and so lower drug prices for medicare beneficiaries was denied. To me that is not free enterprise it is favorable treatment for the drug companies. In any event here is the link to the Physicians website with various articles on healthcare:
http://www.pnhp.org/news/articles_of_interest.php

Less Hearings and Applications for Hearing

According to the Division (Workers Comp) website it appears very clear that over less then ten years there has been a dramatic decrease in hearings and even hearing applications. There may well be many factors to explain this but the stats speak for themselves:

1997 : 12840 hearing applications were filed; actual hearings held were 1987

2006 : 9595 hearing applications were filed; actual hearings held were 1166

By the way the population of Colorado increased ten percent in the last ten years.

Here are the latest Treatment Guidelines

A link is provided so you can see what the latest treatment guidelines are for Colorado physicians to treat in areas like chronic pain, lumbar, cervical, cumulative trauma and the like. These Guidelines are made part of the workers comp rules so they are important. Certainly the treating doctor should be able to treat as needed but the Guidelines are relevant to any treatment.

http://www.coworkforce.com/DWC/Rules/Rules%20pdf/RulesLinksTable.asp#Rule_17

Injured Worker Comments, Suggestions or Questions?

I've set it up so that anyone can comment or leave questions for me. Just click on the comments and leave your question or suggestion...but do so either anonymously or by first name only please. While I cannot guarantee an answer or reply I promise to look at any such comment/suggestion/question. Sometimes we just need to vent or provide our own personal views so if you feel the need then you are free to post your comment on our blog. For example I personally feel the workers comp system in Colorado can be improved upon with better laws. Change can come when we stand up and voice our concerns. Silence only validates the status quo. But if you need professional or individual advice and do not have a lawyer...call my office at 719-596-8900 or email me at workcomp@usa.net.

Workers Comp does not cover all losses

It is important to emphasize that coverage is limited in work injury cases. Workers comp is a creature of statute which sets forth what is covered and what is not. The biggest problem is when someone has a loss of his or her trade or occupation because of a permanent injury and permanent restrictions. Usually some permanent benefits are paid and an effort can be made to maximize these but nothing is paid for the loss of a trade or occupation unless you are permanently and totally disabled. Vocational rehab is seldom offered by the insurer so if this is your situation contact the State Department of Vocational Rehabilitation. This area remains an area of concern and on my wishlist for legislative change. I would strongly urge those who may be in this situation to consult with an experienced workers comp attorney. Never assume the insurers position on your entitlement to benefits is accurate. Moreover if the company designated doctor has released you without impairment or restrictions do not assume that is correct either. You do have recourse here. On numerous occasions such doctors have said no permanent injury and been flat wrong.

Social Security Backlogged

Both nationally and locally the process to obtain Social Security disability benefits is backlogged especially at the hearing level. If denied benefits a claimant can, if he timely acts, appeal for a hearing. It is taking over a year or longer to obtain that hearing in Colorado. Elsewhere the wait can even be longer. It does appear that justice delayed is justice denied. Hopefully over time this backlog can be cleaned up. At my last hearing the hearing Judge was in Tucson and we had the hearing by way of television. Documents are now being scanned in to make a CD so that they are easily handled. All of this provides some hope but it will take some time to speed up the process. Sometimes though it seems like one step forward and two steps back.

May 31, 2007 Court case on prosthetics

If your artificial hip is injured on the job is it covered to receive benefits? Yes said the Court of Appeals in this case. The insurer tried to rely on an old Colorado case that said if your wooden leg was hurt it was not a personal injury just injury to property which was not covered by workers comp. The court said the statutes now do cover injury to prosthetic devices so that old case no longer applies. But can you imagine in that old case being told it's your problem not a workers comp problem since only live legs are covered? At least now its covered though the statute does define what is covered and what is not. In any event here is a link to the case:
http://www.cobar.org/opinions/opinion.cfm?OpinionID=6163&CourtID=1