Workers’ Compensation FAQ

General Questions

I was injured at work but I’m not sure if it would be covered under workers’ compensation. Should I still file a claim?
If you believe your injury is work related, you can file a claim. CSU Workers’ Compensation and the adjuster assigned will complete an investigation and determine if this is a covered workers’ compensation claim. You will need to assist with the investigation and provide accurate information regarding the event.

I had a work related injury but don’t want to see a doctor. Do I still need to go to an Authorized Treating Physician (ATP)?

The university cannot force anyone to seek medical treatment. CSU strongly encourages injured workers to seek medical care with an Authorized Treating Physician (ATP) if they have any concerns. This will allow for documentation of the event and medical condition(s) should you need to seek treatment in the future. It is also important to remember that missed time from work, prior to seeing an ATP, may not be covered for wage replacement benefits under workers’ compensation. If you aren’t seeking medical treatment, you will file an incident report instead of a workers’ compensation claim.

I want to know more about the Colorado Workers’ Compensation Act. What are my rights and responsibilities as an injured worker?

Please review the information on the website and contact CSU’s workers’ compensation office at  (970) 491-4832 with any questions that you have regarding your claim. If you are still needing additional information, the Colorado Division of Workers’ Compensation has a number of resources, including an employee handbook. You may review the Colorado Division of Workers’ Compensation website for more information.

I received an Admission of Liability in the mail. What does it mean?

The Admission of Liability outlines the status of your claim. Please review it thoroughly and contact the adjuster directly to discuss any questions you may have. An admission will also outline your average wages and provide information regarding what to do if you don’t agree the admission. You must respond within 30 days is you have any objections. You may also review the Colorado Division of Workers’ Compensation website for more information.

I received the Authorization for Medical Release and Medical Treatment Information form in the mail. What is this for?

The Medical Treatment Information release form requires that the injured worker provide information for any physicians that they have seen previously, for any prior conditions that are similar or related. The medical release may be a Kaiser Permanente (KP) form. KP will only accept internal forms; other providers will accept a variety of forms. Please fill out the form and return as soon as possible.

For out of state claims, the Authorization for Medical Release needs to be signed and returned to Travelers.

For in state claims, this form should be returned to:
Cannon Cochran Management Services Inc. (CCMSI)
P.O. Box 4998 Greenwood Village, CO 80155
Phone: (303) 804-2000 – Toll-Free: (888) 428-4671
Fax: (303) 804-2005

What is Maximum Medical Improvement (MMI)?

MMI is the point at which the treating physician determines that no further medical treatment can be recommended for the injury and the employee is released from treatment.

I think that my employer or another person is responsible for my injury and I want to sue them. What are my rights?

Workers’ Compensation benefits are your sole remedy under Colorado law. You cannot sue your employer if you get injured on the job. If your accident was caused by a third party (someone other than your employer or co-worker), a subrogation claim maybe filed against them. Contact your claims adjuster for details.

What if my claim is admitted?

The TPA or carrier has 20 days to review your claim prior to making a decision of compensability. You will be notified through a General Admission of Liability, whether the claim has been accepted, denied or placed on Notice of Contest (NOC) for further investigation. If the insurance company determines that you are eligible for benefits, it will start paying for your authorized medical expenses, benefits for lost time from work, if applicable, and will assist you through the workers’ compensation and return to work process.

What if my claim is denied?

The insurance company may deny your claim for a variety of reasons. Examples include:

  • The medical provider indicates that the injury is not work related
  • The employee wasn’t performing work within the course and scope of their employment at time of injury
  • Incomplete or inaccurate information has been provided regarding the injury and medical treatment provided

If your claim is denied, you will be responsible for all medical bills for services not coordinated through CSU’s Authorized Treating Physician (ATP) network. If you believe your claim has been incorrectly denied, there are several options available to you. If you want to request an expedited hearing on the issue of compensability, you must file an Application for Hearing and Notice to Set and a Request for Expedited Hearing within 45 days of the date of mailing of the Notice of Contest. Refer to the Colorado Division of Workers’ Compensation website for more information.

If I don’t file my claim in a timely manner, can I still file?

You may still file a claim for benefits even if you are late reporting the injury to your employer. By law, you must notify your employer in writing within four working days of an injury, even if you have advised them verbally. Keep a copy of your written notice. If you do not report your injury to your employer in writing within four working days, you may be penalized and lose up to one day’s compensation for each day’s delay, When a claim is filed several weeks to months after the event, it is likely to be placed on a Notice of Contest for investigation. This means that the adjuster will need to talk with the injured party and request and receive personal medical information. This can delay the acceptance of your claim, but a claim can still be filed and moved forward through a collaborative effort of all parties.

What is the final admission of liability?

A Final Admission of Liability (FAL) is a final statement from the insurance company about what they believe has been paid or is owed to you. This admission will show the amounts paid for all the benefits that you have received, and any other benefits that they plan to pay in the future. If you receive a Final Admission of Liability from the insurance company, and you disagree with what is written, you must object in writing to this admission WITHIN 30 DAYS. You should receive an Objection to Final Admission form attached to the Final Admission. If you do not receive an objection form, contact the Colorado Division of Workers’ Compensation to obtain a form. Complete the objection form or write a letter, within 30 days, to the Colorado Division of Workers’ Compensation, 633 17th St., Denver, Colorado 80202-3626, and send a copy to the insurance carrier or self-insured.

How is permanent impairment determined?

If you are unable to fully recover from your injury (for example, due to the loss of use of your hand), your authorized treating doctor will decide if there is any permanent impairment or will refer you to a doctor who will make this determination. The doctor will first assess if any functional impairment resulted from your injury. If there is impairment, the doctor will assign an impairment rating based on the “American Medical Association Guides to the Evaluation of Permanent Impairment”, third edition revised. If the insurance company agrees with the rating, they will file a Final Admission of Liability and you will receive weekly benefits for a certain length of time as compensation for the disability. The weekly amount depends on your date of injury and the length of time depends on the total amount of money owed to you according to law.

May I reopen my claim after it is closed?

If you believe you need more medical care and/or temporary disability benefits after your claim has been closed, you may apply to reopen your claim. If it has been less than a year from the date of your injury, contact the adjuster or workers’ compensation manager at (970) 491-4832 and a onetime evaluation with an Authorized Treating Physician maybe authorized to address your new or ongoing issues. You can also file a Petition to Reopen directly with the insurance company. If the insurance company refuses to reopen the claim (or does not respond), you may file an Application for Hearing with the Office of Administrative Courts. The request may be filed within six years from the date of your injury or two years from the date the last benefits (temporary, permanent or dependent) became due and payable, whichever is longer. If these dates have passed and you need only further medical care, not temporary disability benefits, you may apply to reopen your claim at any time within 2 years of the date the last medical treatment. The only reasons accepted when reopening a claim are that an error or mistake occurred or there has been a change in your condition. If your claim is closed by written agreement between you and the insurance company and your settlement agreement states that you waive or give up your right to reopen your claim, then your settlement can ONLY be reopened on grounds of fraud or mutual mistake of material fact.

How will the Authorized Treating Provider know what type of work we do?

The CSU workers’ compensation program will obtain information from the department and have a physical demand analysis, job site evaluation and/or ergonomic evaluation completed when needed. The employee and supervisor are important in the process and can assist in outlining information regarding the worker’s expected job duties, as well as modified tasks available in the department.

Are student internships considered in workers’ compensation?

Students injured in the course of off campus, supervised, unpaid internships for credit may be eligible for coverage by the university’s workers’ compensation benefits. If a student is injured on the job or sustains a work-related illness that is deemed in the course and scope of the internship, reasonable and necessary medical benefits may be paid as provided by workers’ compensation laws.

The following elements are needed in order for coverage to be considered:

1. The work training program or internship is sponsored by CSU
2. CSU placed the individual with the employer for purposes of training
3. The training was prearranged for credit prior to the student beginning the program/activity
4. The internship is an unpaid internship with a cooperative agency
5. The internship is not at or for CSU
6. The injury occurred during the duties assigned and outlined as part of the internship/practica

Students serving in unpaid internships at Colorado State University are not covered by workers’ compensation insurance. If the student intern is receiving any kind of compensation (including room and/or board, salary, etc.) from the host employer, then the intern is entitled to workers’ compensation benefits from that host employer.

Workers’ compensation insurance is provided to student interns serving in internships at a cooperative agency, either by the cooperating agency if the student is compensated in any way (including salary or stipend, room and/or board, etc.), or by the workers’ compensation insurance of the university if the student is not paid. Workers’ compensation insurance is provided, by law, only to students serving in unpaid internships with cooperative agencies; students serving in unpaid internships at Colorado State University are not covered by Workers’ Compensation insurance. If a student is injured in the course of an off campus, unpaid, for credit practicum or internship, they must follow the same process as outlined in the filing of a claim.

Payments, Benefits, Bills and Reimbursements

The doctor gave me a prescription. How do I get it filled?
Within 10 days of filing your claim, you will receive correspondence from the adjuster providing you a personal prescription card and correspondence explaining how to use it for all prescriptions related to your claim. If you need a prescription filled prior to receiving a card in the mail contact, the CSU workers’ compensation office at (970) 491-6745 or (970) 491-4832 and we can provide one to you.

I received a bill associated with my workers’ compensation claim. What should I do with it?

If you receive any bills directly from a provider, DO NOT DISREGARD THEM. Contact the provider with your CSU claim number and the following billing information:

Employees who are based in Colorado:
Cannon Cochran Management Services Inc. (CCMSI)
P.O. Box 4998 Greenwood Village, CO 80155
Phone: (303) 804-2000 – Toll-Free: (888) 428-4671
Fax: (303) 804-2005

Employees who are based out of state:
Travelers Insurance
http://mywcinfo.com
Toll-Free: (800) 252-4633

I ran out of mileage forms. Where can I get more?

Please download and complete the Mileage Reimbursement Form. You can submit your form directly to your adjuster or to the CSU Workers’ Compensation program by email, mail, or fax for review and submittal to the carrier.

CSU Workers’ Compensation
200 W. Lake St., 6002 Campus Delivery
Fort Collins, CO 80523-6002
workcomp@colostate.edu
Fax: (970) 491-4804

What happens if I don’t accept a Temporary Modified Duty offer?

If you are offered work within your restrictions you should accept the position. If you refuse, your lost time benefits will be effected and CSU on-the-job injury leave will not be granted.

How am I paid for time lost from work due to an injury?

Lost time on the date of injury is not counted. If medical treatment is sought on the day of injury, Administrative Leave is granted to benefited employees. The employee must lose over three work shifts (24 hours) before lost time benefits are payable under workers’ compensation.

What is the Lost Time Benefits Waiting Period?

The Workers’ Compensation Act requires that at least 24 hours or three working days of lost time be accrued before any benefits become due and payable. The first 24 hours are deducted from the employee’s sick or administrative leave. If there is no available sick or administrative leave, time missed is taken as leave without pay. Reimbursement for the first 24 hours is only made if the employee is missing time from work for more than two weeks. These days can be in succession or cumulative. All time missed needs to be reported as lost time for tracking purposes. If you are an hourly employee, lost time from work should be turned into your department payroll representative and to the workers’ compensation program at CSU. Following the waiting period you will be paid directly from the insurance carrier or CSU’s third party adjuster (TPA).

Will I be paid for my time off work?

In order to be compensated for time missed due to a work related injury, the employee will need to seek medical treatment by an authorized treating physician (ATP). Time taken off work prior to obtaining documented medical attention is deducted from the employee’s own leave time. When an individual misses more than three shifts due to a work related injury or illness, and is taken off work either by a medical provider or due to lack of work available within restrictions, he/she may be eligible to receive compensation benefits. Wage replacement is calculated from the 4th shift, or day, the employee is unable to work due to the injury. CSU grants administrative leave for permanent employees who seek medical attention on the day of the incident. Payment for the first three work shifts (cumulative) missed is only made if the employee is off work for more than two weeks of actual work time. This wage replacement is called temporary disability benefit and is paid directly by the insurance company or self-insured employer. Hourly employees are paid from the insurance carrier at 2/3 of their average weekly wage for the hours that are missed and reported. Permanent employees may be eligible for full pay under State of Colorado injury leave. Refer to Injury Leave and Lost Time for more information.

Supervisors and Departments

I’m a supervisor. My injured employee is losing time from work. What do I do?
Authorized lost time due to medical appointments, physical therapy, diagnostic testing, or the department’s inability to accommodate a worker’s restrictions must be submitted to CSU Workers’ Compensation on the Injury Timesheet. This can be submitted electronically or in one of the ways listed below.

CSU Workers’ Compensation
200 W. Lake St., 6002 Campus Delivery
Fort Collins, CO 80523-6002
workcomp@colostate.edu
Fax: (970) 491-4804

Please refer to Injury Leave and Lost Time or contact workers’ compensation at (970) 491-6745 with any questions.

What should I do if employee’s medical appointments create numerous interruptions due to a worker’s ongoing medical treatment?

While ongoing medical treatment is common, employers can use their influence in the scheduling of medical appointments to keep interruptions to a minimum. Let employees know when you need them to be at work and ask that they schedule appointments around this time. If scheduling conflicts continue, contact the CSU Workers’ Compensation Manager for assistance with communicating with medical providers to schedule appointments that don’t interfere with work demands.

What if an injured worker moves out of the area or doesn’t want to return to work?

An employer in Colorado is entitled to make an offer of employment in the same geographic area in which the injury took place. An injured worker who relocates is still obligated to acknowledge the offer. If the injured worker is offered modified work using the Rule IX process and fails to return to work, his or her benefits may be modified or terminated.

What if an injured worker on modified duty comes to work and is not productive, takes excessive breaks and/or wastes the time of other workers?

Injured workers are expected to be productive within their capacity and restrictions. If an injured worker persists in non-productive activity, the employer should follow their normal disciplinary procedures. The injured worker should be regarded as any other employee and held to the same university policies.

What if my worker reports to work, but complains that they hurt too bad to work?

If an injured party is having difficulty working, completing a job task or wants to leave work due to their pain, please direct them back to the authorized treating physician. Do not send the injured worker home. The physician will need to address the employee’s current restrictions, additional treatment needs, ability to work modified duty tasks and regular work hours. The ATP will also review the task(s) that aggravate the condition and make sure tasks outlined are within the employee’s abilities.

If an employee takes time off or goes home early due to a work related injury, they need to see a physician or the time off will be their personal leave.

Never hesitate to call the workers’ compensation office at (970) 491-4832 or (970) 491-6745.

What if permanent restrictions do not allow a worker to perform essential functions of his/her job?

An employee who cannot return to their pre-injury position is not guaranteed employment with CSU. Their home department may pursue termination for inability to perform job tasks. It is the worker’s responsibility to contact personnel to pursue alternative employment options that may be available within the university.

The employee should contact the benefits office to discuss resources and options.

Human Resources
555 S. Howes St, 2nd Floor
Fort Collins, CO 80523-6004
(970) 491-MyHR (6947)

The Office of Equal Opportunity is also available to work with individuals seeking assistance.

Office of Equal Opportunity
101 Student Services Building
Colorado State University
Fort Collins, CO 80523-0160
Phone: (970) 491-5836
Fax: (970) 491-2690
http://oeo.colostate.edu/contact-us


Contact CSU Workers’ Compensation
(970) 491-4832 – (970) 491-6745