Workers’ Comp Lawyers in COC
Have You Obtained The Colorado Workers’ Comp Hip, Knee & Other Lower Joint Injury Benefits you are owed?
INTRODUCTION TO COLAHOMA WORKERS’ COMPENSATION HIP, KNEE, ANKLE & FOOT INJURY CASES
Serious injuries that affect an injured Colorado worker’s hip, knee, ankle or other lower extremity joints can be quite disabling since, on either or both a temporary or permanent basis, such injuries can limit such worker to a sedentary job. Since most jobs are classified as light in physical demand, or even heavier, most worker’s limited to sedentary work will be unable to return to the job he or she was performing at the time of the injury. If limited to sedentary work on a temporary basis, such injured worker will either need to be provided with an alternative duty position, or a wage loss benefit check if light-duty work is not offered or for other reasons cannot be provided.
If limited to sedentary work on a permanent basis most worker’s will be forever prevented from returning to his or her usual and customary occupation, which generally will bring forth issues of vocational rehabilitation and training, as well as a permanent disability settlement to help offset the painful effect of a worker’s inability to earn the same level of wages as he or she did before his or her hip, knee and/or other lower extremity joint injury.
Unfortunately, for many older workers for whom retraining is not a viable option, returning to the workforce in any meaningful way may be impracticable following a catastrophic hip, knee or other lower extremity injury. For those workers a lifetime wage replacement check, also known as a permanent total disability settlement, will be needed to prevent this worker and his family from falling into financial hardship or even ruin.
Colorado Workers’ Compensation Hip Injuries
Colorado Workers’ Compensation Knee Injuries
Work-related knee injuries usually happen from direct trauma, twisting, overloading or hyper-extending the knee while performing work-related duties. Typically these things can result in injury or damage to the meniscus, including a meniscal tear, patellar or patella (knee cap) fractures or other damage to the patellofemoral compartment, or even damage to the distal femur where it meets the knee joint. Many of these injuries will require expensive surgical procedures to repair the damage, which could include a micro fracture, cartilage or stem cell transplant, or even a total knee arthroplasty, also known as a total knee replacement, or simply, a “TKA”, or less expensive, but invasive procedures,
Colorado Workers’ Compensation Foot/Ankle Injuries
Hip, Knee, Ankle And Foot Injuries Covered Under Colorado’s Compensation Law
Hip, Knee And Foot Injury Must Arise Out Of And In The Course & Scope Of The Injured Worker’s Job Assignment
Not all Hip, Knee, Ankle and Foot Injuries that occur during work hours or on-premises are covered under Colorado Workmens’ Compensation Law. Generally, for an injury to be covered, the resulting harm or damage to the worker’s lower extremity must have been occasioned or caused by an accident, repetitive motion, overuse, cumulative trauma, and/or an industrial disease that arises out of and in the course and scope of that hurt employee’s job task and/or assignment. 85A O.S. § 3.A
NOTE: Colorado Courts have determined that the term ACCIDENT means just that and only applies to any event or occurrence involving factors not personal to the employee that: (1) were unforeseen, unplanned, unexpected and most importantly, unintended; (2) occurred at a specific time and otherwise identifiable place; (3) was unaccompanied and independent of any sickness, mental illness or other independent or intervening injury or condition affecting the worker.
NOTE: The Colorado Workers Compensation Courts have determined that the phrase COURSE AND SCOPE OF EMPLOYMENT means an engagement and/or course of activity of any kind, type or character for which a worker was hired to do and relates to and derives from the business, occupation or profession of the worker’s employer. This course of activity, to be work related for workers’ compensation purposes, must be performed by a worker in furtherance of the business affairs of his or her employer. The term necessarily includes activity performed by the worker on premises of the employer but also includes off-property work in furtherance of the employer’s business or trade (and travel by the worker necessary to complete that worker’s assigned job task or duty).
Hip, Knee, Leg, Ankle And Foot Case Must Be Proven By Medical Testimony Supported By Objective Medical Findings
In order to be a compensable injury under Colorado Law, a worker’s hip, knee or other lower extremity injury must be proven by testimony from a medical doctor with such testimony being based upon objective medical findings. Furthermore, it must be established that the work-related event was the “major cause” of the resulting disability or need for treatment to the injured worker.
NOTE: The Colorado Workers’ Compensation Commission has determined that the phrase “Major Cause” means that more than 50% of the resulting injury to a worker’s hip, knee, ankle or lower extremity must by caused by that employee’s work and that any finding of major cause must be proven by a preponderance of the evidence.
All medical opinions addressing the compensability of a workers’ hip, knee or ankle injury must be stated within a reasonable degree of medical certainty
Hip, Knee, Ankle, Foot And Other Lower Extremity Injuries Not Covered By Colorado Workers’ Compensation Law
The following lower extremity joint cases are not covered under Colorado Law:
Age-Related, Arthritic And/Or Degenerative Conditions
- Any sprain, degenerative condition, disease, harm, defect or structural damage to a worker’s knee, foot, ankle or hip joint resulting from the employee’s aging process, rheumatoid and/or osteoarthritis or other degenerative process-to include degenerative joint disease;
- Any other then existing or pre-existing hip, knee, ankle or other lower joint condition unless the worker’s treating doctor testifies that his or her patient has suffered “an identifiable and significant aggravation which aggravation occurred through that employee’s work detail”;
Hip, Knee, Ankle Or Foot Injury Occurring While Worker Traveling To And From His Or Her Workplace-The ‘Coming-And-Going” Rule
Any hip, knee, ankle or foot injury which occurs while a worker is simply traveling to and from his or her workplace, work assignment or station is not covered under Colorado Workers’ Compensation Law. These cases usually arise out of a car wreck which occurs while the worker is on his way to or back home from his or her workplace. This is the traditional ‘coming and going’ rule. However–as more fully indicated above, an accident which occurs while a worker is traveling for work, particularly when his or her employer pays for or the worker otherwise is reimbursed for his or her mileage or other travel expenses, is covered under the worker’s compensation law in Colorado.
Travel By Worker That Benefits Both The Worker And His Or Her Employer Not Covered-The “Dual-Purpose Doctrine”
xxxxAny knee, foot or other lower extremity injury that occurs during travel by a worker that is in furtherance of his or her work and the employer’s business and/or trade, but which is also in furtherance of that worker’s own personal or private business is not a covered accident under Colorado’s Workers’ Compensation Law. This is commonly known as the ‘Dual Purpose’ doctrine.
Any Independent And Subsequent Intervening Accident Or Injury Will Prevent Worker From Receiving Further Benefits For Lower Extremity Joint Injury
Assuming an otherwise compensable injury or occupational disease-a subsequent occurring, intervening injury or accident will break the necessary nexus between the original injury and that worker’s ongoing right to medical and indemnity benefits for a knee, hip, foot or ankle joint injury.
Worker Entitled To Cash Benefits And Increased Compensation For A Consequential Injury Under Colorado Law
Colorado Workers Compensation Courts have determined that a consequential injury is that injury or disease to an otherwise separate part of an injured worker’s body that is directly related and proximately caused by that worker’s original, compensable at law, industrial injury (or caused during medical treatment received for the original injury). In Colorado a workers’ compensation court cannot make a finding of a consequential injury unless and until it is determined that medical treatment was required to treat that body part.
Employer Liability For Cumulative Trauma Hip, Knee, Foot And Other Lower Extremity Injuries
A cumulative trauma injury is any damage to a worker’s hip, knee, foot or other extremity joint that is caused or created by the combined, sustained and repeated effect of repetitive physical activity extending over some period of time. Obviously, to be a compensable workers’ compensation case in Colorado the repetitive damage must be caused by activity performed within the course and scope of the employee’s work. The Colorado Courts have determined that ‘cumulative trauma’ does not include fatigue, soreness or general aches and pains that may have been associated with, caused, aggravated, by an injured worker’s job assignment.
OBTAINING MEDICAL TREATMENT FOR COLAHOMA WORKERS’ COMPENSATION HIP, KNEE, FOOT & ANKLE INJURY CASES
Medical Providers Prohibited From Collecting Or Attempting To Collect Bill From Injured Worker
It is unlawful in Colorado for any Hospital, Doctor, Therapist or any other medical provider for that matter to bill, collect, or attempt to collect any fee or portion of a medical fee for treating an injured worker otherwise entitled to benefits under the Colorado Workers’ Compensation Act. This prohibition extends to reporting an injured worker to any credit reporting agency for his or her failure to pay in full or any portion of his or her medical bill for treatment rendered in the Colorado Workers’ Compensation system. 85A O.S. § 18.A
If and when an injury is deemed or found to be not compensable under the Colorado Workers’ Compensation Law—any hospital, physician, or other health provider can then demand payment from the injured worker for any unpaid portion of the outstanding fee or other charges.
Obtaining Medical Treatment Under An Colorado Workers’ Compensation Certified Workplace Medical Plan, Or “CWMP”
In Colorado an employer and/or its workers’ compensation insurance company can choose, under certain limited circumstances, to provide its injured employees medical treatment for on-the-job injuries through a Certified Workplace Medical Plan, which basically is a group or organization of medical treatment providers, certified by the Colorado State Commissioner of Health, that is approved to contract with an employer (or its insurance carrier) to administer medical treatment on a fee-for-service basis pursuant to the express terms of the Colorado Workers’ Compensation Law.
Receiving Continuing Medical Maintenance For Lower Extremity Joint Injuries Under Colorado Law
The Colorado Workers’ Compensation Court has determined that, following a worker’s attaining maximum medical improvement for his or her hip, knee, ankle or foot injury, he or she may be awarded ongoing treatment for that injury if such care is necessary and reasonable to maintain maximum improvement and keep his or her extremity injury condition stable. Colorado Courts have determined that the following treatment modalities are not considered, and cannot be made part of, an injured worker’s continuing medical maintenance plan or program:
- Radiographic or other diagnostic testing and studies
- Surgery or other operative procedures
- Injections and Blocks
- Counseling and other psychological treatment
- Physical and/or Occupational Therapy
- Pain management and other pain management devices
Medical Case Management In Colorado Workers’ Comp Hip, Knee, Ankle, And Lower Extremity Injuries
The Colorado Workers’ Compensation Court has defined Medical Case Management as the systematic coordination, by a nurse or medical case manager, of an injured worker’s medical, hospital, rehabilitation and other care and treatment to ensure that such treatment follows all applicable treatment guidelines, utilization controls and practice parameters and is otherwise delivered in an expedient and cost-effective manner; and finally that the injured employee is adhering to the prescribed treatment plan and otherwise engaging in activity that will promote his or her healing. To be otherwise qualified to be a case manager an individual must be either a registered nurse licensed by the Colorado Board of Nursing or an individual with one or more of the following certifications: (1) Certified Disability Management Specialist; (2) Certified Case Manager; (3) Certified Rehabilitation Registered Nurse; (4) Case Manager–Certified; (5) Certified Occupational Health Nurse; and/or (6) Certified Occupational Health Nurse Specialist.
Colorado Temporary Total Disability (“TTD”) Settlements For Hip, Knee, Ankle, Foot Or Other Extremity Cases
Worker’s Entitlement To Temporary Total Disability (TTD) Benefit Check Under Colorado Law
If it is determined that a hurt worker, owing to his or her work related hip, knee, or other lower joint injury, is medically unable to return to his or her pre-injury or an equivalent job (or any ‘light-duty’ job or work offered to him or her by the employer), by Colorado Workers’ Comp law he or she will receive a wage replacement payment, also known as a Temporary Total Disability check, in an amount and for the time period described below.
NOTE: The Colorado Workers’ Compensation Commission has determined that a “pre-injury or equivalent job” means that job position that the injured worker was performing at the time that worker’s injury occurred—or any job offered by the worker’s employer that pays at least as much as that worker was making at the time he or she got hurt.
Amount Of Injured Worker’s Temporary Total Disability Check Under Colorado Workers’ Comp Law
If otherwise entitled to a Temporary Total Disability Workers’ Compensation check as described above—said check will be paid at seventy-percent (70%) of that worker’s average weekly wage as calculated and described above.
Maximum Amount Of Weekly Workers’ Compensation Check Under Colorado Law, I.E., The Cap
The maximum weekly check an injured worker can receive for his or her hip, knee or ankle/foot joint injury in Colorado is capped at the state’s average weekly wage for any given year. The state’s average weekly wage is changed every year, usually upward, to reflect an increase in the average Colorado worker’s wage or earnings year over year. The amount of an Colorado Worker’s TTD check is capped with the maximum rate for the year in which he or she is injured, i.e. once injured, a worker’s check does not increase with any increase in Colorado’s average weekly wage for the next year or following years. For the year 2020 the maximum Temporary Total Disability benefit is $898.63. The maximum weekly TTD check for those worker’s with dates of injuries in prior years is described in the following chart:
|DATE OF INJURY||MAXIMUM TTD CHECK|
|Jan. 1, 2020 to Dec. 31, 2020||$898.63|
|May 28, 2019 to Dec. 31, 2019||$867.71|
|Jan. 1, 2019 to May 27, 2019||$607.40|
|Nov. 1, 2017 to Dec. 31, 2018||$590.63|
|Nov. 1, 2016 to Oct. 31, 2017||$596.03|
The Colorado Workers’ Compensation Court has determined that the term “Surgery” in reference to limits on TTD for a “soft-tissue” injury, does not include injections, whether performed for a therapeutic or a diagnostic purpose, or even both.
Maximum Duration Or Statutory “Caps” On Length Of TTD Payments In Colorado
Under Colorado Workers’ Compensation Law—the following limits or ‘Caps’ have been placed on the maximum duration of an injured workers’ temporary total disability check in Colorado:
- One-hundred fifty-six weeks, or three years, for an uncomplicated hip, knee, ankle or foot joint injury;
- If a workers’ compensation judge finds, or it is agreed between the parties, that a worker has suffered a consequential injury— and more treatment is needed to cure the worker from that consequential injury, that worker’s Temporary Total Disability check can continue for up to an additional fifty-two (52) weeks, assuming that all other conditions still remain for that worker to receive an ongoing benefit.
NOTE: The Colorado Workers’ Compensation Court has determined that the issue of whether or not an injured worker has sustained a consequential injury and further that additional time and treatment is needed for that worker to reach his or her maximum medical improvement must be proven by that injured worker and/or his or her Colorado City or Denver Workers’ Compensation Lawyer by ‘clear and convincing’ evidence.
Termination Of Injured Worker’s TTD Check Under Colorado Law
Any of the following events will trigger termination of an injured worker’s temporary total disability check under Colorado Workers’ Compensation Commission rules:
- Injured worker’s release from active medical treatment by his or her treating physician on all body parts involved in the case;
- The injured worker, without good reason, fails to attend three successive medical appointments;
- Fails to comply with treatment recommendations made by his or her treating physician; or
- Effectively abandons medical treatment.
NOTE: A judge of the workers’ compensation court may use its power to retain an independent medical examiner to determine whether the injured worker needs further active medical treatment and is otherwise TTD.
Under Colorado law—the Worker’s Compensation Court will enter an order permanently terminating an injured worker’s temporary total disability check if: (1) that worker is either non-compliant or otherwise abandons his or her treatment for a period of sixty (60) consecutive days; or (2) the worker’s benefits have been terminated two times pursuant to any of the above described reasons. 85A O.S. § 45A.2
If any of the above events occur—the worker’s employer is permitted to terminate that worker’s TTD check by notifying the worker, or if represented by an attorney, his or her Denver Workers’ Compensation attorney. 85A O.S. § 45A.2
Injured Worker’s Objection To Termination Of Temporary Total Disability Check Under Colorado Law
If an injured worker disagrees or otherwise disputes that his or her TTD check should be terminated—he or she can file on objection to termination of these benefits. By Colorado Law, such written objection must be filed by the hurt worker and/or his or her Colorado City or Denver Workers’ Compensation Lawyer within ten (10) days of the filing of the notice of termination by the worker’s employer. If so timely and properly filed the Colorado Workers’ Compensation Court will set the case down for a hearing to make a finding as to whether that worker’s TTD check should continue to be paid—said hearing to occur within twenty (20) days of the filing of the injured worker’s objection. 85A O.S. § 45A.2
Temporary Partial Disability Benefits For Hip, Knee And Other Extremity Cases In Colorado
The Colorado Workers’ Compensation Court has determined that Temporary Partial Disability benefits will be available to an injured worker who is temporarily unable to perform his or her regular and customary job, but can perform an alternative duty job offered to him or her by his or her employer. A worker returning to such light-duty work who is earning a wage or salary which is equal to, or even more, than his or her pre-injury average earnings will obviously not be eligible for this type of wage replacement benefit. However, in most cases, owing to working less hours or making less per hour, or both, an injured worker returning to light-duty work will be making less per pay period compared to what he or she was accustomed to earning before his or her injury. In this latter situation the worker will indeed be suffering a decrease in his earnings and will be entitled to a temporary partial disability check under Colorado compensation law.
An injured worker, otherwise with temporary work restrictions, who refuses to perform alternative duty work offered to him or her by his or her employer, will lose his or her eligibility for a temporary partial disability check under Colorado workers’ compensation law. 85A O.S. § 45B.3
Amount Of Temporary Partial Disability Check For Colorado Hip, Knee Or Foot Injury Cases
In Colorado an injured worker, unable to perform his or her regular duty job, but being able to perform an alternative ‘light-duty’ position being offered to him or her by his or her employer, that job paying less than what the worker was making before his or her injury, will be entitled to receive a weekly benefit check. This ‘Temporary Partial Disability’ check will be calculated at seventy percent (70%) of the difference between that worker’s pre-injury average weekly wage (the calculation of which is fully described above) and what the worker is now making performing offered alternative duty work—but again only if his or her earnings performing alternative work is less than his or her pre-injury earnings. 85A O.S. § 45B.1
Worker’s Temporary Partial Disability Check Plus Light-Duty Paycheck Cannot Exceed Maximum TTD Benefit For Year Worker Injured
Additionally, an injured worker’s light-duty gross paycheck plus his or her temporary partial disability benefit cannot exceed, and is hence capped, at the amount of Colorado’s state average weekly wage for the year in which the worker is injured—this amount year-over-year is fully discussed above. 85A O.S. 45B.1
Duration Of Worker’s Temporary Partial Disability Settlement Check Under Colorado Compensation Law
By law—an injured worker’s temporary partial disability check is capped or limited to fifty-two (52) weeks in duration. 85A O.S. B.2
Permanent Partial Disability Awards & Settlements For Hip, Knee, Ankle & Foot Injury Cases
The Colorado Worker’s Compensation Court has determined that the term “permanent partial disability” means only that permanent injury or loss of use of a injured worker’s hip, knee or ankle/foot after after said worker reaches his or her maximum medical improvement following receipt of active medical treatment, including surgery. The ultimate determination of the monetary dollar amount of any given worker’s permanent partial disability settlement will be made by a judge of the Colorado Workers’ Compensation Commission.
All Evaluations Of Permanent Partial Disability In Colorado Must Be Based Upon ‘Objective’ Medical Findings
Any expert medical opinions addressing the issue of permanent partial disability submitted to the Court by any Colorado City or Denver Worker’s Compensation attorney must be supported by objective medical findings. The Colorado Workers’ Compensation Court has defined the term “Objective Findings” to mean only those findings which cannot come under the voluntary control of the hurt worker. To be clear—when determining the amount of an injured worker’s permanent partial disability in Colorado, any doctor, or even the judge deciding the case, cannot consider the injured worker’s subjective complaints of pain. Finally, all medical opinions offered as evidence in a workers’ compensation proceeding in Colorado which address the issue of permanent partial disability and/or impairment must be stated within a reasonable degree of medical certainty.
In Colorado Knee, Ankle, Foot & Other Lower Extremity Injuries Are ‘Scheduled’ Injuries For PPD Purposes
The Colorado Workers’ Compensation Court has determined that, for determining an award for permanent partial disability, an injured worker’s knee, ankle, and foot is a ‘scheduled’ injury.
In Colorado Hip Injuries Are Whole Person—Not Scheduled Injuries—For PPD Purposes
“Permanent disability” means the extent, expressed as a percentage, of the loss of a portion of the total physiological capabilities of the human body as established by competent medical evidence and based upon the sixth edition of the American Medical Association guides to the evaluation of impairment, if the impairment is contained therein.
The Colorado Workers’ Compensation Commission has determined that a pre-existing condition is one, whether or not job-related, for which an injured worker received medical advice, treatment or a diagnosis, before the date of injury of that worker’s current injury.
Combined Permanent Partial Disability Awards Given To One Worker Cannot Exceed 100%
In Colorado an injured worker cannot receive more than one-hundred percent (100%) permanent partial disability or impairment for either a single injury or even a combination of two or more awards or injuries whether for one body part or even for the body as a whole. 85A O.S. § 45C.1
Permanent Total Disability Benefits For Hip, Knee, Ankle And Other Lower Extremity Injury Cases
Introduction To Colorado Workers’ Compensation Permanent Total Disability Settlements
The Colorado Workers’ Compensation Commission has determined that the term ‘Permanent Total Disability” means an injured worker’s inability, as a result of his or her hip, knee, ankle or other lower extremity injury, to make or otherwise earn money in virtually any form or type of employment for which the worker is currently able to perform, or even potentially could become able to perform, by further education or training, including vocational training provided by the worker’s employer and/or its workers’ compensation insurance company.
‘Statutory’ Permanent Total Disability Benefits In Colorado
Under the Colorado Workers’ Compensation law—an injured worker’s total loss of both hands, both feet, both legs or both eyes, or any two of these losses in combination, automatically qualifies such worker to a permanent total disability check.
The Term “Gainful Employment” has been defined by the Colorado Workers’ Compensation Court to mean an injured worker’s capacity to perform employment or other work for pay or wages for a period of time that is not part-time, occasional or sporadic.
Medical opinions addressing permanent disability shall be stated within a reasonable degree of medical certainty.
Computing Injured Worker’s Average Weekly Wage
wages means the monetary compensation received by the injured worker at the time of his or her injury, including the calculable value of that worker’s room, board, rent, housing, lodging or other similar advantage received from the employer, including tips reported for tax purposes.