Can an Employer Deny Workers’ Comp After an Injury in Colorado?

In Colorado, workers’ compensation is designed to protect employees who are injured on the job, ensuring they have access to the medical care and financial support they need during recovery. However, navigating the workers’ compensation system can be confusing, especially if your claim gets denied after an injury. Injured workers may be curious about their legal rights, such as whether an employer can deny a claim. At our Denver law office, we help injured workers navigate the workers’ comp process.

Workers’ Compensation Basics in Colorado

Under Colorado law, unless they are self-insured, almost all employers are required to carry workers’ compensation insurance. This no-fault system means that employees can file a claim for benefits regardless of who was at fault for the injury. Workers’ compensation benefits generally cover medical expenses, a portion of lost wages, and rehabilitation costs, permanent impairment and disfigurement. However, there are cases where an employer may legitimately deny a workers’ comp claim.

Reasons an Employer Might Deny a Claim

1. The Injury Didn’t Happen on the Job: Workers’ compensation only applies to injuries that happen while performing job-related duties. If the injury occurred outside of work or during personal time, the employer might deny the claim.
2. The Employee Failed to Report the Injury Promptly: Colorado law requires employees to report work-related injuries promptly. If you delay reporting, the employer might deny your claim, arguing, for example, that your delay makes it difficult to confirm the injury’s cause. Though there is a two-year statute of limitations for filing most claims, Employees who wait longer than four days to report an injury might face a penalty even if the claim is compensable.
3. Injury Caused Only by Pre-existing Conditions: If the employer believes your injury was due to a pre-existing condition rather than a new work-related incident, they might deny the claim. For example, if you had a history of back issues and report a back injury, the employer might argue that the injury was unrelated to your job. Keep in mind, however, that aggravations of pre-existing conditions are also compensable.
4. Misconduct or Drug/Alcohol Use: If the employer can prove that the injury resulted from the employee’s misconduct, such as unsanctioned horseplay. Intoxication from drugs or alcohol at the time of injury creates a rebuttable presumption that it caused or contributed to cause an injury and can lead to a reduction in financial benefits.

What to Do If Your Claim Is Denied

If your workers’ compensation claim is denied, it doesn’t mean you’re out of options. Colorado has a process in place allowing injured workers to litigate denied claims, and there are steps you can take to fight back.

1. File an for a Hearing: In Colorado, if your claim is denied, you have the right to attend a hearing with the Office of Administrative Courts. At the hearing, you’ll have the chance to present evidence to support your claim.
2. Gather Documentation: To strengthen your case, gather all relevant documents, including medical records, witness statements, and any incident reports. These records can help establish that your injury was job-related.
3. Seek Legal Advice: Litigation can be challenging, and having an experienced workers’ compensation attorney can make a significant difference. An attorney can help you gather evidence, navigate the legal system, and advocate for your rights.