Appealing a Colorado Workers' Compensation Denial
If you're unhappy with the insurance company's decision, you can request a hearing in front of a Colorado worker's comp judge.
If you disagree with any decisions made by the insurance company on your workers' comp claim, you have the right to appeal those decisions. It is a good idea to have an attorney help you navigate this complex procedural process in order to ensure all of your rights are protected. (For information about filing a claim, see our article on eligibility and filing for workers' comp in Colorado.)
First if you are unhappy with the final decision of the insurance company and want to take it to a workers' comp judge, you can ask for a hearing. Before requesting a hearing, you can first try to talk with your employer or their insurance company to work out your differences, but if this doesn't work, you can request a hearing or prehearing. Next, if you are unhappy with the hearing decision, you can appeal to a higher court.
Finding an Attorney
You can use Nolo’s attorney directory to locate a Colorado workers’ compensation attorney. The attorney will not charge you an initial consultation fee and will be paid only if the attorney is successful on the claim. If the attorney wins your case, their fee will be a percentage of the amount of money awarded by the insurance company.
Requesting a Prehearing
If you are unable to resolve any problem by informally discussing your concerns with the adjuster or your employer, you have the right to request a formal hearing on any disputed issue. But before you do that, or while you are waiting for the formal hearing, you can request a prehearing conference, or a settlement conference, through the Division of Workers’ Compensation.
The Worker's Comp Division offers staff persons who will informally meet with you and your employer and/or the insurance company to help settle your differences. But be forewarned: this staff person is not your advocate and cannot give you legal advice. If the informal process doesn't work to your satisfaction, you will still have the right to go to a formal hearing.
For information on setting up a prehearing, contact the Prehearing Unit:
DOWC Prehearing Conference Unit
633 17th Street, Suite 300
Denver, CO 80202-3626
Phone: (303) 318-8736
Fax: (303) 318-8740
What Happens at a Prehearing?
A prehearing is an informal meeting presided at by an administrative law judge. This judge has the right to order both parties to attend. The meeting is a chance to talk about the disagreements in the case before the judge to try and reach a resolution. The judge has the right to order certain documents to be provided to help decide the case.
You can also ask the judge to preside over a settlement conference, but in that case, both parties must voluntarily agree to attend. You may be able to resolve some or all differences. If you are not successful you can go on to the formal hearing.
Requesting a Full Hearing
To ask for a hearing, you will need to file an Application for Hearing. If you want to request an expedited hearing, you must file an Application for Hearing within 45 days of the date the Notice of Contest was mailed to you. (The Notice of Contest is the form you will receive in the mail telling you your claim has been denied.)
You must submit the Application for Hearing online or mail or fax it to the Colorado Office of Administrative Courts that is closest to you. You also must mail a copy to the insurance company.
Here is the contact information for the Office of Administrative Courts:
1525 Sherman Street, 4th Floor
Denver, CO 802013
1259 Lake Plaza Drive, Suite 230
Colorado Springs, CO 80906
Fax: (719) 576-2978
222 S. 6th St., Suite 414,
Grand Junction, CO 81501
Expedited hearings are scheduled within 45 days of the date you submit the Application for Hearing. Other hearings will be scheduled within 80 to 100 days.
You can ask for a hearing in one of the following cities: Denver, Boulder, Colorado Springs, Durango, Fort Collins, Glenwood Springs, Grand Junction, Greeley or Pueblo.
While you are waiting for your hearing date, you can try to reach an agreement with your employer through a prehearing, mediation of a settlement agreement, or arbitration.
What Will the Formal Hearing be Like
The hearing will be a formal proceeding before an administrative law judge. Both you and your employer or the insurance company can present evidence, and a court reporter will make a record of the hearing. There will not be a jury, and you will not be charged a fee for having the hearing.
A decision may be issued against you if you do not appear for the scheduled hearing.
Should I Use Arbitration?
Another informal process for resolving disputes is arbitration. Administrative law judges are available in various cities to conduct arbitrations. These judges are available in Colorado Springs, Boulder, Fort Collins, Durango, Denver, Pueblo, Greeley, Grand Junction, or Glenwood Springs. It is best to hire an attorney to help with arbitration as arbitration, unlike a hearing, may be binding (permanent).
The Division of Workers' Compensation is also a resource for information regarding options for arbitration before an administrative law judge.
What if I Disagree With the Judge's Decision?
The judge's decision is called an order, and you will receive a copy of this decision in the mail.
If you disagree with the judge’s decision you have the right to file an appeal. It is very important to get an attorney to assist you if you want to appeal a hearing decision as there are strict procedural rules that must be followed or you might lose your right to appeal. For example, you must file a Petition to Review within 20 days from the date the judge’s order was mailed to you.
You will also need to order a transcript of your hearing. You’ll need to write to the court reporter who presided at your hearing to request this transcript. There will be a cost for ordering the transcript. If you cannot afford it, file an Application for Indigent Determination (Hearing Transcript). This application must be submitted either online or by mail to:
Division of Workers’ Compensation
633 17th ST., Suite 400
Denver, CO 80202-3626
The next step to appealing a hearing decision is to submit a brief, which will contain detailed legal arguments in support of your appeal. The administrative law judge will read the arguments submitted by both sides and make a decision or may send the appeal to the Industrial Claim Appeals Panel.
The Industrial Claim Appeals Panel will review the judge’s decision and both sides’ arguments and issue a decision within 60 days. The decision will be mailed to you.
If you are still unhappy with the decision, you can appeal to the Colorado Court of Appeals, but you must do so within 20 days. If you are still dissatisfied, you can then appeal to the Colorado Supreme Court, but the court is not able to hear all cases submitted to it.