Why Estate Planning Matters in Colorado

In workers’ compensation, the immediate response to a workplace accident is often to file a General Admission of Liability, especially when the incident meets the legal criteria of occurring during working hours and employment. However, a prudent approach suggests pausing before rushing into such an admission and carefully examining the legal definition of “injury.” 

Consider a scenario where an employee experiences an accident at work, resulting in physical symptoms that prompt a visit to a medical facility. The medical diagnosis indicates contusions and abrasions consistent with the reported injury. The employee returns to work, fulfilling regular or modified duties without apparent disruptions. Has an “injury” occurred in this case?

Surprisingly, the answer is no. According to the Colorado Workers’ Compensation Act interpretation, a distinction exists between an “accident” and an “injury.” An accident is defined as an unexpected or undesigned occurrence. At the same time, an injury involves not only physical trauma but also the need for ongoing medical treatment and temporary disability. Mere conservative medical treatment, without the loss of more than three regular working days, does not transform physical symptoms into a legally recognized “injury.”

Furthermore, complications arise when an employee requiring extended medical treatment and missing more than three days of work has a significant prior medical history. For instance, if the employee had a pre-existing back condition with a history of surgery, the decision to file a General Admission of Liability becomes more complex. In such cases, filing a Notice of Contest is wiser, indicating that further investigation is needed. This cautious approach allows for thoroughly examining the employee’s medical history, potentially revealing that the work accident only caused a minor aggravation of a pre-existing condition, making it non-compensable.

Concerns about the possibility of bad faith claims when filing a Notice of Contest in clear-cut cases may arise. However, the essential lies in how the notice is framed – filing it “for further investigation” is distinct from declaring the incident as “not work-related.” Conducting a comprehensive investigation into prior injuries and medical conditions is acceptable before deciding on compensability. Simultaneously, authorizing and paying for conservative medical treatment does not implicitly acknowledge liability.

The strategic advantage of “contesting first and admitting later” becomes evident in its ease of allowing adjustments based on investigative findings. Conversely, admitting liability prematurely and attempting to withdraw that admission later can be complex and challenging.