If you have a Colorado Workers’ Compensation claim, at some point your insurance company will send you either a General Admission of Liability, or a Final Admission of Liability. These documents list the benefits that the insurance company thinks it should pay you.
The General Admission has no deadline attached to it, but the Final Admission has some very important deadlines that you must meet.
The Final Admission of Liability is used by the insurance company to close your workers’ compensation case. It is generally filed after your treating physician has placed you at maximum medical improvement (MMI) and issued a report stating whether you have any permanent impairment from your injury.
Key facts about your Final Admission of Liability:
- This is one of the most important documents that you will get in your case.
- You have only 30 days from the date of the admission to respond to it.
- The 30-day deadline is very strict.
- If you miss the deadline you can destroy your case.
- Protecting your rights at this stage of your claim is very important.
What do I have to do when I receive a Final Admission?
- You must file an Objection to Final Admission within 30 days from the date the admission was mailed to you.
- You must also either request a hearing or ask for a Division Independent Medical Examination (DIME).
Deciding whether to request a hearing or DIME is best left to an experienced attorney. Also, the insurance company is required by law to include two forms with the Final Admission: (1) the Objection to Final Admission and (2) the Notice and Proposal to Select a Division IME. But they are not required to send you a copy of the Application for Hearing form. As a result, you may not even have all of the documents you need to protect your right to seek additional benefits for your injuries!
You must be very careful when deciding to ask for a DIME.
The selection of the DIME doctor can make or break your case.
Choosing the DIME doctor can have drastic consequences for your case. If your case ends up in court, the DIME doctor’s opinion is entitled to extra weight, and can only be overcome with “clear and convincing” evidence.
It is crucial to select a doctor who is likely to be fair to you. Overcoming the opinion of the DIME doctor is usually very difficult. Generally, judges will not find that a DIME doctor is wrong.
The law requires you to negotiate with the insurance company and try to agree on a doctor to perform the DIME. Of course, the claims adjuster has done this multiple times and knows which doctors are more likely to favor the insurance company and the employer. On the other hand, you have no way to know which doctors tend to be fair.
For this reason, its easy for the adjuster to take advantage of you and trick you into agreeing to an unfavorable doctor. At the very least, you lose the opportunity to suggest a reasonable doctor that the insurance company might agree to.
If you cannot agree with the adjuster on a doctor to perform the DIME, the Division of Workers’ Compensation will issue a list of three doctors, and each side has a chance to strike one doctor. The adjuster knows what doctor on the list will give them the best result, but probably won’t know which doctor is most likely to be fair to you.
For these reasons, it is generally advisable to have an experienced attorney working for you to maximize your odds of a favorable DIME.
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