A PUBLICATION BY THE LAW FIRM OF

Clifton, Mueller & Bovarnick, P.C.

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ATTORNEYS AT LAW

2005

DECEMBER

   The Division of Workers’ Compensation has adopted new rules of procedure to take effect January 1, 2006. 

   The new rules will no longer be numbered by Roman numerals.  Former Rule VIII regarding hearings and discovery has been repealed and replaced by Office of Administrative Courts Rules 1 through 28 which will also take effect January 1, 2006.  Claims Adjusting Requirements now fall under Rule 5.  It is important to note several changes and requirements, for example:

  

   Rule 5-1(C) states effective July 1, 2006, all first reports of injury and notices of contest shall be transmitted electronically, which includes either electronic data interchange, or via the Division’s internet filing process, but not via electronic mail.

  

   Adjusters may request releases and medical records pursuant to Rule 5-4(C) which states a party must, within 15 days from the date of mailing, complete, sign, and return releases for medical or other relevant information.  Claimant must also provide a list of healthcare providers.  Treatment for the past 5 years will be considered reasonable.  These requests are not considered discovery.

  

   The Division now has the statutory authority to levy fines against an insurer for a pattern and practice of poor claims adjusting.  Rule 4-1(C) allows audits to be performed on insurers to establish a baseline of their compliance with statutes and rules. 

   Subsequent audits could result in fines if adjusting practices do not meet acceptable

Clifton, Mueller & Bovarnick, P.C., has a new address, effective immediately.  The new address is:

789 Sherman Street, Suite 500

Denver, CO 80203  

Telephone (303-988-7692) and facsimile (303-988-7724) numbers remain the same.

CMB Has Moved!

 

levels.  Compliance levels below 90% are considered to be noncompliant with applicable statutes and rules. 

   Rule 11-4(A) allows a DIME doctor to request additional payment if the case is complex or involves multiple body parts.

   Rule 11-2(H) better defines the situations in which an appearance of conflict does not exist when determining whether a particular doctor can perform the DIME.

   Rule 11-4(C) allows the DIME doctor to keep $250 (previously $150) if the appointment is not cancelled timely, the claimant does not appear, or medical records are not submitted timely.

  

   These are just a few of the new rules intended to reduce litigation; however, the additions and deletions of certain rules may in fact increase litigation.  Contact any of the attorneys at CMB to avoid unnecessary penalties or fines. 

New Workers’ Compensation Rules

CMB Welcomes New

Attorney Michael P. Curry

   Michael P. Curry was born and raised in Cleveland, Ohio.  Michael received a Bachelor of Science degree in business from Miami University and is a graduate of Miami University International Business School, in Luxembourg, Europe.

   Michael received a joint JD/MBA degree from Case Western Reserve University and is licensed to practice law in Ohio and Colorado.

   In addition to practicing law, Michael likes to snowboard, hunt, and play piano.   While studying for the bar exam, he coached little league baseball.

Supreme Court Finds General Contractor

Immune

Hall & Co., Inc. v. Newsom, 04SC275 (December 19, 2005)

   The Supreme Court (SC) reversed the Court of Appeals and found Hall & Co. (Hall) as a general contractor was Newsom’s statutory employer and therefore immune from a personal injury suit.

   Newsom was employed by Diamond Excavating, a subcontractor engaged by Hall to perform excavation work.  Newsom was injured and recovered from Diamond’s workers’ compensation insurance carrier.  After recovering from Diamond, Newsom filed suit against Hall. 

   A jury found Hall negligent which resulted in a $160,000 judgment against Hall.  The SC relied on C.R.S. 8-41-401 and found Newsom had no right of action against Hall as Newsom was an employee of a subcontractor for whom the general contractor was liable.

   What this means to you:  General contractors, as statutory employers, are immune from tort liability to employees of their subcontractors. This decision restored the law to what it was before the Court of Appeals decision.