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3rd Quarter 2025
Newsletter
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Major Colorado Changes Regarding
ATP Selection
COMING IN 2028
Cameron Azimi
On June 4, 2025, Governor Jared Polis signed House Bill 25-1300 “Workers’ Compensation Benefits Proof of Entitlement” into law.
Workers’ compensation stakeholders should become familiar with this law, as it (1) dramatically changes the method of selecting an authorized treating physician; (2) changes the method of changing an authorized treating physician (“ATP”); and (3) clarifies the consequences of not using the Medical Treatment Guidelines.
Selecting an ATP
The law’s most significant change is to the provisions on the process of initially selecting an ATP contained in C.R.S. § 8-43-404(5)(a)(I). Currently, employers must provide an injured worker with a Designated Provider List within seven business days of having notice of a work injury. The required number of providers on the list varies based on the employer’s place of business. The injured worker then selects a physician from this Designated Provider List, who then serves as the ATP. . .
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Implementation:
This law will take effect on January 1, 2028. Governor Polis has called for the creation of a working group of stakeholders, legislators, and agency staff to formulate recommendations for the law’s implementation. Specifically, this working group is to address the following issues:
1. Further clarifying the permissibility of in-house clinics that employ level 1 or 2 accredited physicians as an option available to injured workers.
2. Clarifying that nothing precludes an employer or insurer from selecting any number of level 1 or level 2 accredited physicians to provide as a list of recommendations.
3. The functionality of DOWC’s provider directory and clarifications around appropriate provider types to serve as a designated provider.
4. The accreditation process for providers, including DOWC tracking of licensure and malpractice status.
5. The applicability of the premium credit described in the Division of Insurance’s Amended Regulation 5-1-1 Section 5(E).
6. Clarification of any timelines, including around designation of and change of physician, or other legislative provisions to ensure workers receive prompt care; and
7. Identifying mechanisms to lower costs.
While it remains to be seen how the working group may shape the law’s implementation, the “Workers’ Compensation Benefits Proof of Entitlement” law will have a profound effect on medical treatment under the Colorado Workers’ Compensation Act.
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May the Holidays Bring You Joy!
To our great clients, employees and friends, enjoy the Holiday Cheer. May the New Year be bright and filled with endless opportunities.
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Substantial justice requires that the resolver of testimonial conflicts, for either expert or non-expert witnesses, directly hear all conflicting testimony.
In Yant, the applicant, an airline attendant, sustained an admitted workplace injury by rolling her right ankle in October 2022, then in December 2022, she rolled the same ankle while at home, and then in March 2023, while working, she experienced pain in her right ankle when she had to jump over a coworker who had fallen in the aisle of a plane.
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ARIZONA CASE LAW UPDATES
Requirements of Substantial Justice re Conflicting Testimony
Maura Healy
The provider under the claim, Dr. Jason Lake, indicated that the injury caused and was exacerbated in December 2022, and that the March 2023 incident also aggravated the existing injury.
Dr. William Leonetti performed an IME in April 2023 and concluded that the applicant had reached maximum medical improvement and was stationary with no permanent impairment. This conclusion formed the basis of the respondents’ closure of the claim. The applicant applied for hearing to challenge the closure.
...[more]
Yant v. Indus. Comm'n of Arizona, No. 1 CA- IC 24-0057, 2025 WL 2355438 (Ariz. Ct. App. Aug. 12, 2025).
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ARIZONA CASE LAW UPDATE
Average Monthly Wage as a Reflection of the Applicant’s Actual Monthly Earning Capacity
The average monthly wage should reflect the injured worker’s actual monthly earning capacity.
In Douglas, the applicant, a nurse, was injured on December 17, 2021. The respondent parties calculated the applicant’s average monthly wage at the time of the injury by taking her total earnings from January 1 through December 15, 2021, and dividing it by the number of days in the period to obtain her daily earnings, which was the basis to calculate her average monthly wage.
This total was approved by the Industrial Commission of Arizona (ICA). The applicant challenged this calculation, asserting that her average monthly wage should be the 2021 statutory maximum.
The applicant worked for the employer since 2011. For most of her employment, she worked full-time as a licensed practical nurse (“LPN”). In August 2020, she returned to nursing school, and her employment status with the employer changed to “part time or as needed” at an hourly rate of $32.96.
On October 30, 2021, she became licensed as a registered nurse (“RN”), and her employment status changed to full time at an hourly rate of $36. The employer’s minimum hour requirement for full-time employment was 32 hours per week, but nurses could work more than that. Additionally, the applicant worked fewer hours than the minimum in November 2021, with permission from the employer, for personal reasons. On December 1, 2021, she returned to full-time hours, approximately 16 days before the incident occurred. ...[more]
Douglas v. Indus. Comm'n of Arizona, No. 1 CA-IC 24-0034, 2025 WL 2453105 (Ariz. Ct. App. Aug. 26, 2025).
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Workers' Compensation Defense, Employment Law Attorney
SPOTLIGHT
Meet Associate Attorney Maura Healy who serves our Denver, Colorado and Phoenix, Arizona offices.
Maura focuses their practice on insurance defense litigation, including representing companies, employers, and insurance carriers in workers’ compensation, liability, and subrogation matters, as well as employment law matters, including employee discipline, termination, and labor law. Maura is licensed to practice law in Colorado and Arizona.
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To read all of the latest Legislative and Case LawUpdates
visit our web blog.
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Beeler v. Xcel Energy, W.C. No. 5-214-976-005, (I.C.A.O. May 19, 2025).
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COLORADO CASE LAW UPDATES
Road Rage Leads to Whole Person Rating
Charles Foster
In Beeler, the Industrial Claims Appeals Office (the Panel) affirmed the ALJ’s decision, finding that the situs of the claimant’s functional impairment extended beyond the arm at the shoulder, and therefore the permanent disability rating was properly calculated as a whole person impairment.
On August 4, 2022, the claimant was assaulted in a road rage incident while working as a utility meter reader. He sustained a traumatic, incomplete tear of the right rotator cuff, requiring shoulder replacement surgery and biceps tenodesis. ...[more]
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Colorado:
Penalties - Failure to Timely File Final Admission of Liability
Charles Foster
In Cardona, the Industrial Claims Appeals Office (the Panel) affirmed the ALJ’s decision to award $18,000 in penalties under § 8-43-304(1), C.R.S. for failure to timely file a final admission of liability in accordance with WCRP 5-5(E).
In Cardona, the claimant suffered a work-related injury to his left knee on April 20, 2022. He was placed at maximum medical improvement (MMI) by his authorized treating physician (ATP) on January 17, 2023, and assigned a 16% lower extremity impairment rating on January 24, 2023. The MMI report and related documents were mailed to the insurer on January 26, 2023.
The ALJ found that the respondents received the ATP’s report and worksheet on February 1, 2023, as evidenced by a date stamp. However, they did not file a Final Admission of Liability (FAL) until February 27, 2024, more than a year later ...[more]
Cardona v. Baker Concrete, W.C. No. 5-219-483-002, (I.C.AO. July 28, 2025).
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Colorado:
Average Weekly Wage Calculation – Default vs Discretionary Method
Charles Foster
In Hargon, the Industrial Claims Appeals Office (the Panel) found no reversible error in the ALJ’s exercise of discretion regarding calculation of the claimant’s average weekly wage (AWW). The Panel affirmed that the ALJ correctly cited the law and reasonably declined to base the claimant’s AWW on speculative future earnings.
The claimant was injured in a motor vehicle accident on February 29, 2024, while working for Milvets Systems Technology. At the time, she also held concurrent employment with Client Services Architect (CSA). The respondents submitted a General Admission of Liability, admitting for an average weekly wage (AWW) of $382.65 and awarding ongoing temporary total disability (TTD) benefits beginning March 16, 2024.
The claimant had worked for both Milvets and CSA since 2019. Her work typically involved participating in military exercises lasting two to three weeks, with 12-hour shifts over seven consecutive days.
...[more]
Hargon v. Milvets Systems Tech. Inc., W.C. No. 5-267-135-001, (I.C.A.O. May 6, 2025).
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