Richard E. Falcone, P.C.
Colorado Attorney
Retired

Seeking Justice in Colorado Workers Compensation and
Social Security Disability


(719) 505-8584

Colorado Workers Compensation and Social Security Disability Attorney
5 Things Never Told you
                        THE 5 THINGS INSURANCE NEVER TELLS YOU

Well - almost never. Occasionally an insurance adjuster mentions some of these but it is rare. Here are the 5 things:

1. Deadlines: While paperwork you receive may indicate a deadline, they never or seldom tell you about them. Moreover, deadlines are imposed even if you have moved. For example, you have 30 days to act when a Final Admission is mailed to you. It is the mailing date! Plus, no matter what was told to you about your future medical treatment by the doctor or adjuster, if the Final Admission doesn't mention it - it will be closed unless you act. The burden is on you!

2. Disfigurement: Any scar or burn is entitled to a benefit that depends on the discretion of a Judge. However, it can now amount to several thousand dollars. Again, it is not a huge benefit but it is important in some cases especially with a recent law change that can double the dollar amount.

3. You can have another medical opinion: Often the treating doctor is picked by the insurance or the employer. This usually means a low final benefit as they tend to rate or minimize the injury. The right to a Division Independent Medical Examination is often critical in a worker's compensation case. It can lead to further medical treatment and an increased benefit. This alone can mean many thousands of dollars. It is an enormous right that often is not mentioned by the insurance. Perhaps the paperwork mentions it but the fact is it is the Claimant's burden to timely ask for it. Over and over again this has benefited our clients.

4. If you have a second job when you were hurt seldom is it picked up by the insurance: Having a second job means the potential for higher temporary and permanent benefits. Again this can mean several thousand dollars to which a claimant may be entitled but it is seldom mentioned by the insurance. Even your average weekly wage at one job can be decided by a judge. By the way it can include overtime. Check out a case on average weekly wage decided December 2008 at our blog.

5. Your benefits can be lifetime benefits: Almost never does an insurance company acknowledge you are permanently and totally disabled or incapable of working. They usually pay you a permanent partial disability amount based on the damage you sustained from an injury (measured by a doctor). The fact is there really are lifetime benefits both financially and medically in some cases. Since this is costly, I never expect the insurance to agree on it.

Oh, there actually are more things they don't tell you about. They don't tell you about penalties, lump sums, your right to reopen, and many other matters. While most insurance companies are not going to violate the law, they are not your friend. A shoulder injury could result in permanent benefits calculated two different ways - one high, one low. The insurer almost always uses the low calculation. The difference could be many thousands of dollars. The bottom line is: Never, Never, Never assume the insurance is right or being fair.  Call us at (719) 505-8584 but Mr Falcone is now retired and not taking any legal matters at this time. He encourages you to obtain an attorney whenever possible as these areas are terribly difficult especially when there is a dispute or a serious injury.

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