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Claims adjusting in the Colorado workers’ compensation system requires extensive knowledge of and compliance with all statute and rule requirements governing the handling of claims. It is the first point at which the facts of a claim are reviewed in light of thresholds established by law. Reviewing all available information, the adjuster must timely state a position and either assign liability to its insurer, or deny liability for the payment of benefits in the first instance.
Rule 4 Carrier Compliance
Rule 5 Claims Adjusting Requirements
Rule 6 Modifications, Termination or Suspension of Temporary Disability Benefits
Rule 7 Closures of Claims, Approval of Settlement Agreements and Petitions to Reopen
Rule 8 Authorized Treating Physician/Independent Medical Examination
Rule 9 Division of Workers' Compensation Dispute Resolution
Rule 10 Medical Utilization Review
Rule 11 Division Independent Medical Examinations
Rule 16 Utilization Standards
Rule 17 Medical Treatment Guidelines
Rule 18 Medical Fee Schedule
The Adjuster’s Guide was developed by the Division of Workers' Compensation as an informational tool for claims adjusting in Colorado. Generally, the information pertains to claims with dates of injury on or after July 1, 1991, when significant reform legislation was signed into law. The Workers’ Compensation Act of Colorado can be accessed through our website or a copy may be obtained from Customer Service. If this Guide does not answer a specific question or if you would like to scheduel tailored training to meet the specific needs of your organization, contact us at 303-318-8700.
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Insurers are required to conduct an exit survey of injured workers, or if deceased, the decedent’s dependents upon closure of a claim. This applies to all claims that close on or after July 1, 2010. In accordance with the referenced legislation, the survey was developed by the Director with input from insurers for the least administrative burden possible. The results of the survey must be reported to the Division annually.
Send in first reports and subsequent injuries online and access trading partner forms.
At the time a position statement is mailed, the insurer must provide the claimant with a copy of the Claimant Brochure describing the claims process and informing the claimant of his or her rights.
Division of Workers' Compensation
633 17th Street, Suite 400
Denver, CO 80202
303-318-8700 (Metro Area)