Red Flags Adjusters Look for in Colorado Work Injury Claims

Insurance adjusters look for specific problems or signs with every work injury that will cause them to investigate and deny claims. Before joining Kaplan Morrell, Margaret worked as workers' compensation adjuster for 12 years and had to admit or deny work injury claims. She tells us what red flags caused her to question a claim's legitimacy.
If your claim has been denied, call Kaplan Morrell for your complimentary workers' compensation consultation at 303-780-7329.
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This video is designed to provide accurate and authoritative information regarding the workers’ compensation law in Colorado. This information is given with the understanding that this video does not create an attorney-client relationship. Since the details of your situation are fact-dependent; you should contact us to advise you how the law affects your particular circumstances.

[@ladyj5682]

Thanks for coming to the right side and empowering us all

[@KaplanMorrellLaw]

Our pleasure!

[@specialboy7809]

Thank you

[@KaplanMorrellLaw]

Thank you for watching the videos, we are glad you like it.

[@Matthew-tn3dl]

I injured my back on a Friday. I got home late from work that night hurting pretty bad, but thought I would just rest for the weekend and be ok by Monday. Also, I'm not the type of person who goes running to the doctor right away just because something hurts. On Sunday I was still hurting so I called my boss to let him know. I was working with a supervisor at the time so I had a witness. About a week later I ended up going to an Urgent Care because the pain just wasn't going away, it was actually getting worse. I told doctor where, when, and what happened. Also told her I had a previous back surgery 13 years ago (non-work related and well documented) had fully recovered, no restrictions, and been working for past 12 years with no issues. The doctor thanked me for my honesty and took some x-rays. Unfortunately x-rays came back with abnormalities, so an MRI was ordered, that showed an Injury and could explain the pain I was having. After watching your video it seems that I was showing "red flags" such as getting hurt on Friday, not reporting it same day, and even having a previous back injury, but not all red flags mean a person is being dishonest. Unfortunately there are people out there making bogus claims that put legitimate injuries in question.

[@KaplanMorrellLaw]

Matthew you are absolutely right. Red flags don't mean the claim will get denied - as always the best policy is to be open and forthcoming.

[@nappyfries]

Same goes for me. I was hurt on a Friday before memorial day weekend & didn’t report it until Tuesday when we got back for 2 reasons. One bc of what you said. I don’t run to the dr for everything & I also thought I’d feel better but I didn’t. But also my boss is known for intimidating people & I was worried what would happen if I filed a claim.

[@benalexender3046]

Thanks ❤

[@juanvillarreal4112]

A supervisor hit me with the forklift and they're getting a f****** lawsuit

[@KaplanMorrellLaw]

Hi Juan, We are sorry to hear about this, in which state were you injured?

[@jearelleno11]

Ughhh been going through this mess for two years two back surgerys and still am not fixed the worst part after the first year no one calls you any more and doctors appointments get very spread out ... If I didn't call my lawyers every time workmans comp didn't pay me for the week or they didn't pay for my prescription I'd never even talk to my lawyers lol ... I don't want to say my lawyer's but it's not these guy's .

[@KaplanMorrellLaw]

Hi Josh! I am sorry to hear this. For prescription issues - if you are in Colorado - get in touch with Injured Worker Pharmacy - they may be able to take that worry off your hands. kzbin.info/door/7C3DdgF0I7OWBMJd8anmrA

[@ernestorodriguez8367]

You are a good person always and good smile. Always Dios te bendiga siempre

[@KaplanMorrellLaw]

So nice of you

[@lillyhammer1227]

Great info, thanks for posting this video.👍

[@KaplanMorrellLaw]

You're welcome! Thanks for watching!

[@deborahforrest5601]

4 mris, 3 found none 4th found tare and when the doctor did surgery, he says he was shocked what he found and questioned who was reading all my MRI's.

[@KaplanMorrellLaw]

Wow - that's awful to hear. Unfortunately too often Doctors think MRIs are perfect. They are not! Thanks for sharing.

[@19lol19]

I wish this video was longer? Why is it so short?

[@KaplanMorrellLaw]

Heck we could talk all day! We just wanted to give the community a few of the big red flags. Thanks for asking!

[@oliverseamus4133]

Quick question knowing its hard to give a exact answer. Fell down at work ups Nd tore meniscus in left knee bruised right knee. Got meniscus surgery and 7 months workmans comp. Got MMI on both knees. 15% ON RIGHT KNEE and waiting on MMI percentage on left knee. Both knees need have horrible arthritis and need surgery. Getting $14k for left knee and right probably the same. Future medical care provided. Does it sound fair ?

[@KaplanMorrellLaw]

Hi Oliver! Sorry to hear and yes it's hard to give you an exact answer because I haven't looked at everything in your case. The 15% =$14 might be right BUT it really depends. (It's like asking me how much a car is worth without knowing mileage, make, model and the interior) Feel free to reach out and send me your Final Admission and I will be happy to give you a free consultation which hopefully can give you more details. Text me at 970-356-9898.

[@Erthquake-c4g]

what happens if your employer didn't have OSHA posters posted during the time of your injury on how to report work place injury's and you reported it to your supervisor and he didn't report it? I had an MRI 17 days after my injury which showed my disk touching my sciatic nerve and still within the 30 day window for my agency to report and my supervisor still didn't report my injury. He literally thought I was lying I kept the text messages and it literally took me 7 months to get to physical therapy and I had to use my annual leave and sick leave during a 6 month span before my injury got approve by OWCP. I'm completely outraged at my supervisors and agency because now I have to go back in time and prove things just to recover wage loss which is so hard to do because of the time that passed in between of the day I reported to my supervisor to the time it was accepted that was 6 months than a total of 7 months before i got to physical therapy I literally cried because Ihad to fight for medical care . It's sad supervisors should be held accountable for there actions to deny someone free medical care. Agency's can challenged to see if someone is lying but the medical evidence was there 17 days after the injury and I provided detailed updates to my supervisor when it happened within two days of the pain becoming so bad I couldn't walk. He knew this and still didn't report it and the agency didn't have the OSHA posters posted up on how to report injury's. I'm bringing this up to my claims examiner in the DOL in California this is unacctable . The agency should be held accountable for there actions.

[@KaplanMorrellLaw]

Since it is California I can't get you clear advice since I practice in Colorado. I agree that too often Supervisors don't (or won't learn) what to do when an injury is reported. You could file a complaint with OSHA - or the State of California Occupational Safety Department.

[@brendathornlimb7677]

Why would an employer send you to a kaiser on the job if your doing your same job? Is this so they can try to pay you less. Or try ing to say your injury is different. Also if got concussion with a neck compression they only trying to except half of claim.

[@brendathornlimb7677]

Also if they say camera wasn't working but you know it was. Also you've told employer there were witnesses but you didn't know the names

[@KaplanMorrellLaw]

If the employer is sending you to Kaiser after you report a work injury - something is wrong. Kaiser doesn't (to my knowledge) offer care for work injuries. Make sure you are telling everyone in writing that this work related.

[@richardgabriel8783]

You need microphones

[@KaplanMorrellLaw]

I hear you....(pun intended) ha ha ha ha.. Sorry had to do that - but you are right. Give us time and we'll be a little more polished.

[@saljavati5856]

You guys talk too much