Colorado: Workers’ Compensation Changes to Employee Selection of Treating Physician
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APPLIES TO All Employers with Employees in CO |
EFFECTIVE January 1, 2028 |
QUESTIONS? Contact HR On-Call |
Quick Look
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Discussion
HB 1300 will give employees broader ability to select their primary treating physician for purposes of receiving health care in connection with a workers’ compensation claim. Within seven days of receiving notice of an on-the-job injury, employers must give written notice to the employee of their right to designate a treating physician, including where to access the Division of Workers’ Compensation’s list of Level I and Level II accredited physicians. The Division will provide a template designation form on which employees are required to designate their preferred provider.
The designated physician must be within 70 miles of the employee’s work or home address, unless there are three or fewer physicians within 70 miles who are willing to treat the injured employee, in which case the designated physician must be within 100 miles, unless the employee can show good cause otherwise.
The employee may make one treating physician designation any time after injury, but before being placed at maximum medical improvement. If the employee declines to designate a physician within seven days after receipt of notice of their right to designate, an employer or insurer may designate the Level I or Level II listed physician on their behalf. However, the employee may still subsequently designate a physician. An employee can subsequently change their designated treating physician once within 120 days after the first physician designation, but before the employee reaches maximum medical improvement.
For injured employees who are not a resident of Colorado, an employer must designate a treating physician within 10 days after receiving notice of an on-the-job injury and notify the employee of the designation in writing. The treating physician may be within 100 miles of the employee’s home address. If the employer or insurer declines to timely designate, the employee may designate a treating physician within 100 miles of the employee’s home in writing to the employer or through attendance at an appointment with the employee’s designated physician.
In an emergency situation, an injured employee must be taken to any physician or health-care facility that is able to provide the necessary care. Once emergency care is no longer required, the treating physician selection procedures may be followed. Within seven days of receiving notice that emergency care is no longer required, an employer or insurer must provide written notice to the injured employee of their right to designate a treating physician.
Additionally, an employer or the employer’s insurer will be required to use the Division of Workers’ Compensation’s utilization standards when responding to a request for authorization from a treating physician. If they do not, the director of the Division may deem the physician’s services as authorized, reasonable, and necessary and require payment for the services by the employer or the employer’s insurer.
Action Items
- Review the bill here.
- Implement the notice of rights and physician designate form when provided by the Division.
- Update procedures to include timing requirements to send the notice.
- Have appropriate personnel trained on the requirements.
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