In a bill passed May 4, injured workers in Colorado will have more control over the selection of their primary treating physician in workers’ compensation cases.
S.B. 21-197 would allow workers to choose from any level I or level II accredited physician through the Colorado Division of Workers’ Compensation. If a worker is unable to make a selection or declines to do, the bill requires the employer or insurer to choose a treating physician.
First introduced on March 24, the bill is moving quickly and has a high probability of passing. It has passed both the 1st Committee and the Colorado Senate as of May 04, 2021, with amendments. Currently, the bill is headed to the 2nd Committee and the 2nd Chamber, where it has a 95% chance of passing and becoming enacted.
Current amendments to S.B. 21 197 as of May 4, 2021 indicate the following:
- Within seven (7) days of notice of an on-the-job injury, the employer or insurer shall provide the injured employee with written notice of the following:
- Their right to designate a treating physician; and
- Where to access the list of level I and level II accredited physicians.
- The employee may make one treating physician designation any time after the on-the-job injury, but before being placed at maximum medical improvement.
- If the employee declines to designate a physician within seven (7) business days after receipt of the notice, the employer or insurer may designate a level I or level II accredited physician on the employee’s behalf.
- In an emergency, the injured employee shall be taken to any physician that can provide the necessary care. However, when emergency care is no longer required, the rules above will take effect.
- An employee may obtain a one-time change in treating physician provided that:
- It is within ninety (90) days of the first physician designation;
- The notice is in writing and directed to the insurer or employer’s authorized representative; and
- The new physician is a level I or level II accredited physician and the transfer of care does not pose a threat to the employee’s health.
- The insurer, or an employer’s authorized representative (self-insured), must track how often injured employees change their treating physician.
- If the new physician refuses to treat within five (5) days after change notice, the employee may request a different authorized physician.
- If no other authorized physician is willing to provide treatment, then the insurer (or designee) can designate a new authorized physician within fifteen (15) calendar days.
- Upon written request to the insurer or the employer’s authorized representative (self-insured), an injured employee may procure written permission to have a personal physician or chiropractor treat the employee.
- If the employer or insurer neither grants nor refuses the permission request (in writing) within twenty (20) days after the date of the written request, any objections to the request will be waived.
If you would like to voice concerns on CO S.B. 21-197, you may utilize the Colorado General Assembly ‘Find My Legislator’ tool here.
As the bill moves through the legislative committee process, Broadspire’s compliance and claims teams are closely monitoring amendments and updates and are prepared to execute the ruling once passed by the State of Colorado.