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You can’t keep withheld benefits if worker skips doc visit

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The Colorado Supreme Court has issued an interpretation of the suspension language in the state’s workers’ compensation law. The law says an employer can suspend total temporary disability benefits when an employee misses a doctor’s appointment. Now the Supreme Court has ruled that while the employer can temporarily hold those funds, it must turn them over to the employee once she shows up for a rescheduled medical appointment.

In other words, the employee doesn’t permanently forfeit the money. Her employer merely holds the funds until she complies with the law requiring doctor visits.

Recent case: When Eva Sigala was hurt while working at Atencio’s Market, she began receiving temporary total disability benefits under Colorado’s Workers’ Compensation Act.

That law requires injured employees to attend scheduled doctors’ appointments. If an employee misses an appointment, the law requires employers to notify employees that their benefits may be suspended if they don’t show up for a rescheduled appointment.

Sigala missed an appointment, and Atencio’s Market warned her it would suspend payments. She didn’t show for a rescheduled appointment, and her benefits were suspended.

She finally saw her doctor two months later, and the employer started paying her benefits again. The employer said Sigala permanently lost the benefits she would have received had she kept her appointments. It reasoned that the word “suspend” meant she lost the money permanently.

The Colorado Supreme Court interpreted “suspend” as a temporary term that does not signal a permanent benefit loss. It reasoned that a temporary withholding of benefits was a reasonable way to encourage employees to get appropriate medical treatment to recover from their injuries.

Now Atencio’s Market must pay Sigala all the money it withheld for the 60 days between her missed appointment and the one she finally kept. (Sigala v. Atencio’s Market, et al., No. 07-SC-73, Supreme Court of Colorado, 2008)

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