Broadspire Colorado
10375 East Harvard, Ste 240
Denver, CO 80231-3966
Mailing Address:
P.O. Box 5347
Denver, CO 80217-5347
Lost Time Claims Adjuster: Lucy Arguello
Phone: 303-632-3861
Fax:
e-mail: Luciana_Arguello@choosebroadspire.com
Non-Lost Time Claims Adjuster: Gerard Henry
Phone:303-632-3854
Fax:
e-mail: ghenry@choosebroadspire.com
Employee Responsibility | Supervisor Responsibility | Chapter 5 of the State Personnel Rules
The following is a list of Benefits Provided to Employees Covered Under the Worker's Compensation Act. Your claim must be compensable for the following benefits to apply. These benefits are provided by Broadspire Colorado.
MEDICAL
Employees must use the designated providers for all treatment related to work injuries/illnesses. Inform the provider to bill Broadspire Colorado.All authorized medical treatment related to your work related injury/illness is covered by Pinnacol Assurance. Including doctor/therapy visits, hospitalization, ambulance, surgical, crutches, apparatus, and vocational rehabilitation. You are not financially responsible for any portion of authorized medical treatment.
PRESCRIPTIONS
Prescriptions that are prescribed to you from your authorized treating physician for your work related injury/illness are covered by Pinnacol Assurance. You are not financially responsible for any portion of the prescription. You will receive an Expresscripts Card in the mail and this card will need to be presented when filling prescriptions.
MILEAGE REIMBURSEMENT
You will be reimbursed for your mileage that is required for travel to and from required medical treatment. You must submit mileage information directly to Pinnacol Assurance. (Attach mileage form) Mileage is reimbursed at .28 a mile or .32 a mile if you drive a 4 X 4.
TEMPORARY TOTAL DISABILITY (TTD)
TTD benefits are provided to you in the event that you are totally disabled from performing any work. You will be compensated at a rate of 66 2/3% of your average weekly wage in effect at the time of the injury/illness not to exceed the statutory maximum of $593.81. TTD benefits are provided if you are unable to work for more than 3 scheduled work days or 24 hours if missing time from work intermittently. If unable to work for more than 14 calendar days compensation will be paid from the day the claimant began missing work. Compensation for TTD benefits are paid every two weeks directly to you from Pinnacol Assurance.
TEMPORARY PARTIAL DISABILITY (TPD)
TPD benefits are provided to you in the event that you are able to work but are working a reduced schedule (not full time) or missing time intermittently. You will be compensated at a rate of 66 2/3% of the difference between your average weekly wage at the time of the injury/illness and the employee's average weekly wage during the continuance of the temporary partial disability not to exceed the statutory maximum. Compensation for TPD is paid directly to you every two weeks by Pinnacol Assurance.
Employee's Responsibility for Worker's Compensation
- Notify a supervisor within four days of the work related injury/illness.
- Provide a written statement describing the work related injury/illness.
- If the injury/illness requires medical attention you must use the department's designated provider, in the event of an emergency go to the nearest emergency facility and then follow up with the department's designated provider.
- Provide your supervisor a copy of the work status report that you receive from the physician each time you visit the physician.
- Report via leave slip time that is missed as a result of your injury/illness. If you are missing time from work intermittently, you must complete an Addendum to Supplemental Report Form and submit to the Human Resource Office.
- Keep track of the mileage you travel as a result of the treatment you received for the injury/illness on the Claimant Mileage Reimbursement Request Form and submit to the Human Resource Office for reimbursement.
- Keep your supervisor informed!
Supervisor's Responsibility for Worker's Compensation
- When the work related injury/illness is severe, call 911 or the local emergency number, the employee may be sent to the closest emergency facility to seek emergency medical attention. When the employee is stabilized, the employee will need to be examined by the designated provider and need to seek all follow-up care with the designated provider.
- Immediately report the work related injury/illness to Pinnacol Assurance by filing a First Report of Injury via the internet or completing the First Report of Injury form and calling Pinnacol Assurance at 303-361-4274 or 1-888-852-2239. You may fax the First Report of Injury to Pinnacol Assurance at 1-888-329-2204 or 303-361-5250. If you report the work related injury/illness via fax you must also fax a copy to the Human Resource Office at 239-4509.
- Obtain a written explanation from the employee, describing the incident that led to the work related injury/illness. This written explanation needs to be sent to Human Resource as soon as possible.
- Immediately notify Human Resource, via e-mail, if your employee misses more than three regular scheduled work shifts.
- Notify Human Resource immediately, via e-mail, when your employee returns to work after missing work as a result of the on-job injury/illness.
- Review all work status reports (medical reports) that your employee should provide to you each time they visit the designated provider.
- Ensure that the employee can continue to do their current duties if there are any restrictions listed on the report.
- Work with employees who have restrictions that prevent them from doing their current duties to determine if modified duty is an option. Remember with Worker's Compensation an employee DOES NOT have to request modified duty, the employer can initiate the modified duty! Contact Human Resource if you need assistance.
- Stay in close contact with the injured employee. Show genuine concern. Provide a point of contact for your employee to ask for information.
- WHEN IN DOUBT DO NOT HESITATE TO CALL HUMAN RESOURCE FOR ASSISTANCE!!!