As used in articles 40 to 47 of this title 8, unless the
context otherwise requires:
(1) Accident means an unforeseen event occurring without the will or
design of the person whose mere act causes it; an unexpected, unusual, or
undesigned occurrence; or the effect of an unknown cause or, the cause, being
known, an unprecedented consequence of it.
(2) Accident, injury, or injuries includes disability or death resulting
from accident or occupational disease as defined in subsection (14) of this section.
(2.5) Repealed.
(3) Board means the board of directors of Pinnacol Assurance.
(3.4) Chief executive officer means the chief executive officer of Pinnacol
Assurance.
(3.5) Repealed.
(3.6) Claimant means a person who either:
(a) Receives benefits under articles 40 to 47 of this title; or
(b) Has or asserts, in any administrative or judicial forum or in any
communication with the director, the division, or an employer, insurer, or self-insured employer, a right to receive such benefits.
(4) Division means the division of workers' compensation in the department
of labor and employment.
(5) Director means the director of the division of workers' compensation.
(6) Employee has the meaning set forth in section 8-40-202 and the scope
of such term is set forth in section 8-40-301.
(7) Employer has the meaning set forth in section 8-40-203 and the scope
of such term is set forth in section 8-40-302.
(8) Employment means any trade, occupation, job, position, or process of
manufacture or any method of carrying on any trade, occupation, job, position, or
process of manufacture in which any person may be engaged; except that it shall
not include participation in a ridesharing arrangement, as defined in section 39-22-509 (1)(a)(II), C.R.S., and participation in such a ridesharing arrangement shall not
affect the wages paid to or hours or conditions of employment of an employee; nor
shall it include the employee's participation in a voluntary recreational activity or
program, regardless of whether the employer promoted, sponsored, or supported
the recreational activity or program.
(9) Examiner means one of the industrial claim appeals examiners
appointed to the industrial claim appeals panel in the industrial claim appeals
office.
(10) Executive director means the executive director of the department of
labor and employment.
(11) (Deleted by amendment, L. 2002, p. 1882, � 27, effective July 1, 2002.)
(11.5) Maximum medical improvement means a point in time when any
medically determinable physical or mental impairment as a result of injury has
become stable and when no further treatment is reasonably expected to improve
the condition. The requirement for future medical maintenance which will not
significantly improve the condition or the possibility of improvement or
deterioration resulting from the passage of time shall not affect a finding of
maximum medical improvement. The possibility of improvement or deterioration
resulting from the passage of time alone shall not affect a finding of maximum
medical improvement.
(12) Mediation means a process through which parties involved in a dispute
concerning matters arising under articles 40 to 47 of this title meet with a mediator
to discuss such matter or matters, defining and articulating the issues and their
positions on such issues, with a goal of resolving such dispute or disputes.
(13) Mediator means an individual who is trained to assist disputants in
reaching a mutually acceptable resolution of their disputes through the
identification and evaluation of alternatives.
(13.5) Repealed.
(14) Occupational disease means a disease which results directly from the
employment or the conditions under which work was performed, which can be seen
to have followed as a natural incident of the work and as a result of the exposure
occasioned by the nature of the employment, and which can be fairly traced to the
employment as a proximate cause and which does not come from a hazard to which
the worker would have been equally exposed outside of the employment.
(15) Order means and includes any decision, finding and award, direction,
rule, regulation, or other determination arrived at by the director or an
administrative law judge.
(15.5) (a) Overpayment means money received by a claimant that:
(I) Is the result of fraud;
(II) Is the result of an error due only to miscalculation, omission, or clerical
error asserted in a new admission of liability filed within thirty days of the erroneous
admission of liability;
(III) Is paid in error or inadvertently in excess of an admission or order that
exists at the time that the benefits are paid to a claimant; or
(IV) Results in duplicate benefits because of offsets that reduce disability or
death benefits payable under articles 40 to 47 of this title 8. Duplicate benefits
include any wages earned by a claimant in the same or other employment while a
claimant is also receiving temporary disability benefits.
(b) For an overpayment to result, it is not necessary that the overpayment
exist at the time the claimant received disability or death benefits under articles 40
to 47 of this title 8.
(c) Nothing in this subsection (15.5):
(I) Prevents an insurance carrier or an employer from receiving a credit
against permanent disability benefits for temporary disability benefits paid beyond
the initial date of maximum medical improvement assigned by an authorized
treating physician or the final date of maximum medical improvement established
by any other means, whichever is later and to the extent that permanent disability
benefits remain unpaid at the time of the filing of a final admission of liability; or
(II) Affects the power of the director or administrative law judges to
determine overpayments and require repayment of overpayments pursuant to
sections 8-42-113.5 and 8-43-207 (1)(q).
(16) Panel means the industrial claim appeals panel that conducts
administrative appellate review pursuant to articles 40 to 47 of this title.
(16.5) (a) Permanent total disability means the employee is unable to earn
any wages in the same or other employment. Except as provided in paragraph (b) of
this subsection (16.5), the burden of proof shall be on the employee to prove that
the employee is unable to earn any wages in the same or other employment.
(b) Total loss of or total loss of use of both hands, or both arms, or both feet,
or both legs, or both eyes, or any two thereof shall create a rebuttable presumption
of permanent total disability. Total loss of use shall be a medical determination,
based upon objective findings, made by an independent medical examiner who is a
level II accredited physician in the appropriate field.
(17) Place of employment means every place whether indoors, outdoors, or
underground and the premises, workplaces, works, and plants appertaining thereto
or used in connection therewith where either temporarily or permanently any
industry, trade, or business is carried on; or where any process or operation directly
or indirectly relating to any industry, trade, or business is carried on; or where any
person is directly or indirectly employed by another for direct or indirect gain or
profit.
(18) State includes any state or territory of the United States, the District
of Columbia, and any province of Canada.
(18.5) Temporary help contracting firm means any person who is in the
business of employing individuals and, for compensation from a third party,
providing those individuals to perform work for the third party, under the
supervision of the third party.
(19) (a) Wages shall be construed to mean the money rate at which the
services rendered are recompensed under the contract of hire in force at the time
of the injury, either express or implied.
(b) The term wages includes the amount of the employee's cost of
continuing the employer's group health insurance plan and, upon termination of the
continuation, the employee's cost of conversion to a similar or lesser insurance
plan, and gratuities reported to the federal internal revenue service by or for the
worker for purposes of filing federal income tax returns and the reasonable value of
board, rent, housing, and lodging received from the employer, the reasonable value
of which shall be fixed and determined from the facts by the division in each
particular case, but does not include any similar advantage or fringe benefit not
specifically enumerated in this subsection (19). If, after the injury, the employer
continues to pay any advantage or fringe benefit specifically enumerated in this
subsection (19), including the cost of health insurance coverage or the cost of the
conversion of health insurance coverage, that advantage or benefit shall not be
included in the determination of the employee's wages so long as the employer
continues to make payment. Medicaid and other indigent health-care programs are
not health insurance plans for the purposes of this section.
(c) No per diem payment shall be considered wages under this subsection
(19) unless it is also considered wages for federal income tax purposes.