DEPARTMENT OF LABOR AND EMPLOYMENT
Division of Workers’ Compensation
7 CCR 1101-3
	WORKERS’ COMPENSATION RULES OF PROCEDURE

Rule 5	Claims Adjusting Requirements

RULE 5-5 	ADMISSIONS OF LIABILITY

(J) 	THIS SECTION (J) APPLIES TO CLAIMS WITH A DATE OF INJURY ON OR AFTER JULY 1, 2008. A CARRIER MAY NOT REDUCE A CLAIMANT’S TEMPORARY TOTAL DISABILITY, TEMPORARY PARTIAL DISABILITY OR MEDICAL BENEFITS BECAUSE OF A PRIOR INJURY, WHETHER WORK RELATED OR NON WORK RELATED.

IF A PERMANENT IMPAIRMENT RATING IS REDUCED ON AN ADMISSION PURSUANT TO SECTION 8-42-104, A COPY OF THE PREVIOUS AWARD OR OTHER DOCUMENTATION SUPPORTING THE APPORTIONMENT MUST BE ATTACHED TO THE ADMISSION.

DEPARTMENT OF LABOR AND EMPLOYMENT
Division of Workers’ Compensation
7 ccr 1101-3
WORKERS’ COMPENSATION RULES OF PROCEDURE
Rule  12	Permanent Impairment Rating Guidelines

12-3	APPORTIONMENT

(A)	Pursuant to §8-42-104(2), C.R.S., FOR CLAIMS WITH A DATE OF INJURY PRIOR TO JULY 1, 2008, a Level II accredited physician (“THE PHYSICIAN”) shall apportion the ANY pre-existing medical impairment, WHETHER WORK- RELATED OR NON-WORK-RELATED, from a work-related injury or occupational disease using the AMA Guides, 3rd Edition, Revised, where medical records or other objective evidence substantiate a pre-existing impairment TO THE SAME BODY PART.  Any such apportionment shall be made by subtracting from the injured worker’s impairment the pre-existing impairment as it existed at the time of the subsequent injury or occupational disease.  The physician shall explain in their written report the basis of any apportionment.  If there is insufficient information to measure the change accurately, the Level II accredited physician shall not apportion.

(B)	FOR CLAIMS WITH A DATE OF INJURY ON OR AFTER JULY 1, 2008, THE LEVEL II ACCREDITED PHYSICIAN (“THE PHYSICIAN”) MAY PROVIDE AN OPINION ON APPORTIONMENT FOR ANY PRE-EXISTING WORK-RELATED OR NON-WORK-RELATED PERMANENT IMPAIRMENT TO THE SAME BODY PART USING THE AMA GUIDES, 3rd EDITION, REVISED WHERE MEDICAL RECORDS OR OTHER OBJECTIVE EVIDENCE SUBSTANTIATE A PRE-EXISTING IMPAIRMENT. ANY SUCH APPORTIONMENT SHALL BE MADE BY SUBTRACTING FROM THE INJURED WORKER’S IMPAIRMENT THE PRE-EXISTING IMPAIRMENT AS IT EXISTED AT THE TIME OF THE SUBSEQUENT INJURY OR OCCUPATIONAL DISEASE.  THE PHYSICIAN SHALL EXPLAIN IN THEIR WRITTEN REPORT THE BASIS OF ANY APPORTIONMENT.  IF THERE IS INSUFFICIENT INFORMATION TO MEASURE THE CHANGE ACCURATELY, THE PHYSICIAN SHALL NOT APPORTION. THE PHYSICIAN MAY BE ASKED TO PROVIDE AN OPINION AS TO WHETHER THE PREVIOUS MEDICAL IMPAIRMENT WAS IDENTIFIED, TREATED AND INDEPENDENTLY DISABLING AT THE TIME OF THE WORK-RELATED INJURY THAT IS BEING RATED.

(1)	THE EFFECT OF THE PHYSICIAN’S APPORTIONMENT DETERMINATION IS LIMITED TO THE PROVISIONS IN §8-42-104.  WHEN FILING AN ADMISSION AN INSURER MAY APPORTION ONLY IF DOCUMENTATION IS PROVIDED REFLECTING COMPLIANCE WITH §8-42-104.         

(2)	THE LEVEL II ACCREDITED PHYSICIAN MAY PROVIDE AN OPINION ON THE APPORTIONMENT OF MEDICAL AND TEMPORARY DISABILITY BENEFITS.  THE CLAIMANT’S RECEIPT OF MEDICAL AND TEMPORARY DISABILITY BENEFITS MAY NOT BE REDUCED BASED UPON ANY SUCH OPINION.