1 Colo. Code Regs. § 104-3-9
Current through Register Vol. 48, No. 1, January 10, 2025
Rule 1 CCR 104-3-9 - Application for Expedited Hearing ("Expedited Application")A. Any Expedited Application shall be on a form provided by the OAC, or on a substantially similar form.B. An Expedited Application may be filed: 1. By claimant, if the respondent filed a Notice of Contest and less than 45 days have passed since the Notice of Contest was filed. The issues in an expedited hearing shall be limited to compensability, medical benefits, applicable affirmative defenses, and other issues as agreed upon by the parties, or as ordered by an ALJ.2. By claimant, if there is an urgent need for prior authorization of health care services recommended in writing by an authorized treating provider, and prior authorization has been denied. A copy of a medical record documenting the urgent need for prior authorization of health care services shall be attached to the Expedited Application. The issues will be limited to liability for those health care services, applicable affirmative defenses, and other issues as agreed upon by the parties, or as ordered by an ALJ.3. By respondent, if it has filed a Petition to Suspend, Modify, or Terminate Compensation, and the claimant has filed an objection. The issues at the hearing shall be limited to a determination of the Petition to Suspend, Modify, or Terminate Compensation, applicable affirmative defenses, and other issues as agreed upon by the parties, or as ordered by an ALJ.4. By any party, on the issue of whether the employer or insurer provided a list of designated providers in compliance with section 8-43-404(5), C.R.S., and less than 45 days have passed since the claimant provided notice of the injury to the employer. The issues will be limited to whether the respondent provided a compliant list of designated providers, applicable affirmative defenses, and other issues as agreed upon by the parties, or as ordered by an ALJ.5. By any party, on the issue of whether the employer or insurer provided a list in compliance with section 8-43-404(5), C.R.S., if the insurer or self-insured employer admitted liability for the claim and the Expedited Application is filed within 45 days after the initial admission of liability for the claim. The issues will be limited to whether the respondent provided a compliant list of designated providers, applicable affirmative defenses, and other issues as agreed upon by the parties, or as ordered by an ALJ.6. By any party, on the issue of whether the employer or insurer may reduce compensation pursuant to section 8-42-112, C.R.S, if the insurer or employer has admitted liability for a claim, and less than 45 days have passed since the admission reducing compensation was filed. The issues will be limited to whether the respondent may reduce compensation pursuant to section 8-42-112, C.R.S., applicable affirmative defenses, and other issues as agreed upon by the parties, or as ordered by an ALJ.7. Where otherwise authorized by the Colorado Workers' Compensation Act, or the Colorado Workers' Compensation Rules of Procedure, 7 CCR 1101-3.C. If the applicant qualifies for an expedited hearing, the OAC shall set the matter for hearing to occur consistent with the provisions of the Workers' Compensation Act. The OAC shall determine the location, date, and time of the expedited hearing, and shall send notice of the hearing to the parties, as provided by OACRP 11.D. The opposing party may file a Response to the Expedited Application within 10 days of service of the Expedited Application, as provided by OACRP 6, unless agreed upon by the parties or approved by an ALJ.E. The OAC may reject any Expedited Application that is not complete, or does not meet the criteria for an expedited hearing as determined by an ALJ. The rejection shall be without prejudice.F. When the Expedited Application is rejected for not meeting the criteria for an expedited hearing, the applicant may then file an Application for Hearing pursuant to OACRP 8.38 CR 05, March 10, 2015, effective 3/30/201542 CR 16, August 25, 2019, effective 9/14/201944 CR 11, June 10, 2021, effective 6/30/202146 CR 15, August 10, 2023, effective 9/1/2023