7 Colo. Code Regs. § 1107-4.3

Current through Register Vol. 47, No. 24, December 25, 2024

Section 7 CCR 1107-4.3 - FAMLI Benefits and Workers' Compensation Benefits

1. Benefits under the FAMLI Act and its implementing regulations are separate benefits claims from benefits under the Workers' Compensation Act of Colorado, C.R.S. § 8-40-101 et seq. or its implementing regulations (the "Workers' Compensation Act"). Regardless of an individual's status as a covered individual, if an absence from work is caused by circumstances that would entitle an individual to temporary total or partial indemnity benefits under the Workers' Compensation Act, the individual is not entitled to family and medical leave insurance benefits for that absence.

2. An individual applying for family and medical leave insurance benefits must disclose whether their serious health condition was caused by or otherwise related to a workplace injury or illness.

3. Health care providers, in completing a "Serious Health Condition Certification - Self Form," must disclose any information or belief that the individual's serious health condition was caused by or otherwise related to a workplace injury.

4. If either the individual applying for family and medical leave insurance benefits or the health care provider completing the "Serious Health Condition Certification - Self Form" indicates that the individual's serious health condition was caused by or otherwise related to a workplace injury, then the application for benefits will be denied unless the individual submits proof that they are either ineligible or no longer eligible for temporary total or partial indemnity benefits under the Workers' Compensation Act. The Division will accept and review the following documents as evidence an individual is not eligible or is no longer eligible for temporary total or partial indemnity Workers' Compensation benefits:

A. A Final Admission of Liability with a mailing date that is at least 30 days prior to the benefit start date;

B. A Final Order by an Administrative Law Judge showing temporary total or partial indemnity benefits under Workers Compensation Act have been denied or are no longer being paid; or

C. A Notice of Contest issued to the claimant by a Workers' Compensation insurer.

5. An individual must notify the FAMLI Division if they receive any benefits under the Workers' Compensation Act during a period of family and medical leave and may be required to complete a release for records relating to the workers' compensation injury.

6. If an individual is paid or entitled to receive any temporary total or partial indemnity benefits under the Workers' Compensation Act during a period of family and medical leave, then any wage replacement benefits paid or owed to the individual in association with the same job and the same time missed as the temporary indemnity benefits under the Workers' Compensation Act will be considered an overpayment of family and medical leave insurance benefits.

7. The Division may recover an overpayment of paid family and medical leave insurance benefits due to an individual's entitlement to receive temporary total or partial indemnity benefits under the Workers' Compensation Act during a period of family and medical leave from either the individual overpaid or directly from the Workers' Compensation insurer that awarded the benefits.

8. An individual's failure to disclose either a workplace injury related to an application for family and medical leave insurance benefits, or the receipt of benefits under the Workers' Compensation Act related to an injury that is related to the receipt of family and medical leave insurance benefits, may constitute grounds for disqualification of benefits pursuant to C.R.S. § 8-13.3-513.

7 CCR 1107-4.3

45 CR 23, December 10, 2022, effective 12/30/2022

46 CR 12, June 25, 2023, effective 7/15/2023

46 CR 23, December 10, 2023, effective 1/1/2024

47 CR 23, December 10, 2024, effective 1/1/2025