Colo. Rev. Stat. » Title 8
Colorado Revised Statutes

Colo. Rev. Stat. § 8-43-304 (2024)

Violations - penalty - offset for benefits obtained through fraud - rules

✓ C.R.S. 2024: the 2025 and 2026 sessions are not included
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(1) Any employer or insurer, or any officer or agent of either, or any employee, or any other person who violates articles 40 to 47 of this title 8, or does any act prohibited thereby, or fails or refuses to perform any duty lawfully enjoined within the time prescribed by the director or panel, for which no penalty has been specifically provided, or fails, neglects, or refuses to obey any lawful order made by the director or panel or any judgment or decree made by any court as provided by the articles shall be subject to such order being reduced to judgment by a court of competent jurisdiction and shall also be punished by a fine of not more than one thousand dollars per day for each offense, to be apportioned, in whole or part, at the discretion of the director or administrative law judge, between the aggrieved party and the Colorado uninsured employer fund created in section 8-67-105; except that the amount apportioned to the aggrieved party shall be a minimum of twenty-five percent of any penalty assessed.

(1.5) (a) (I) An insurer who knowingly or repeatedly violates any provision of articles 40 to 47 of this title shall be subject to a fine as determined by the director. If necessary, the director may conduct a hearing or may refer the matter to the office of administrative courts for the entry of findings of fact. The director shall promulgate rules that specify, with respect to an insurer's willful or repeated violations that are subject to this subsection (1.5):

(A) The circumstances pursuant to which the director may issue an order imposing a fine; and

(B) Criteria for determining the amount of the fine.

(II) If the division determines, as part of a compliance audit of an insurer or self-insured pool, that an injury or occupational disease was not reported to the division within the time specified in sections 8-43-101 and 8-43-103 because the insurer or self-insured pool did not have notice or knowledge of the injury, occupational disease, or fatality within a period of time that would allow the information to be reported to the division within the time specified in sections 8-43-101 and 8-43-103, the director shall not impose a fine for late reporting under this subsection (1.5). The director may impose a fine under this subsection (1.5) for late reporting under sections 8-43-101 and 8-43-103 as part of findings from a compliance audit if the director finds that the late reporting constituted a knowing or repeated pattern of noncompliance with the reporting requirements of sections 8-43-101 and 8-43-103 and was not caused by the insurer or self-insured pool's lack of notice or knowledge of the injury, occupational disease, or fatality within a period of time that would allow the information to be reported to the division within the time specified in sections 8-43-101 and 8-43-103.

(b) Fines imposed pursuant to this subsection (1.5) on or after July 1, 2018, shall be transmitted to the state treasurer, who shall credit the fines to the Colorado uninsured employer fund created in section 8-67-105.

(2) An insurer or self-insured employer may take a credit or offset of previously paid workers' compensation benefits or payments against any further workers' compensation benefits or payments due a worker when the worker admits to having obtained the previously paid benefits or payments through fraud, or a civil judgment or criminal conviction is entered against the worker for having obtained the previously paid benefits through fraud. Benefits or payments obtained through fraud by a worker shall not be included in any data used for rate-making or individual employer rating or dividend calculations by any insurer or by Pinnacol Assurance.

(3) The director and each administrative law judge shall report to the division each time a penalty is imposed pursuant to this section. Each such report shall include the amount of the penalty, the name of the administrative law judge awarding the penalty, if applicable, and the name of the offending party.

(4) In any application for hearing for any penalty pursuant to subsection (1) of this section, the applicant shall state with specificity the grounds on which the penalty is being asserted. After the date of mailing of such an application, an alleged violator shall have twenty days to cure the violation. If the violator cures the violation within such twenty-day period, and the party seeking such penalty fails to prove by clear and convincing evidence that the alleged violator knew or reasonably should have known such person was in violation, no penalty shall be assessed. The curing of the violation within the twenty-day period shall not establish that the violator knew or should have known that such person was in violation.

(5) A request for penalties shall be filed with the director or administrative law judge within one year after the date that the requesting party first knew or reasonably should have known the facts giving rise to a possible penalty.

Source: L. 90: Entire article R&RE, p. 510, § 1, effective July 1. L. 91: Entire section amended, p. 1323, § 35, effective July 1. L. 92: (1) amended, p. 1828, § 1, effective May 19. L. 94: (3), (4), and (5) added, p. 1878, § 11, effective June 1. L. 97: (3) amended, p. 1474, § 9, effective June 3. L. 2002: (2) amended, p. 1883, § 30, effective July 1. L. 2005: (1.5) added, p. 199, § 2, effective July 1. L. 2006: IP(1.5)(a) amended, p. 1489, § 6, effective June 1. L. 2010:

(1) amended, (SB 10-012), ch. 287, p. 1340, § 1, effective August 11. L. 2012: (1.5)(a) amended, (HB 12-1033), ch. 43, p. 147, § 1, effective August 8. L. 2017: (1) and (1.5)(b) amended, (HB 17-1119), ch. 317, p. 1706, § 4, effective July 1.

Editor's note: This section is similar to former § 8-53-116 as it existed prior to 1990.

Notes of Decisions
Cited in 33 cases (2 in the last 5 years), 1994–2026 · leading case: Vaughan v. McMinn, 945 P.2d 404 (Colo. 1997).
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Vaughan v. McMinn, 945 P.2d 404 (Colo. 1997). · cites it 116× “11, § 8-43-304, 1994 Colo. Sess. Laws 1873 , 1878-79.”
Wolford v. Pinnacol Assurance, 107 P.3d 947 (Colo. 2005). · cites it 22× “35, § 8-43-304(2), 1991 Colo. Sess. Laws 1291 , 1323-24.”
Holliday v. Bestop, Inc., 23 P.3d 700 (Colo. 2001). · cites it 15× “The employer objected to the penalty request, arguing that the claimant had not set forth sufficient facts for a penalty under section 8-43-304(1). ALJ Stuber determined that the claimant's claim was barred by the court of appeals' holding in Sears.”
Pena v. Indus. Claim Appeals Off., 117 P.3d 84 (Colo. Ct. App. 2005). · cites it 15× “Subsection (3) of that statute states that any party who willfully refuses to comply with the claims management efforts of the division is subject to the penalty provisions set forth in § 8-43-304, C.R.S.2004. *88 Section 8-47-107, C.”
Dami Hosp., LLC v. Indus. Claim Appeals Off., 2017 COA 21. · cites it 23× “Incorporating Provisions of Section 8-43-304 into Section 8-43-409 ¶ 103 Dami next contests the fine by contending that provisions of section 8-43-304, C.R.S. 2016, must be read into section 8-43-409.”
Brodeur v. Am. Home Assurance Co., 169 P.3d 139 (Colo. 2007). · cites it 4× “The court of appeals noted that after the ALJ and the ICAO determined that penalties under section 8-43-304(1) were not available for a violation of the regulations, this court in Holliday v.”
Cnty. Mem'l Hosp. v. ICAO, 2021 COA 84. · cites it 6× “See § 8-43-304(1), C.R.S. 2020. The Panel limited the daily penalty to those specific dates on which the hospital issued medical bills to claimant after learning that her injuries were work-related.”
Sears v. Penrose Hosp., 942 P.2d 1345 (Colo. Ct. App. 1997). · cites it 12× “Thus, the ALJ determined that employer acted reasonably in denying payment of the bill, and that claimant failed to prove that penalties should be assessed against employer.”
Moland v. Indus. Claim Appeals Off. of Colorado, 111 P.3d 507 (Colo. Ct. App. 2004). · cites it 5× “Claimant has asserted that payment of twenty-five percent of the penalties to the Subsequent Injury Fund (SIF) under '§ 8-43-304(1), C.R.S.2003, is an unconstitutional taking of his' property.”
Associated Bus. Prods. v. Indus. Claim Appeals Off., 126 P.3d 323 (Colo. Ct. App. 2005). · cites it 7× “§ 8-43-304(1.5)(a), C.R.S.2005 (authorizing additional penalty against insurer who knowingly or repeatedly violates provisions of Workers’ Compensation Act and authorizing Director to promulgate rules that specify circumstances under which the penalty may be imposed and criteria…”
Crowell v. Indus. Claim Appeals Off., 2012 COA 30, 298 P.3d 1014. · cites it 12× “Amount of Penalty ¶ 16 The amount of the penalty the ALJ may impose is addressed in section 8-43-304(1), C.R.S.2011. A prior version of the statute provides that the daily penalty shall not exceed $500.”
Colorado Comp. Ins. Auth. v. Indus. Claim Appeals Off., 907 P.2d 676 (Colo. Ct. App. 1995). · cites it 7× “3B) (now codified with changes at § 8-43-304(1), C.R.S. (1994 Cum.Supp.)). The Panel affirmed.”
Show all 33 citing cases →
Colo. Rev. Stat. § 8-43-304(1): 26 cases
Vaughan v. McMinn, 945 P.2d 404 (Colo. 1997). “11, § 8-43-304, 1994 Colo. Sess. Laws 1873 , 1878-79.”
Holliday v. Bestop, Inc., 23 P.3d 700 (Colo. 2001). “The employer objected to the penalty request, arguing that the claimant had not set forth sufficient facts for a penalty under section 8-43-304(1). ALJ Stuber determined that the claimant's claim was barred by the court of appeals' holding in Sears.”
Pena v. Indus. Claim Appeals Off., 117 P.3d 84 (Colo. Ct. App. 2005). “Subsection (3) of that statute states that any party who willfully refuses to comply with the claims management efforts of the division is subject to the penalty provisions set forth in § 8-43-304, C.R.S.2004. *88 Section 8-47-107, C.”
Brodeur v. Am. Home Assurance Co., 169 P.3d 139 (Colo. 2007). “The court of appeals noted that after the ALJ and the ICAO determined that penalties under section 8-43-304(1) were not available for a violation of the regulations, this court in Holliday v.”
Cnty. Mem'l Hosp. v. ICAO, 2021 COA 84. “See § 8-43-304(1), C.R.S. 2020. The Panel limited the daily penalty to those specific dates on which the hospital issued medical bills to claimant after learning that her injuries were work-related.”
Colo. Rev. Stat. § 8-43-304(2): 2 cases
Wolford v. Pinnacol Assurance, 107 P.3d 947 (Colo. 2005). “35, § 8-43-304(2), 1991 Colo. Sess. Laws 1291 , 1323-24.”
Lewis v. Sci. Supply Co., 897 P.2d 905 (Colo. Ct. App. 1995).
Colo. Rev. Stat. § 8-43-304(4): 4 cases
Diversified Vets. Corp. Ctr. v. Hewuse, 942 P.2d 1312 (Colo. Ct. App. 1997).
Cnty. Mem'l Hosp. v. ICAO, 2021 COA 84. “See § 8-43-304(1), C.R.S. 2020. The Panel limited the daily penalty to those specific dates on which the hospital issued medical bills to claimant after learning that her injuries were work-related.”
Dami Hosp., LLC v. Indus. Claim Appeals Off., 2017 COA 21. “Incorporating Provisions of Section 8-43-304 into Section 8-43-409 ¶ 103 Dami next contests the fine by contending that provisions of section 8-43-304, C.R.S. 2016, must be read into section 8-43-409.”
Crowell v. Indus. Claim Appeals Off., 2012 COA 30, 298 P.3d 1014. “Amount of Penalty ¶ 16 The amount of the penalty the ALJ may impose is addressed in section 8-43-304(1), C.R.S.2011. A prior version of the statute provides that the daily penalty shall not exceed $500.”
Colo. Rev. Stat. § 8-43-304(5): 2 cases
Spracklin v. Indus. Claim Appeals Off., 66 P.3d 176 (Colo. Ct. App. 2002).
Dami Hosp., LLC v. Indus. Claim Appeals Off., 2017 COA 21. “Incorporating Provisions of Section 8-43-304 into Section 8-43-409 ¶ 103 Dami next contests the fine by contending that provisions of section 8-43-304, C.R.S. 2016, must be read into section 8-43-409.”
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