Authorized Treating Physician Colorado Workers Comp: Why Your Doctor Choice Can Make or Break Your Case
Introduction to Colorado Workers’ Compensation
Colorado workers’ compensation is a no-fault insurance system designed to protect both employees and employers when a workplace injury or illness occurs. Nearly every Colorado employer is required by law to carry workers compensation insurance, ensuring that injured workers have access to essential medical care and wage replacement benefits without the need to prove fault. This system is intended to provide prompt medical benefits and financial support, helping Colorado workers recover and return to their jobs as soon as possible.
The Division of Workers’ Compensation oversees the entire process, making sure that employers, insurance carriers, and injured employees all follow the rules set out by Colorado law. Whether you’re dealing with a sudden accident or a work-related illness, the workers compensation system is structured to deliver the medical care and wage replacement you need. By streamlining the claims process and removing the need for lengthy legal battles over fault, Colorado’s workers compensation benefits are designed to support injured workers and their families during a difficult time.
Quick Answer: Why Your Authorized Treating Physician Choice Matters
In Colorado workers’ compensation cases, your authorized treating physician controls nearly every medical decision that affects your claim. This doctor decides what treatment you receive, when you can return to work, whether you need surgery or specialist referrals, and ultimately, how much your permanent disability benefits will be worth.
Colorado law requires nearly every employer to carry workers' compensation insurance, even if they only have one employee.
Here’s what many injured workers don’t realize: in most cases, the insurance company or your employer initially controls which doctor you see. If you end up with an ATP who minimizes your injury, rushes you back to work, or gives you a low impairment rating, your entire claim can suffer. We’ve seen workers lose tens of thousands of dollars in benefits because of a single doctor’s biased opinion.
Under current law in Colorado (as of 2025), employers must provide a designated provider list with up to four physicians for you to choose from. However, significant changes are coming. HB 25-1300, a bill passed by the Colorado legislature, will expand worker choice starting January 1, 2028, allowing injured workers to select from a statewide panel of accredited workers’ compensation physicians instead of a small employer-controlled list. This bill represents a legislative change that will impact claimant rights and employer obligations.
Steve Johnston, a Pueblo-based workers’ compensation attorney at Johnston Law Firm, LLC, helps injured workers across Colorado—including Pueblo, Otero, Fremont, Custer, Huerfano, Las Animas, and Crowley Counties—navigate the complex rules around choosing, challenging, or changing an ATP.
Whether your injury happened yesterday or years ago, understanding your medical rights under Colorado workers’ compensation is critical to protecting your health and financial recovery.
If you were hurt on the job and aren’t sure which doctor you must see—or if you’re worried your current doctor is working against you—call Johnston Law Firm, LLC at (719) 309-9484 or message us online immediately for guidance.
What Is an Authorized Treating Physician (ATP) in Colorado Workers’ Comp?
An authorized treating physician is the specific doctor authorized under Colorado workers’ compensation law to direct and control all medical care related to your workplace injury. The ATP is responsible for overseeing the treatment of the injured employee, who is defined under Colorado law as any person in service of an employer under a contract of hire, whether expressed or implied, and who is entitled to workers’ compensation benefits for injuries arising out of and in the course of employment. This isn’t just any doctor you see—it’s the physician whose opinions carry legal weight with the insurance carrier and the Division of Workers’ Compensation.
Your ATP handles critical responsibilities, including:
Diagnosing your work related injury and determining its full extent
Ordering diagnostic tests such as MRIs, CT scans, and EMGs
Prescribing medications and physical therapy
Recommending surgery or other procedures when necessary
Setting work restrictions and light-duty limitations
Deciding when you’ve reached Maximum Medical Improvement (MMI)
The ATP is also responsible for completing Form WC 164 to report the physician's details at the start of treatment and whenever work restrictions change.
The ATP typically issues your official impairment rating using the American Medical Association Guides. This rating directly influences your permanent partial disability benefits, settlement value, and whether you’ll receive ongoing medical benefits after your claim closes.
Even if you see multiple specialists during your treatment, your authorized treating physician acts as the “gatekeeper.” Their opinions carry the most legal weight in any workers compensation claim. If your ATP says you’re fine to work without restrictions, the insurer will likely stop paying temporary disability—regardless of what a specialist might recommend.
Johnston Law Firm, LLC regularly evaluates whether a particular ATP is helping or hurting a client’s case. When the treating physician seems biased toward the insurance company, Steve Johnston advises on strategies to protect the injured employee’s rights.
How Your Authorized Treating Physician Is Chosen in Colorado (Current Rules)
Under current Colorado law, employers and their insurance carrier maintain significant control over the initial provider selection. However, specific notice rules and deadlines apply that can work in your favor if you know them. To trigger the process, the employee's employer must be notified in writing of the workplace injury.
Here’s how the process works:
The Designated Provider List: After you report a workplace injury, your Colorado employer must provide you with a written list of at least four designated physicians or clinics within 7 business days. You then choose your ATP from this list. In Colorado, you are required to notify your employer in writing about your workplace injury within 4 working days of when the injury happened.
If No List Is Provided: When an employer fails to provide a proper designated provider list within the required timeframe, you may have the right to select your own doctor as the ATP under Division of Workers’ Compensation rules.
Emergency Care Exception: Treatment at the nearest ER during a true emergency is always allowed. However, once stabilized, your follow-up medical care must transition to an authorized provider for workers compensation insurance to cover ongoing treatment.
The Hidden Problem: In practice, many employer provider lists are stacked with “insurance-friendly” clinics. These facilities may be incentivized to minimize injuries, recommend early return-to-work, and issue low impairment ratings.
If an employee does not report their injury to their employer in writing within four working days, they may be penalized and lose up to one day's compensation for each day's delay. However, you may still file a report at any time, though delays can result in penalties.
Before you choose from a designated provider list—or immediately after if you’ve already selected—getting advice from a workers’ compensation lawyer can prevent costly mistakes. The doctors you don’t choose are often just as important as the one you do.
Upcoming Changes: HB 25-1300 and Expanded Physician Choice (2028 and Beyond)
Colorado’s workers compensation system is about to change significantly. HB 25-1300, passed in 2025, represents the most substantial reform to physician choice rules in decades. If you’re injured after these changes take effect, you’ll have far more control over your medical treatment.
What HB 25-1300 Changes:
Current Rules (Pre-2028) | New Rules (Starting January 1, 2028) |
|---|---|
Limited to employer’s 4-doctor list | Choose from statewide panel of accredited physicians |
Narrow window to change doctors | Extended window (up to 120 days or before MMI) |
Insurance company has more control | Greater control for injured workers |
Limited utilization standards | Required evidence-based care guidelines |
The new law also requires employers and insurers to follow Division of Workers’ Compensation utilization standards. These evidence-based care guidelines should limit unjustified denials of diagnostic tests and specialist referrals that currently frustrate many injured workers.
Important Limitation: These changes will not apply retroactively. If you were injured before January 1, 2028, you still operate under the current “designated provider list” system.
If you’re unsure which rules apply to your date of injury, contact Johnston Law Firm, LLC at (719) 309-9484 or message us online. Understanding whether you fall under the old or new rules can dramatically affect your options for medical treatment.
Emergency Care vs. Non-Emergency Treatment After a Colorado Work Injury
Knowing when to seek emergency care versus following the designated provider process can affect your claim from day one. Here’s practical guidance for both situations, including the importance of using authorized services to ensure your medical treatment is covered under Colorado workers’ compensation.
True Emergencies—Act Immediately:
In a life-threatening emergency—severe bleeding, suspected head trauma, broken bones from a fall on a Pueblo construction site, chest pain, or loss of consciousness—go immediately to the nearest emergency room or urgent care. Do not worry about authorization in these situations.
Colorado workers’ compensation law recognizes that emergency medical care takes priority. The ER doctors who treat you initially have authorized treating status for that emergency care.
After the Emergency:
Once your condition stabilizes, you must transition to an authorized treating physician selected from your employer’s designated provider list (assuming one was properly provided). The emergency room does not remain your ATP for ongoing treatment, and all ongoing services must be coordinated through the authorized network to ensure coverage.
Non-Emergency Injuries:
For injuries that don’t require immediate emergency care—repetitive motion injuries, back strain from lifting, gradual-onset pain, or minor sprains—follow this process:
Report the injury to your employer promptly with written notice
Ask for the designated provider list before seeking care
Choose your ATP from the list carefully
Keep documentation of every step
If your employer refuses to provide a list or insists you see only their “company doctor” with no other options, that may violate Colorado law. An attorney can challenge improper ATP designations and help you secure the medical care and services you deserve.
If your claim is denied, you will be responsible for all medical bills for services not coordinated through your employer's Authorized Treating Physician network.
What Your Authorized Treating Physician Controls in Your Case
The phrase “make or break your case” isn’t an exaggeration when it comes to your authorized treating physician. This doctor’s decisions shape both your medical recovery and financial benefits in ways that can affect you for years.
Decisions Your ATP Controls:
Time off work: Whether your injury requires you to miss work, and for how long
Work restrictions: What duties you can and cannot perform during recovery
Modified duty: Whether light-duty work is safe and appropriate
Return-to-work clearance: When you can resume full duties
Impact on Wage Replacement:
Your ATP directly influences temporary disability benefits. Insurance companies often stop paying wage replacement the moment an ATP clears you to return to work without restrictions—even if you still feel pain or haven’t fully recovered. A premature return-to-work opinion can cost you thousands in lost temporary benefits.
MMI and Your Claim’s Value:
The ATP decides when you’ve reached maximum medical improvement. This determination triggers critical deadlines and typically cuts off most curative medical treatment. A premature MMI date can:
End your temporary disability payments too early
Limit future medical benefits
Lock in a lower impairment rating
Reduce your final settlement value
The Impairment Rating:
Perhaps most critically, your ATP’s impairment rating usually forms the foundation for permanent partial disability benefits. In Colorado, impairment ratings are calculated using the AMA Guides, and even a few percentage points can mean the difference between a $20,000 settlement and a $75,000 settlement.
When the ATP’s rating seems inaccurate or biased, Johnston Law Firm pursues a Division Independent Medical Examination (DIME) to challenge unfair opinions.
Seeing Specialists and Other Providers: Who Is Really in Charge?
Many injured workers assume that once they see a specialist—an orthopedic surgeon, neurologist, or pain management doctor—that specialist takes over their case. This is a common and costly misunderstanding.
How the Referral System Works:
Your authorized treating physician may refer you to specialists for consultations, surgery recommendations, or specialized treatment. However, these providers typically work “under” the ATP for workers’ comp purposes. The ATP remains the primary decision-maker.
When Specialist Opinions Conflict:
Here’s where problems often arise: a specialist might recommend surgery, extended time off work, or additional treatment, but if the ATP disagrees or the insurance company prefers the ATP’s more conservative opinion, the specialist’s recommendation may be ignored.
The insurance carrier tends to rely on whichever opinion supports denying or limiting benefits. This is why choosing the right ATP from the start is so critical—it’s not just about that first doctor but about who controls the entire trajectory of your care.
Unauthorized Treatment Risks:
If you see your own doctor, chiropractor, or therapist without proper authorization, you face two problems:
Workers’ compensation likely won’t pay those bills
Those providers’ opinions may carry little legal weight in your claim
This doesn’t mean unauthorized treatment is never strategic—sometimes a medical opinion from outside the workers’ comp system helps build a case for a DIME or hearing. But this requires careful coordination with a workers’ compensation attorney.
Workers in Pueblo, Otero County, Fremont County, and surrounding areas should contact Johnston Law Firm, LLC to review whether their current specialist referrals and ATP structure are helping or hurting their case.
Appointments During Work Hours and Travel Reimbursement
Colorado law recognizes that you must attend medical appointments as a necessary part of recovering from a work related injury. You shouldn’t have to choose between keeping your job and getting treatment.
You are encouraged to work with your employer to find the best time to schedule your appointments with your ATP.
Coordinating Appointments:
When possible, coordinate appointment times with your employer to minimize workplace disruption. However, attending authorized medical visits is essential for both your health and your claim’s credibility. Skipping appointments can be used against you by the insurer.
Tracking Missed Work Time:
Keep detailed written records of all time missed from work due to ATP or specialist appointments. Include:
Date and time of each appointment
Name of provider seen
Time you left work and returned
Any overtime or wages lost
Submit this documentation to your adjuster for potential temporary disability benefits covering the time you missed.
Mileage Reimbursement:
Colorado workers can request reimbursement for travel expenses related to their work related illness or injury, including:
Round-trip mileage to medical visits
Parking expenses
Travel to physical therapy appointments
Pharmacy trips for work injury medications
You must typically submit reimbursement requests within 120 days of travel. The requesting party (you) should maintain a simple mileage log with the date, provider name, location, and miles traveled.
Insurance carriers must pay valid reimbursement claims within 30 days or provide a written denial with reasons. If your carrier is delaying or refusing legitimate travel reimbursement, a Pueblo workers’ compensation lawyer can help enforce your rights.
Claims Process for Colorado Workers’ Compensation
Navigating the claims process for Colorado workers compensation can feel overwhelming, but understanding each step can help you protect your rights and secure the benefits you deserve. If you’re injured on the job, your first responsibility is to provide written notice to your employer within four working days of the injury. This written notice is crucial—it starts the official process and ensures your claim is recognized under Colorado law.
Once notified, your employer must report the injury to their insurance carrier and provide you with a list of designated physicians. You have the right to choose your own doctor from this list, and the physician you select becomes your authorized treating physician. This treating physician will oversee your medical treatment, coordinate your care, and make key decisions about your recovery.
Throughout your claim, you have the right to attend all necessary medical appointments and receive reasonable and necessary medical care for your work-related injury. If your injury prevents you from returning to work, you may be eligible for temporary disability benefits, which provide wage replacement while you recover. The insurance carrier will review your claim, determine your eligibility for benefits, and coordinate with your authorized treating physician to manage your ongoing care.
By following the correct process—providing written notice, selecting a treating physician, and attending medical appointments—you help ensure your claim moves forward smoothly and that you receive the full range of workers compensation benefits available under Colorado law.
MMI, Impairment Ratings, and Second Opinions (DIME vs. IME)
Maximum medical improvement (MMI) is the point where your ATP determines your condition is as good as it’s expected to get with reasonable treatment. Once you reach MMI, your workers compensation case shifts from temporary benefits to permanent disability calculations.
What Happens at MMI:
After declaring MMI, your ATP may assign a permanent impairment rating using the American Medical Association Guides. This rating—expressed as a percentage of whole-person impairment—is the primary factor in calculating permanent partial disability benefits.
For example, under Colorado’s PPD formula:
A 5% impairment rating might yield approximately $12,000 in benefits
A 15% impairment rating could yield over $35,000
The difference often comes down to which doctor examines you
IME vs. DIME—Know the Difference:
Independent Medical Examination (IME) | Division Independent Medical Examination (DIME) |
|---|---|
Requested by insurance company | Requested by either party through the Division |
Often used to limit treatment or dispute disability | Used to challenge ATP’s MMI or impairment rating |
Doctor selected by insurer | Doctor assigned by Division of Workers’ Compensation |
Opinion doesn’t override ATP | DIME opinion carries significant legal weight |
The insurance company may request an independent medical examination at any point to get a second opinion that supports denying benefits. These IME doctors often have reputations for favoring insurers.
A DIME is different—it’s your opportunity to challenge an unfair MMI date or impairment rating. The DIME doctor’s opinion presumptively stands unless overcome by clear and convincing evidence.
Critical Deadlines Apply:
You must request a DIME within strict timeframes, and upfront costs may apply. Missing the deadline can lock in a bad ATP rating permanently, costing you thousands in benefits.
Any worker in Pueblo, Huerfano, Las Animas, Crowley, or Custer Counties who has been placed at MMI or given a low impairment rating should call Johnston Law Firm, LLC at (719) 309-9484 or message us online right away to review DIME options before time runs out.
Final Admission of Liability: What It Means for Your Case
A final admission of liability is a pivotal moment in your Colorado workers compensation claim. When the insurance carrier issues a final admission, it means they have accepted responsibility for your work-related injury and will provide the medical benefits and wage replacement you are entitled to under the law. This step typically occurs after your authorized treating physician determines you have reached maximum medical improvement (MMI)—the point at which your condition is not expected to improve further with additional treatment.
Once a final admission of liability is filed, your claim is officially accepted, and you will continue to receive medical care from your treating physician as needed. If your injury results in a permanent impairment, you may also qualify for permanent partial disability benefits, calculated based on your impairment rating. The Division of Workers’ Compensation oversees this process to ensure that workers receive fair and timely benefits, and that insurance carriers comply with all legal requirements.
Understanding the significance of a final admission is essential, as it marks the transition from temporary benefits to long-term support, and sets the stage for any future disputes or appeals regarding your workers compensation benefits.
Changing Your Authorized Treating Physician in Colorado
While the ATP wields enormous power over your case, you’re not necessarily stuck with a bad doctor forever. Colorado law provides limited but important opportunities to change physicians. This process applies whether your claim is handled by an insurance carrier or a self insured employer.
Ways to Change Your ATP:
One Statutory Change: Under C.R.S. §8-43-404(5), injured workers get one change of physician. You must submit a written request (Form WC-175) to your employer or insurer, specifying a new provider from the designated provider list.
Mutual Agreement: You and the insurance company can agree to a different ATP at any point.
Referral Becomes Primary: In some situations, a specialist the ATP referred you to may functionally become your primary treating physician.
ALJ Order: An Administrative Law Judge can order a change in physicians after a hearing if you can demonstrate good cause.
Important Procedure Notes:
The employer/insurer has 5 business days to object to your change request
No objection typically means approval
If the new provider refuses (must notify within 5 days), the employer provides an alternative within seven days
Your original ATP’s work restrictions control until your first visit with the new doctor
Under HB 25-1300 (for injuries occurring after January 1, 2028), the time window for changing your primary treating physician extends to up to 120 days after injury or before reaching MMI.
Warning: Switching to an unauthorized doctor without following proper procedure may leave you with unpaid bills and no formal change in ATP. The insurer can claim you’re still under the original doctor’s care for legal purposes.
Contact Johnston Law Firm, LLC before making any moves to change doctors. Call (719) 309-9484 or message us online for case-specific strategy.
Nurse Case Managers, Adjusters, and Insurance Company Influence
Behind the scenes, insurers use several tactics to influence your medical treatment and steer the ATP toward opinions that save the insurance company money. Utilization standards set by the Division of Workers' Compensation (DWC) play a key role in determining which services provided by your authorized treating physician are approved and paid for. If an employer or insurer fails to meet the DWC's utilization standards when reviewing a request for authorization, the services provided by an authorized treating physician may be deemed authorized, reasonable, and necessary.
Nurse Case Managers (NCMs):
Many insurance carriers assign a nurse case manager to injured workers with significant claims. While they may present themselves as helpful advocates, NCMs work for the insurer. Their goals often include:
Attending your doctor appointments
Speaking with your ATP privately
Suggesting treatment limitations
Pushing for early return-to-work
These interactions can subtly—or not so subtly—influence your treating physician’s opinions and recommendations.
Your Rights with NCMs:
In many cases, you have the right to:
Decline a nurse case manager’s presence in the exam room
Request private time with your doctor
Limit what information the NCM receives
Adjuster Conversations:
Be cautious in casual conversations with adjusters or NCMs. Questions about:
Hobbies and physical activities
Side jobs or self-employment
How you’re “really” feeling
Weekend plans
These seemingly friendly conversations can appear in claim documents later and be used to question your credibility or restrict your medical benefits.
A Pueblo workers’ compensation lawyer can help set appropriate boundaries with NCMs, monitor adjuster conduct for violations, and ensure your ATP hears your complete story—not just the insurer’s preferred version.
Further Investigation: What Happens If There’s a Dispute or More Information Is Needed?
Sometimes, a workers compensation claim in Colorado requires further investigation before benefits can be finalized. If there is a dispute about the nature of your injury, the extent of your disability, or the medical treatment recommended, the insurance carrier may initiate additional steps to gather more information. This can include requesting further medical evaluations, collecting witness statements, or seeking other evidence to clarify the facts of your case.
Either the employer or the injured worker—the requesting party—may ask for an independent medical examination (IME) to resolve disagreements about your condition. An IME is conducted by a Level II accredited physician who is not involved in your regular care. The results of this examination help determine your eligibility for ongoing medical benefits and wage replacement.
During this period of further investigation, you may continue to receive medical benefits, but your wage replacement benefits could be on hold until the dispute is resolved. The Division of Workers’ Compensation may step in to oversee the process, ensuring that all parties follow Colorado law and that the investigation is handled fairly and efficiently. Remember, Colorado law requires all employers to carry workers compensation insurance, and the insurance carrier is responsible for managing your claim and providing the benefits you are entitled to as an injured worker. If you find yourself in a dispute or facing further investigation, it’s important to understand your rights and seek guidance to protect your claim.
How Johnston Law Firm, LLC Protects Injured Workers’ Medical Rights
Johnston Law Firm, LLC is a Pueblo-based firm focusing on workers’ compensation, personal injury, automobile accidents, estate planning, criminal law, and social security law. Protecting injured workers is a core focus of the practice.
Serving Southern Colorado and Beyond:
Steve Johnston represents clients throughout Colorado, with particular emphasis on:
Pueblo County
Otero County (La Junta area)
Fremont County (Cañon City area)
Custer County
Huerfano County (Walsenburg area)
Las Animas County (Trinidad area)
Crowley County
Specific ATP Assistance:
Johnston Law Firm helps injured workers with authorized treating physician issues in several ways:
Service | How It Helps |
|---|---|
Reviewing employer provider lists | Identify insurance-friendly doctors to avoid |
Advising on doctor selection | Choose ATPs known for fair, thorough care |
Challenging improper designations | Fight when employers violate notice rules |
Preparing clients for critical appointments | Ensure doctors hear your complete story |
Pursuing DIME examinations | Challenge unfair MMI dates or low impairment ratings |
Monitoring NCM and adjuster conduct | Protect against improper insurance influence |
Coordinated Legal Support:
When a workplace injury intersects with other legal issues, Johnston Law Firm coordinates:
Third-party personal injury claims (when someone other than your employer caused the accident)
Social Security Disability applications for long-term or permanent disability
Estate planning when injuries have life-changing consequences
The firm provides personalized attention, explains medical-legal terms in plain English, and fights to ensure doctors base decisions on medical facts rather than insurer pressure.
For a free consultation or claim assistance regarding your authorized treating physician or other workers’ compensation services, you can call our toll-free number.
When to Call a Colorado Workers’ Compensation Attorney About Your Doctor
Timing is everything in Colorado workers’ compensation. Many rights related to ATP choice, MMI challenges, and DIME requests are controlled by strict deadlines. Missing these deadlines can permanently harm your claim.
Red Flags That Demand Immediate Legal Attention:
Your ATP downplays obvious pain or dismisses clear diagnostic findings
You’re being pushed back to heavy-duty work too quickly
The doctor refuses to order tests despite ongoing symptoms
You’ve been declared at maximum medical improvement MMI while you still can’t perform your job safely
Your impairment rating seems unreasonably low given your limitations
The ATP won’t refer you to specialists who could help
Employer Violations:
If your employer in Pueblo or any surrounding county insists you see “their doctor” but refuses to give you a list with at least two to four options, they may be violating Division rules. This could give you the right to choose your own doctor—but only if you act promptly and properly.
Before Signing Anything:
If you’re confused about whether your current doctor is actually an authorized treating physician, or if you’re worried about an upcoming MMI appointment, get legal help before:
Signing any forms
Agreeing to a settlement
Accepting a final admission of liability
Missing a DIME deadline
Call Johnston Law Firm, LLC at (719) 309-9484 or message us online for a confidential, no-obligation consultation about your authorized treating physician and overall workers’ comp case.
Get Help Today: Protect Your Health and Your Colorado Workers’ Comp Case
In Colorado’s workers compensation system, your authorized treating physician choice can dramatically impact your medical recovery, wage replacement benefits, and final settlement. The wrong doctor can minimize your injury, rush you back to work, and leave you with a low impairment rating that costs you tens of thousands of dollars. The right doctor—and the right legal support—can ensure you receive fair treatment and full compensation.
Johnston Law Firm, LLC stands with injured workers across Pueblo and throughout Colorado. Steve Johnston ensures that insurers and employers follow the law, that ATPs treat clients fairly, and that clients understand every step of the process—from first visit through MMI and beyond. Whether you need help choosing from a designated provider list, challenging a biased ATP, or pursuing a DIME after an unfair impairment rating, the firm is ready to fight for you.
Don’t let your employer or their insurance company control your medical care and your future. Call Johnston Law Firm, LLC at (719) 309-9484, message us online, or schedule a consultation today.
Early legal guidance on the ATP issue can prevent costly mistakes, preserve important rights, and help you focus on healing while Johnston Law Firm handles the legal and insurance battles on your behalf.