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Showing posts with label workers comp qa. Show all posts
Showing posts with label workers comp qa. Show all posts

Thursday, January 31, 2013

I Told My Supervisor - Why Do I Need To File An Accident Report In Writing?

Today's post comes from Matthew Funk of the NY Bar.

QUESTION: I TOLD MY SUPERVISOR ABOUT THE ACCIDENT BUT I DID NOT SUBMIT AN ACCIDENT REPORT. AM I GOOD TO GO WITH THE VERBAL NOTICE?
ANSWER: ALWAYS REPORT AN INJURY IN WRITING
Joe was working a construction job when Mike accidentally beaned Joe on the head with a 2X4. After seeing a couple of Tweety Birds and a whole bunch of stars, Joe went down to his supervisor’s station and told him he had just had an accident. Then he went off to the ER to make sure he was not seriously injured, relieved he had taken care of business at the job site. All he had to do now was get better.
No, Joe! No! Yes, Joe satisfied the notice requirement. However, Joe was NOT good to go.
Supervisors sometimes have a funny habit of forgetting conversations or oral notices of an accident. Even if Joe’s supervisor were his best friend, when push came to shove there could be no telling what the supervisor might say in Court front of a Judge. Furthermore,

Thursday, December 27, 2012

Who Calls The Shots, Your Employer-Selected Doctor Or The Insurance Company?


Insurance companies sometimes tell doctors that they will not pay for procedures that the doctor says are medically appropriate.

Today's post comes from guest author Nathan Reckman from Paul McAndrew Law Firm.

In Iowa, employers have the right to control an injured worker’s medical care. This means that if you are injured at work, your employer gets to send you to a doctor of their choosing. The doctors chosen by the employer are called “authorized treating physicians.” In theory, after an employer chooses their authorized treating physician, they are required to pay for any care that doctor believes is necessary to treat the work injury. In practice, the employer and their workers’ compensation insurance company often try to interfere with the care the injured worker is entitled to by refusing to pay for procedures or tests recommended by their handpicked doctor.

Typically, when an authorized doctor suggests an expensive course of care (like surgery) the first thing the doctor will do is check with the insurance company to make sure the surgery is going to be paid for. Instead of immediately scheduling the needed surgery, the doctor will wait until the insurance carrier agrees to pay for the procedure. Doctors do this so they don’t have to worry about how they are going to be paid. Asking for this unneeded authorization from the insurance company means the insurance company now has a say in determining what individual procedures are proper for the care of the work injury.

We often see injured workers whose injury was initially accepted by the employer until the doctor requests authorization for an expensive surgery. When faced with the additional cost of surgery, the insurance carrier denies the work injury hoping the injured worker will either forego surgery or try to pay for the surgery through other means, such as their personal health insurance.

This situation may also arise when the authorized doctor recommends expensive diagnostic procedures, like CT scans, or refers the injured worker to a specialist, for example a psychiatrist for depression related to the work injury.

To make sure your rights are protected, it’s often helpful to have an experienced workers’ compensation attorney on your side if you’re facing a situation where your employer is trying to interfere with the decisions of their handpicked doctor. Injured workers should get the care that their doctor, not an insurance company, determines is medically appropriate.

Read more about "medical treatment" and workers' compensation.


Nov 16, 2012
New York Worker's Compensation Board's proposed new medical treatment guidelines that will modify 2010 previously implemented. Adopt the new carpal tunnel syndrome (CTS) medical treatment guidelines (MTG) as the ...
Nov 09, 2012
On Tuesday, the American people expressed its support for a unified medical care program that will embrace all aspects of life, including industrial accidents and diseases. They validated, as did the Supreme Court, the ...
Nov 01, 2012
Planned changes by Mitt Romney to Medicare and Medicaid will have a dire effect on the regulations of the future cost of workers' compensation medical treatment. Proposed changes to the Federal program will indirectly ...
Jan 22, 2011
The court held that the failure of the employer/insurance carrier to provide medical care for out-of-state treatment, even though requested by the employee, was deemed a refusal of the employer to provide adequate medical ...

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