Workers Comp Question and Answers
At Midlands Family Urgent Care, we specialize in helping employees with worker’s compensation claims. Our professionals will provide comprehensive treatment to help you regain your health and assist you to return to work safely. For more information, call us or book an appointment online. We have 2 convenient locations to serve you in Omaha NE and Papillion NE.
What is a Workers Comp visit?
A Workers Comp visit is a doctor’s visit that is required as part of the filing of a worker’s compensation claim. Any claims for a work-related illness or injury must be accompanied by a medical evaluation and proper diagnosis by a doctor that has been approved by the insurance company of record for your employer’s workers’ compensation benefits. Depending on the laws of the state in which you reside, you may be able to seek treatment from your own primary care physician or another doctor of your choice. In order to prepare for a Workers Comp visit, you can request a copy of the medical records that will be sent to the doctor overseeing your case. You should either make notes of the accident or ensure you have a solid recall of the events to be able to tell the doctor your recollection of the events leading up to or causing the injury. The version of events that you tell the doctor must match the description of the accident that the insurance company has on record. With your current medical history in hand, the doctor for the Workers Comp visit will want to get an understanding for anything in your existing health that is different as a result of the incident.
What do workers comp doctors do?
Workers Comp doctors are responsible for treating their patients after a work-related injury or illness to monitor their recovery and report back to the insurance company. The treating doctor is tasked with getting a thorough understanding of your condition, what medical treatment is needed, any ongoing physical limitations and how likely you are to make a full recovery, and when. Their professional medical opinion carries significant weight in the outcome of your worker’s compensation case as they are the medical expert in your unique situation. The Workers Comp doctor will diagnose your condition through a physical exam and any additional diagnostic tests, and then provide a treatment plan that could include medication and physical therapy if necessary. They will also refer you to any specialists needed for your condition. As you progress through your treatment, the doctor will decide on your work restrictions, including when it is safe for you to return to work. Their determination will factor into your ability to receive partial wage benefits while you are off recovering. The doctor will evaluate your condition once you are deemed as healed to determine if there are any permanent limitations. Finally, the doctor will provide all of your medical records as evidence in your workers’ comp case. The doctor will potentially need to testify on your behalf on all aspects of your case, from injury through to treatment and on to final recovery. The more thorough the medical records, the smoother the case runs with the insurance company.
How does the worker’s compensation process work?
Worker’s compensation is an insurance program that provide employees with medical, rehabilitation and disability benefits should they become injured or ill as a result of their job. It can also pay death benefits to an employee’s family should they be killed as the result of a work-related accident. The steps of a worker’s compensation claim are as follows:
- The employee notifies their employer immediately if they are injured on the job.
- The employer provides medical assistance to the employee in an emergency or permits the employee to leave work and seek medical treatment for a less severe injury.
- The employer must send their insurer the First Report of Injury Form.
- Within the mandated time frame, the employer must provide the employee with the Worker’s Compensation Claim Form.
- The employee must then return the completed form to their employer within the mandated time frame.
- The employer must then report the completed claim to the insurer, and state if required by law, within the mandated time frame.
- The insurer will then investigate the claim.
- The insurer will notify the employee if the claim has been denied, accepted or delayed.
- If the claim has been accepted, the employee will receive their benefits. The worker may appeal if their claim is denied.
What injuries are not covered by workers’ compensation?
Worker’s compensation is intended to protect the employees from unsafe work situations and assist them if they are injured and unable to perform their job as a result of an accident at work. The injuries that are covered are injuries, or illnesses, that are a direct result of the employee’s job. Things that aren’t covered are injuries as a result of an employee being under the influence of drugs or alcohol or as the result of not performing your job following the protocols set out to safely complete your tasks. Injuries sustained on the commute to and from work are excluded, as are injuries that happen while you are on a break and off the premises of your work, for example, if you got hit by a car crossing the street to buy lunch. Injuries sustained at work-related recreational events will depend on a few factors, such as if your attendance was required and if your attendance benefited your employer. Other injuries that wouldn’t get covered by worker’s compensation include goofing off with another employee, injuries that are self-inflicted, and injuries as a result of the employee’s own illegal actions.
Don’t hesitate to reach out to us if you think you may need any of our services. Visit us today! We serve patients from Omaha NE, Papillion NE, La Vista NE, Fairview NE, Ralston NE, Bellevue NE, Springfield NE, and surrounding areas.