Hurt On The Job: Common Mistakes (Part 3)

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The first step in starting this communication process is filling out an 827 Form.  This form is what gives the workers’ compensation doctor authority to not only treat you, but to request treatment, provide medical services and authorize time loss.  When filling out this form, it is very important to give an accurate description of how the work comp incident occurred.  The workers’ compensation insurance company assigned to your case will be reviewing this form very carefully for any errors or discrepancies in your description of what you are now telling your doctor versus what you told other people and other medical providers in earlier statements or chart notes. BE VERY ACCURATE WHEN FILLING OUT THIS FORM!

Once you have picked the authorized provider and have filled out the necessary 801 form, YOU MUST, SEE THIS PROVIDER EVERY 30 DAYS. Failure to do so could result in suspension of time loss benefits or administrative closure of your workers’ compensation claim.  As it pertains to time loss authorization, make sure you get that in writing every thirty days and provide a copy of that to your attorney; your attorney will then give that authorization script to the workers’ compensation insurance company to ensure that your time loss benefits continue in a timely manner.  Failure to keep the time loss current can also lead to huge overpayments in your claim.

Let me explain:  You go to the doctor every thirty days as you are supposed to do.  For the first couple of visits, the doctor will write down your work restrictions and provide a copy of this to you and to the workers’ compensation carrier.  However, on subsequent visits the doctor forgets to do this.  Should the workers’ compensation carrier continue to pay time loss for all the months the doctor did not provide updated work restrictions in writing, all of that time loss could be considered an overpayment!  This overpayment can then be covered out of any money awards that might be owed to you or out of future compensation you might receive on not only this claim, but other claims filed with the same insurance company.  ALWAYS, ALWAYS, have your medical doctor fill out the appropriate off-work slips in writing to be sent to the workers’
compensation carrier and to your attorney.

Now that you understand the importance of picking the right doctor, filling out the 827 Form, seeing your doctor every thirty days and making sure that time loss forms are in writing and sent to both the insurance company and your attorney every thirty days, it is critical that you make your doctor aware of all the symptoms or conditions that might be bothering you as a result of the workers’ compensation claim. This must be done early on and repeated on every visit.  Do not assume that your doctor knows what you are thinking or how you might be feeling.

For example, you get hurt on the job and suffer a broken leg from a serious fall off a ladder.  For the immediate time after the fall, it seems that the main focus of your health care is on the treatment of the broken bone.  If you are experiencing any other symptoms such as back, knee or other areas of pain, REPORT THIS TO THE DOCTOR RIGHT AWAY, AND OFTEN.  The insurance companies are notorious for denying treatment of other subsequent conditions and complaints, if they were not spoken of or addressed early on by you with your doctor.  It is not a bad idea to make sure that your health care providers are writing down the things you are telling them.  If you think they are not listening, not writing down, or not interested in what you are saying, immediately discuss these concerns with them and communicate this to your attorney.

 

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