Category Archives: Doctor

Workers’ Compensation Basics: Understanding the Injured Worker’s Right to Medical Care

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choose-a-family-doctorHere’s the next installment in the series that looks at the basics of workers’ compensation.

Under the Nebraska workers’ compensation laws, you may have the right to choose a family doctor to treat you for your work-related injury.

You may choose a doctor who has treated you or an immediate family member before this injury happened.

Immediate family members are your spouse, children, parents, stepchildren and stepparents. The doctor you choose must have records to show that past treatment was provided.

If you want to choose your doctor, you must tell your employer the name of the doctor you choose.  You need to do this as soon as is practical after the accident or as soon as your employer gives you the notice of the right to choose your family physician to treat you for your work injury form.

If you are in need of immediate medical attention and or emergency medical care, you have the right to obtain care immediately.

If you, or your family, do not have a family physician, then your employer has the right to choose the doctor to treat you.

However, if your workers’ compensation claim is denied for any reason, you have the right to choose any doctor to treat you for your injury.

Any time you are faced with a major surgery recommendation for your injury, you have the right to choose the surgeon to do the surgery.  You can choose any surgeon.

If you have any questions about your medical rights please feel free to contact us.

Read the previous blog posts in the workers’ compensation basics series by clicking on these links:

The offices of Rehm, Bennett & Moore, which also sponsors the Trucker Lawyers website, are located in Lincoln and Omaha, Nebraska. Five attorneys represent plaintiffs in workers’ compensation, personal injury, employment and Social Security disability claims. The firm’s lawyers have combined experience of more than 95 years of practice representing injured workers and truck drivers in Nebraska, Iowa and other states with Nebraska and Iowa jurisdiction. The lawyers regularly represent hurt truck drivers and often sue Crete Carrier Corporation, K&B Trucking, Werner Enterprises, UPS, and FedEx. Lawyers in the firm hold licenses in Nebraska and Iowa and are active in groups such as the College of Workers’ Compensation Lawyers, Workers' Injury Law & Advocacy Group (WILG), American Association for Justice (AAJ), the Nebraska Association of Trial Attorneys (NATA), and the American Board of Trial Advocates (ABOTA). We have the knowledge, experience and toughness to win rightful compensation for people who have been injured or mistreated.

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Workers’ Compensation Basics: Understanding Medical Care and Treatment

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Doctor_examines_patientThis blog post is the next in the series that examines the basics of workers’ compensation.

The first, and perhaps most important, workers’ compensation benefit is the medical benefit. This is a workers’ compensation benefit that includes payment of all treatment for a work injury. The treatment can be as small as stitches from a cut finger all the way to complex spine surgery. Regardless, the treatment and medical care should be covered 100 percent by the employer or workers’ compensation insurance company. There is neither co-payment nor deductible due for the treatment for the work injury. This medical coverage for work injuries can potentially last for life, depending on the injury and circumstances.

Not only is all treatment, like surgery, covered for work injuries, but so are other methods of rehabilitation: like physical therapy and medication. In other words, there should not be any co-payments for physical therapy, prescription medication, or other medical devices. Further, the mileage traveling to and from the treatment (or even to the pharmacy) should be reimbursed. This year that rate is 57.5 cents per mile.

These tips below are important to ensure that all of your medical bills and prescriptions for your work injury continue to be properly paid in full.

When you go to your doctor for treatment, make sure to inform your medical provider that you are seeing them for a work-related injury or illness, and ask them to send the bills to your employer. Also, make sure to thoroughly explain to your medical provider how you were injured or how you became ill. Give details about how the accident or work activities injured you or made you sick. Finally, inform the medical provider everything about your injury or illness: where you hurt, how the pain feels, your ability to function at home and work, etc. If your doctor wants you to avoid certain activities in order to promote healing, be sure to get a written copy of those restrictions from your doctor.

Look for information about choosing a physician (physician choice) to treat a work injury in an upcoming blog post in the workers’ compensation basics series.

Read the previous blog posts in the series by clicking on these links:

The offices of Rehm, Bennett & Moore, which also sponsors the Trucker Lawyers website, are located in Lincoln and Omaha, Nebraska. Five attorneys represent plaintiffs in workers’ compensation, personal injury, employment and Social Security disability claims. The firm’s lawyers have combined experience of more than 95 years of practice representing injured workers and truck drivers in Nebraska, Iowa and other states with Nebraska and Iowa jurisdiction. The lawyers regularly represent hurt truck drivers and often sue Crete Carrier Corporation, K&B Trucking, Werner Enterprises, UPS, and FedEx. Lawyers in the firm hold licenses in Nebraska and Iowa and are active in groups such as the College of Workers’ Compensation Lawyers, Workers' Injury Law & Advocacy Group (WILG), American Association for Justice (AAJ), the Nebraska Association of Trial Attorneys (NATA), and the American Board of Trial Advocates (ABOTA). We have the knowledge, experience and toughness to win rightful compensation for people who have been injured or mistreated.

This entry was posted in Cancer, Doctor, health insurance, healthcare, mental health, prescription drugs, Workers' Comp Basics, Workers' Compensation and tagged , , , .

Are Medical Doctors Willing Puppets for Cross-examination?

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It used to be that the most to fear from an examination scheduled by an insurance company would be an unfair or incomplete assessment of the work injury. Now it seems insurance companies are using doctors to essentially cross-examine injured workers and delve deeply into irrelevant issues in an attempt to embarrass, harass and probe where they do not belong.

 

-Do you have painful, frequent, or difficulty urinating?

-Do you have painful breasts, periods or intercourse?

-Have you suffered physical, sexual or emotional abuse?

-Do you have erectile difficulty?

-Do you get along with supervisors and other employees?

-Do physical or mental problems run in your family?

-Is anyone in your family disabled?

-Did you smoke, drink or use illegal drugs in the past?

 

These are some of the more disturbing questions asked by a doctor of a patient in a pre-exam questionnaire sent directly from the doctor’s office to the injured worker. You might surmise that this was a case of some sort of reproductive injury associated with mental duress of some type by looking at the questions. In fact, this worker only alleged carpal tunnel syndrome! Most assuredly, embarrassing facts about this worker would just happen to show up in the defense doctor’s final report for the Court’s review at trial.

 

Any time anyone other than your lawyer sends you something to complete, you should be very careful about filling it out. It’s probably unethical for doctors to send these reports to injured workers who are represented, but we’re seeing more and more of these go out. They are becoming more and more intrusive; in fact, this questionnaire was 11 pages long. It’s my practice not to have clients complete any of these pre-exam questionnaires from doctors.

The offices of Rehm, Bennett & Moore, which also sponsors the Trucker Lawyers website, are located in Lincoln and Omaha, Nebraska. Five attorneys represent plaintiffs in workers’ compensation, personal injury, employment and Social Security disability claims. The firm’s lawyers have combined experience of more than 95 years of practice representing injured workers and truck drivers in Nebraska, Iowa and other states with Nebraska and Iowa jurisdiction. The lawyers regularly represent hurt truck drivers and often sue Crete Carrier Corporation, K&B Trucking, Werner Enterprises, UPS, and FedEx. Lawyers in the firm hold licenses in Nebraska and Iowa and are active in groups such as the College of Workers’ Compensation Lawyers, Workers' Injury Law & Advocacy Group (WILG), American Association for Justice (AAJ), the Nebraska Association of Trial Attorneys (NATA), and the American Board of Trial Advocates (ABOTA). We have the knowledge, experience and toughness to win rightful compensation for people who have been injured or mistreated.

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Take Someone to the Doctor with You

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Having a work injury is incredibly stressful. Sometimes when a worker is under stress, they won’t understand what a treating doctor is telling them, which leads to frustration and anger on the part of the worker directed toward the doctor. In turn, the worker’s attitude will lead many doctors to not cooperate in a worker’s case. This is especially true if the insurance company has a nurse case manager working on the claim.

One solution for an injured worker is to bring a trusted friend or family member to the doctor with them to medical appointments. I see at least two advantages to bringing in someone else:

1) another person would be able to help you describe symptoms and how the injury happened and

2) the other person can help you understand what the doctor is telling you.

But not every friend or family member is the right choice to go to an appointment with you. You should choose someone who is level headed so that they do not get into an argument with the doctor. You should remember that the doctor is taking down a record of your visit and that that written record will likely be looked at by the judge deciding your workers’ compensation case, should your case go to trial. If you or a friend or family member gets into an argument with a doctor, it will likely hurt your case.

Injured workers who are non-English speakers can present more challenges to effective medical treatment. Not only is there a language barrier but there is often a cultural barrier as well. The language barrier is often used to the advantage of the employer and insurer, because they will often provide interpreters to the doctor. Non-English speakers should try to bring along a fluent interpreter in their language. A bad interpreter can almost be as bad as no interpreter. However, the same rules about temperament and judgment apply for those who go to doctors with non-English speakers. Sometimes doctors get frustrated with language and cultural barriers of non-English speaking injured workers. Employers and insurers know this and use this to their advantage.

The offices of Rehm, Bennett & Moore, which also sponsors the Trucker Lawyers website, are located in Lincoln and Omaha, Nebraska. Five attorneys represent plaintiffs in workers’ compensation, personal injury, employment and Social Security disability claims. The firm’s lawyers have combined experience of more than 95 years of practice representing injured workers and truck drivers in Nebraska, Iowa and other states with Nebraska and Iowa jurisdiction. The lawyers regularly represent hurt truck drivers and often sue Crete Carrier Corporation, K&B Trucking, Werner Enterprises, UPS, and FedEx. Lawyers in the firm hold licenses in Nebraska and Iowa and are active in groups such as the College of Workers’ Compensation Lawyers, Workers' Injury Law & Advocacy Group (WILG), American Association for Justice (AAJ), the Nebraska Association of Trial Attorneys (NATA), and the American Board of Trial Advocates (ABOTA). We have the knowledge, experience and toughness to win rightful compensation for people who have been injured or mistreated.

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What Medical Expenses Are Covered In A Workers’ Compensation Case?

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In Nebraska and Iowa, as is the general rule, an employer is liable for all reasonable medical services incurred as a result of a work injury. This is interpreted fairly broadly to include plastic or reconstructive surgery, prosthetic devices, and medicines, among other treatments. As long as the treatment is designed to relieve pain or promote and hasten the employee’s restoration to health and employment, the employer is liable. When a treatment meets these conditions, an injured worker should not be responsible for any portion of the medical bill.

 

The main difference is in Nebraska, as long as the worker elects a prior treating doctor to treat their injury (for example, the worker’s family doctor), that doctor can dictate the medical care and refer them to others for treatment. If no election is made, then like in Iowa, the employer can choose the doctor to treat a work injury as long as the employer accepts compensability for that injury. However, in Iowa, if the worker can establish that the medical care furnished is unreasonable, then the worker can choose another medical provider.  In both states, if a claim for a work injury is denied, the worker can choose their own doctors to treat with.

 

If no Petition is filed in Nebraska, an employer continues to be responsible for medical care as long as there is less than a two-year gap in the payment of a medical bill by the employer or insurance company or the payment of temporary or permanent benefits to the injured worker. Also, if the Court enters an order finding the injured worker entitled to future medical care, there is technically no time limit for seeking medical care.

 

In Iowa, medical benefits cannot be used to extend the deadline to file a claim for benefits. There is no time limitation in seeking medical care relating to an injury either before or after an Award for benefits.

 

However, in practical terms, large gaps in treatment will likely be met with skepticism from the employer – and possibly the Court – concerning the relationship between the work injury and the medical care. We recommend you seek consistent medical care where there is a need for it to avoid such issues.

The offices of Rehm, Bennett & Moore, which also sponsors the Trucker Lawyers website, are located in Lincoln and Omaha, Nebraska. Five attorneys represent plaintiffs in workers’ compensation, personal injury, employment and Social Security disability claims. The firm’s lawyers have combined experience of more than 95 years of practice representing injured workers and truck drivers in Nebraska, Iowa and other states with Nebraska and Iowa jurisdiction. The lawyers regularly represent hurt truck drivers and often sue Crete Carrier Corporation, K&B Trucking, Werner Enterprises, UPS, and FedEx. Lawyers in the firm hold licenses in Nebraska and Iowa and are active in groups such as the College of Workers’ Compensation Lawyers, Workers' Injury Law & Advocacy Group (WILG), American Association for Justice (AAJ), the Nebraska Association of Trial Attorneys (NATA), and the American Board of Trial Advocates (ABOTA). We have the knowledge, experience and toughness to win rightful compensation for people who have been injured or mistreated.

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Are Big Business and Big Insurance Making Nebraska Doctors Scapegoats?

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New legislation has been proposed to reduce the quality of medical care for workers under the guise of reducing costs

Evidence-based medicine and utilization review (EBM/UR) of medical care for workers’ compensation are currently being pushed by big business and big insurance interests.

We are facing such legislation in Nebraska this year.

One reason supporters of this way to control medical care for workers give seems to be that medical care currently provided is “inefficient.”

This is a euphemism for medical costs are too high. I view this as critical of physicians and other health-care providers who are taking care of injured workers. The Florida Medical Association (FMA) has recently responded to this type of criticism of the medical profession. In their case, the Office of Insurance Regulation (OIR) and National Council on Compensation Insurance (NCCI) say workers’ comp rates are being raised because drugs are dispensed directly by doctors. But an OIR report, according to the article linked below, “shows virtually no difference in the cost of such drugs whether dispensed by doctors or pharmacies,” so the FMA disagrees with blaming their doctors for rate increases.

This quote is from the story linked to above: “The truth is that the NCCI and carriers have used physician dispensing as a scapegoat for hundreds of millions of dollars in rate increases when other medical costs have been the real cost drivers in workers’ compensation,” the group charged. “The numbers are fabricated in an attempt to eliminate doctor dispensing.”

The offices of Rehm, Bennett & Moore, which also sponsors the Trucker Lawyers website, are located in Lincoln and Omaha, Nebraska. Five attorneys represent plaintiffs in workers’ compensation, personal injury, employment and Social Security disability claims. The firm’s lawyers have combined experience of more than 95 years of practice representing injured workers and truck drivers in Nebraska, Iowa and other states with Nebraska and Iowa jurisdiction. The lawyers regularly represent hurt truck drivers and often sue Crete Carrier Corporation, K&B Trucking, Werner Enterprises, UPS, and FedEx. Lawyers in the firm hold licenses in Nebraska and Iowa and are active in groups such as the College of Workers’ Compensation Lawyers, Workers' Injury Law & Advocacy Group (WILG), American Association for Justice (AAJ), the Nebraska Association of Trial Attorneys (NATA), and the American Board of Trial Advocates (ABOTA). We have the knowledge, experience and toughness to win rightful compensation for people who have been injured or mistreated.

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If I am Hurt on the Job, What Should I Tell My Doctor?

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One of the most important parts of any case is the history of your injury that you provide to your doctor when you first see him or her.

If you were hurt during a specific incident, make sure to tell your doctor how you were hurt, when you were hurt, where the injury took place, and who else was present. Tell him about the pain and symptoms that you have been experiencing. Also be sure to describe in detail all of the body parts that you have injured. Even if one injury hurts more than the others, make sure to tell your doctor about every single injury.

If you have been hurt by repetitive-work activities, be specific about the number of movements that you make. For instance, tell your doctor about the number of times you lift or grip things in an hour, day, or week.

If you have been hurt by exposure at work, whether it is to a hot, humid environment, chemicals, or any other environmental condition, be specific when you tell your doctor about the pain and symptoms that you have due to that exposure.

If you leave work and become better, and then return to work and experience an increase in your symptoms, be specific when you tell your doctor about any changes in your condition.

It is important to be accurate and honest the first time that you seek treatment with your doctor, for both your health and your workers’ compensation claim.

The offices of Rehm, Bennett & Moore, which also sponsors the Trucker Lawyers website, are located in Lincoln and Omaha, Nebraska. Five attorneys represent plaintiffs in workers’ compensation, personal injury, employment and Social Security disability claims. The firm’s lawyers have combined experience of more than 95 years of practice representing injured workers and truck drivers in Nebraska, Iowa and other states with Nebraska and Iowa jurisdiction. The lawyers regularly represent hurt truck drivers and often sue Crete Carrier Corporation, K&B Trucking, Werner Enterprises, UPS, and FedEx. Lawyers in the firm hold licenses in Nebraska and Iowa and are active in groups such as the College of Workers’ Compensation Lawyers, Workers' Injury Law & Advocacy Group (WILG), American Association for Justice (AAJ), the Nebraska Association of Trial Attorneys (NATA), and the American Board of Trial Advocates (ABOTA). We have the knowledge, experience and toughness to win rightful compensation for people who have been injured or mistreated.

This entry was posted in Doctor, workers comp basics, Workers' Compensation, Workplace Injury and tagged , , .

Medical Bills After an On-The-Job Injury – Do I Have to Pay Them? (PART 2)

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A few weeks ago we shared a guest post from Kit Case of the Causey Law Firm in Seattle on medical bills. Today we present part two in this series.

In our last post about dealing with medical bills after an on-the-job injury, our quick answer was that you most likely do not have to pay these bills, depending on your specific circumstances. So, let’s say that you don’t actually have to pay these bills, but you’ve already paid some of them. Here are a few more questions and answers.

What About Everything I Have Already Paid? Can I Be Reimbursed??

Question: My private insurance has covered the cost of my medical care while my workers’ compensation claim was in dispute. I have been making payments to my doctor’s office, too, for co-pay and other charges. Can I be reimbursed? What about my prescription costs?

Answer: Yes, you can be reimbursed for your expenses!

You can be reimbursed for medical expenses, prescription costs, travel expenses (when appropriate) and other costs once your workers’ compensation claim has been approved. In Washington State, though, the Department of Labor and Industries will only make payment to medical providers directly for services rendered, so you cannot receive direct reimbursement for payments to your doctor, physical therapist, chiropractor, etc… These providers will need to submit bills for services under the allowed claim, receive payment for those services, and then issue refunds to you and your private insurance carrier for payments previously made. This can be a difficult process, though, as the medical providers have already been paid, often at a higher rate than what is allowed under a workers’ compensation claim, so they often would prefer to not go to the hassle of rebilling for services they have already been paid for and then make refunds to you and/or your insurance carrier in excess of the workers’ compensation payments.

Prescription costs are easier to have reimbursed. If you have receipts, you can submit a Statement for Pharmacy Services form to request reimbursement. If you do not have your receipts, you can submit this form with a printout from your pharmacy of all filled prescriptions related to the claim. The printout and the form must be signed by the pharmacist to certify that you have paid for the claimed prescriptions. Reimbursement for pharmacy expenses will be paid to you directly.

Similarly, travel expenses can be claimed under certain circumstances. If the travel was at the request of the Department of Labor and Industries, or if travel greater than 30 miles round-trip was needed to see the closest appropriate medical provider, then you can request reimbursement of mileage at the State’s rate and some extra expenses, such as ferry fares, parking charges or meal expenses. The Travel Reimbursement Request form must be submitted using the appropriate code for the type of expense incurred and receipts must be provided to support the reimbursement request. As with pharmacy reimbursements, travel reimbursements are paid to you directly.

The offices of Rehm, Bennett & Moore, which also sponsors the Trucker Lawyers website, are located in Lincoln and Omaha, Nebraska. Five attorneys represent plaintiffs in workers’ compensation, personal injury, employment and Social Security disability claims. The firm’s lawyers have combined experience of more than 95 years of practice representing injured workers and truck drivers in Nebraska, Iowa and other states with Nebraska and Iowa jurisdiction. The lawyers regularly represent hurt truck drivers and often sue Crete Carrier Corporation, K&B Trucking, Werner Enterprises, UPS, and FedEx. Lawyers in the firm hold licenses in Nebraska and Iowa and are active in groups such as the College of Workers’ Compensation Lawyers, Workers' Injury Law & Advocacy Group (WILG), American Association for Justice (AAJ), the Nebraska Association of Trial Attorneys (NATA), and the American Board of Trial Advocates (ABOTA). We have the knowledge, experience and toughness to win rightful compensation for people who have been injured or mistreated.

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