What does Worker's Comp have to do with whether or not a doctor will treat you?

There are doctors specifically trained in Workers Comp procedures from what I understand. My husband got hurt on a job and could only go to one specific knee surgeon and he hated him (sub par idiot) so he had to request another. That’s what I got out of it, may not be right.

There are rules and regulations that have to be followed in order for the services to be paid for. If the injury occurred at work, your son’s health insurance will deny the claim and not pay the doctor, and your son might lose his rights if he seeks medical care without going through worker’s comp. Typically an incident report has to be filed with the employer, and they file a claim through their worker’s comp. insurance company.

The initial examinations are usually done through the clinics that are contracted through that insurance company, although I believe the worker does have a right to get a second opinion. I’m sure the website for your state’s department of labor will have more specific information.

Thanks.

@hearkat: Someone could be taken to the ER with a Comp claim – it doesn’t have to be only at a certain clinic. If someone had a heart attack while at work, they’re not going to a clinic!

@jca – True – obviously the urgency of the medical situation dictates that.

You just made me remember the time 27 years ago, when my fingers got slammed in the shop door by a gust of wind, and it hurt but I went right on up to the office, where my coworkers proceeded to ask me why I was green – I had gone into shock and not known it! They took me to the E.R. and amazingly, nothing was broken and I made a full recovery.

In a case where the extent of the injury is not realized until the next day, as with @Dutchess_III‘s son, they might send him to a facility authorized by their insurance company, since it is not an emergency. We see Worker’s Comp patients for second opinions and I often see reports from those clinics. I would recommend that he contact his Human Resources manager, if he hasn’t already.

My son was working on his own car after hours and managed to walk into his exhaust pipe and put a huge gash in his forehead. He went to the E.R. for stitches and our insurance tried to deny the claim because it happened at his job, so he had to go through an appeals process and explain he was on his own time, working on his own vehicle, so it wasn’t a worker’s comp case.

In my experience, the second opinion from the Comp doctor is way down the road. First things first, get treated and don’t worry about formalities or second opinions.

Agreed – when we see worker’s comp cases, it’s often more than a year after the incident. The first step is to contact management at the job and follow their instructions for where to seek treatment if you don’t want to get stuck with the bills or lose rights as an injured employee.

When I took Workmen’s Comp training, we were taught that the employee should never provide their own insurance information to the doctor. Doctors will be happy to have the employee’s regular insurance information so if they have trouble with comp, they’ll just bill the regular insurance. No no no. The employee should specify that it’s going to be a comp claim, and then provide the number and other information down the road. I work for the government and we don’t need to go through management to seek medical treatment and I am guessing nobody else should, either. Management has nothing to do with whether or not the employee is treated.

It also helps to have a lawyer to handle your case. (That part is just my opinion.)

He tried to get treated! What he needs to do is go to a different doctor and just not tell him he hurt himself at work.

He needs to say it’s a Comp case, so he needs to say he did it at work.

Why?

Because who’s going to pay for it?

At some point, a conversation with the medical provider is going to be “how did it happen.” Furthermore, the forms might have a question about “where were you when this happened” or “were you at work?”

@Dutchess_III If he does not say it’s workers comp and goes to any old doctor, he will have to pay for everything. Employers have workers comp insurance for claims like that and it’s very specific.
Also, hate to say it, but a lot of employers will ‘find a reason’ to let employees go after being injured on a job so most just pay for it themselves and never say anything.

He has insurance @jca and @KNOWITALL. He could tell them he did it shoveling snow, just not mention that it was at work.

I think that’s his concern because he’s not going to pursue the workers comp angle. He’s just going to wait until it gets better. Poor kid.

@Dutchess_III Good call. My husband used a WC once and never worked for that company again, it really sucked because he made really good money, but we had no idea they’d get mad for making their ‘rates go up’.

If he has back pain, they’re probably just going to prescribe a painkiller anyway.

Yes, and a muscle relaxer. He pulled a muscle. Doctor didn’t prescribe anything, just sent him home.

He needs to go to the Dr. and just say he did it shoveling snow if he’s not planning on pursuing a WC claim.

If he has insurance, it’s silly and dangerous not to go to the Dr. If it’s muscle related, the heat is recommended. If it’s a bulged disc, cool is better – heating a bulged disc makes it worse.

I know this sounds simplistic, but if heat is the needed thing, those Therapedic patches are fantastic! Warm snuggy on a cold day. They make them in belts or if some other place is needed get the ones for PMS. Best size and adhesive. Put one of those babies on with a tight T-shirt (to minimize friction) and your set.

The problem is that if it does turn out to be more than a muscle strain and he needs more evaluation and treatment down the road, he may have difficulty getting it covered. Hopefully this was just a very minor injury and he recovers quickly.

I agree, @hearkat, if he chooses the non-WC road, he’s likely on it for the duration. I worked for a multi-national and he’d already be ineligible for WC, and any accident not reported the shift that it happened was scrutinized, even if you reported it first thing the next available shift. They had to know before you went to any Dr.

He went to the Doctor’s @ibstubro.

Well, that’s the important thing, @Dutchess_III.

Doctor is #1.

The diagnosis is #2.

Funding? Flock that…it’s there.

(Don’t worry. No payment owed. I’m still trying to repay the kindness you payed me as a Newbie on Fluther.)

The doctor just told him to go home cuz it was a WC issue.

I was kind to you as a newbie? What was I thinking other than I liked you and still do?!

When I hurt my wrist at work I had to fill out forms and then I was sent to a clinic. I think it is because a different part of your insurance comes to play. It is the companies insurance that has to be notified and not the insurance (although the same) you have. If it becomes a liability case against your company, than their liability insurance pays for that. When I went. There was no co-pay and the clinics help fill out the forms. I think it is also because your personal insurance is not permitted to give out info without your permission.
Of course for a more serious thing, like poisoning, getting a severe cut or heart attack or lung problems, you would go see a doctor in a hospital. They will worry about the workmans comp later. It does suck. They did the same thing with my brother and he was in pain for a long time. Best thing to do is for him to fill out the paperwork asap so he can be seen asap.
Think of it like insurance for your car. When you drive it and get in an accident, they pay you right away. When you loan your car out to someone and they wreck your car, your insurance isn’t going to pay a dime till the drivers insurance pays first. Even if it is the same company. They have to investigate the situation to see how much they are libel for before paying up.

Okay, I’m going to apply myself to this question.

If your son’s ailment is taken on as Workman’s Comp, the company basically takes him on to raise until the issue is 100% resolved. They are responsible for treatment, and any disability cannot result in the loss of his job. Whether he is able to work or not, they will be responsible for him and his medical bills because the injury occurred while in their employ, and during the hours of employment.

Your son’s employer will basically do anything they can to weasel out of such responsibility. Or, rather, his employer’s insurance will do anything they can. So if a doctor treats your son for an ailment he claims is WC, then it’s likely the insurance company would go after the doctor, claiming mistreatment, misdiagnosis, etc. etc. If they can create a doubt, the the doctor’s insurance is on the hook. It should go without saying, of course, that both your son’s employer’s insurance and the doctor’s insurance are now invested in proving that the injury did not happen at work, i.e. that your son is a liar.

Basically it’s a volleyball game between the insurance companies to keep the ball in the air long enough for your son to be killed or cured. In cases of serious injury, these cases can drag on for years and years, possibly with the patient having no insurance, because no one will accept responsibility for payment.

Jaded? Yes.
Cynical? Yes.
Real life? I believe so.

Yeah, well, he decided to tough it out. Anyone got any muscle relaxers hanging around that they can send me?

Sorry, I tossed my suscle relaxers from the whiplash in my last car accident – they never seemed to help much, anyway. I am always amazed at how well the BenGay patches work when I strain my back. I tend to forget about them, and once I remember and put them on they really make such a difference – it’s like magic. I have cherry stone pillows that I heat up and put on sore muscles. If it’s my lower back (typically the problem for me) I sleep on my side with my knees bent and a pillow between them to keep my back straight. We have “Stressless” recliners in the living room that have great back support, so I will sit in those instead of on the soft couch, too.

I’ll tell my son about the Ben Gay. (Wonder if they would have chosen a different name for that product today…)

He just texted me, said he’s doing much better.

Thermacare, @Dutchess_III.