Before discussing which doctor to see, you might be wondering if you even have a workman’s comp case. Let’s take a closer look at what is workman’s comp, how it works and what are your rights as a worker.
Then you’ll better understand why it’s so important to see a doctor who specializes and understand the intricacies of worker’s comp cases.
Workers’ compensation is a type of insurance. It is, in most states, New Jersey included, required that employers carry some kind of worker’s comp insurance.
The insurance covers employees in the event they sustain some kind of injury while on the job. The injury can happen in any number of ways.
Your injury could be the result of an accident at work. It could also be the result of an injury that happens over time because of the work you do.
NJ worker’s comp insurance covers any employee injury no matter how it happened. If the injury happened because of a work-related injury you are covered. If another employee was at fault and caused the injury, you can still be protected.
You might be traveling for work and sustain an injury, you would have coverage for your injury. If your boss sends you out to run errands during work hours and you are injured, that too is considered a work-related injury.
The workers’ compensation, though, is the actual insurance that the employer is required by the state to buy to protect workers in the event they are injured and the injury is related to their work.
There is also a federal worker’s compensation. The US government carries worker’s compensation coverage for federal employees too.
If you are injured on the job and need immediate medical attention, of course, you should get the treatment you need right away.
If you sustain an injury on the job that is not life-threatening, then there are some steps you should note.
First, it is essential to notify your employer of your injury. You don’t have to do this in writing, although having documentation of the notification is always a good idea.
Not sure who to tell? You can notify any of the following:
You need to do this as soon as you sustain the injury so that the correct insurance process can be followed.
If you need medical attention, your employer can ask you to see a specific doctor that is approved by their worker’s comp insurance comp company. Typically, these are doctors who specialize in work-related injuries.
Your most important role is done once you notify your employer of the injury. You need to be examined by a doctor and be treated for your injury.
It’s important that you follow doctor’s orders as they pertain to your injury. This could be significant as you seek worker’s compensation.
If your employer wants you to see a certain worker’s comp doctor, you need to do that to be eligible for coverage. You can also see your own doctor for another opinion if you feel uncertain about your care.
Once your employer starts the process with their insurance, they will need to complete paperwork. They will ask you to take the paperwork to the doctor who has treated you.
Once you notify the employer of your injury, they are obligated to immediately notify their worker’s comp insurance company of your injury. Then the First Report of Injury is filed with the State of New Jersey.
The insurance company then takes a look at all the information. They evaluate all the information they have available to determine if the claim is eligible for worker’s compensation benefits.
They will make contact with the:
This will help them to establish if they feel compensation is due to the claim. The insurance company may send tan injured worker back to the workers’ compensation doctor for additional evaluation.
If the worker is out of work because of the injury, the worker could be granted temporary disability benefits. Workers’ compensation can cover medical care, rehabilitation care, and lost wages while recovering.
The role of the doctor in your worker’s compensation case is so important. Of course, you want a doctor who will give you optimal care. Their role in the benefits part of the case is also significant.
You need to use a doctor who will be involved with the treatment of the injury. But you need a doctor who will go beyond the initial treatment of your injury.
Your doctor will:
This treating doctor will have the necessary information as your case is considered with the worker’s comp insurance company.
It’s important to understand the role of the workman’s comp doctor in your care. This doctor will be responsible for making important decisions regarding your injury and care. These include things like:
For you to get benefits from your employer’s workman’s compensation insurance, you must have a medical diagnosis. Then the doctor will handle your medical care and continuing care like physical therapy. They will also be responsible for diagnosing medications as needed.
If your injury requires the care of another doctor or specialist, like a surgeon or pain management doctor, the treating physician will be responsible for making these referrals. So, your communication with the treating doctor is essential. You also need to feel confident in the care they are providing.
Once you have been evaluated and a treatment plan is in place, the doctor will need to make decisions about your ability to work. The doctor will decide on these things:
If the doctor gives you an extended restriction you can become eligible for temporary disability benefits.
If you don’t abide by the doctor’s restrictions and return to work too soon, you risk further injury or worsening of your current injury.
There is something called maximum medical improvement. It means that your medical condition has reached maintained stability and will no longer improve beyond where it is now. When you reach this status, the doctor must evaluate you to decide if you have permanent limitations.
Permanent limitations and the doctor’s opinions on them will be used to make decisions about permanent disability benefits that you might qualify for.
Your doctor will be involved in the documentation of your prognosis, treatments, and recovery.
If you become involved with a legal dispute regarding potential benefits, it’s likely the workman’s comp doctor will need to testify. The documentation from your care will become an important part of the case.
The rules on what doctor will treat you in a workman’s comp case vary from state to state. In some states, you can see your own doctor right away. In a few states, you have to designate with your employer before an injury that you would want to see your doctor.
In most states, however, you will need to see the doctor or medical service provider that your employer designates. This provider might be the one designated by your employer’s insurance agency too.
Often, you must first see the designated doctor, then you can also see your own doctor.
Why does this matter? You might be thinking as long as I get treated why does the doctor matter?
It is significant because if there is a dispute about worker’s comp benefit, often the doctor’s testimony is key. You want a doctor who will represent you and not the insurance company’s interest.
While most doctors take their oath seriously and patient care is optimal. There can be a conflict of interest if the doctor is paid by the insurance company or the employer and involved with representing your condition.
Because many jobs come with risk and because accidents happen despite the extensive safety measures put in place by employers. Worker’s compensation insurance is important.
First, it gives employees important coverage in the event of an injury. It also protects the employer. You might be wondering how the employer is protected if they are the ones required to obtain the insurance, to begin with.
If an employee agrees to the benefits provided through the workers’ comp insurance plan, in most cases, they are forfeiting their right to later sue the employer.
The benefits are paid through by the insurance company. This means that while the employer pays for the actual insurance policy, they don’t pay the benefits awarded from the policy.
Coverage from workers’ comp insurance covers injury, illness, and death.
Injury can come in a variety of forms. It could be from a work-related accident, a singular event where a worker is injured because of an accident.
Injury can also come in the form of a repeated motion at work. These repetitive motion or overuse injuries are often covered through worker’s comp insurance.
In the event of work-related death, medical care and treatment would be covered. The insurance would also pay survivors benefits to the family of the deceased.
In each of these scenarios, medical care, rehabilitative care, lost wages, and even disability wages can be part of the benefits package.
Unfortunately, because the insurance company is the one paying the benefits, it isn’t uncommon to have disputes over benefits and coverage.
Employees often will end up hiring their own legal counsel to represent their interests. The dispute becomes between the workers’ comp insurance company and the employee, not the employer.
Although, the employer will surely have to provide details of the injury if the case were to go to court.
Because workers’ comp cases often have disputes, having a qualified doctor who understands the intricacies of these cases is key.
If you have been injured on the job, you want to get the best care possible. Aside from worrying about insurance claims and disputes, you want your injury treated so you can be on the road to recovery.
You want to find a doctor who understands the often unique circumstances that come with a workplace injury. Whether from an accident or repetitive motion injury, you want expert care.
If you have an injury and need care, contact us to find an experienced New Jersey workers’ comp doctors to get the care you need. Whether you need a qualified orthopedic surgeon, neurologist, pain management specialist, physiatrist, chiropractor, physical therapy clinic, or another specialist, we are here to help you find the best!
Ready to get on the road to recovery? Call 1-800-897-8440 now or fill out a short form below to request an appointment with the best NJ doctors near you who accept workers’ compensation.
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