The first 30 days of a serious job injury claim are confusing and scary. Here are a few important tips :
- Keep a copy of the C-4 Claim for Compensation form that you filled out to start the claims process when you first got medical care. Check it to see whether you were taken off work or released to work with restrictions.
- It is the worker’s comp adjuster who will be making important decisions on your medical care and compensation benefits. Ask your employer or a clinic staff person to give you the adjuster’s name, phone number and fax number.
- An adjuster has 30 days to accept or deny your claim. If your employer questions whether you were hurt at work, your assigned claims adjuster may want to take a recorded statement by phone before deciding to accept or deny your claim. (Now would be a good time to get a lawyer if you think your claim will be denied.)
- Unless you require real emergency care by a specialist, don’t expect your adjuster to approve expensive diagnostic tests like MRI’s until the adjuster decides to accept your claim.
- If you don’t like the medical care at the clinic, unless you have an emergency, the adjuster won’t allow you to transfer care to a different doctor or clinic until the claim is accepted.
- If your claim is accepted and you need to see a specialist like an orthopedic physician, fax a request to your adjuster for the names of the doctors on the provider list. You may request transfer to a doctor you choose from the provider list. Try to make an informed choice.
- In order to receive compensation benefits, you must be off work for 5 days in a row, or 5 days within a 20-day period of time. You must have an off work slip by the authorized treating doctor. Calling in sick without a doctor’s note will not qualify you.
- If the clinic doctor releases you to return to work with restrictions, you must call your employer and ask whether your employer has temporary light duty work within your restrictions. Show up for work if your employer tells you to come in for modified work. If your employer doesn’t have modified work available, then you need to request work comp benefits from the adjuster.
- if you are worried you may need a surgery or that you will be unable to return to work soon, get a free consultation from a reputable attorney so that you know what else to expect and what your rights are under the law. If you aren’t good about reading the fine print of papers you receive in the mail about your claim, getting legal help is even more important.
