Report Injury and Seek Medical Treatment
Step 1. Notify your employer
As soon as possible, injured workers must report their injury to their employer. There are various ways to do this depending on your situation. However, you want to make sure that the formal “first report of injury” (FROI) form is filled out by a supervisor. The FROI must be filed within 15days of the injury. If you do not file within that time frame you run a serious risk of your claim being denied.
The sooner you notify your employer, the sooner you can start receiving treatment and obtain your benefits. The longer you wait, the more skeptical the insurance company will become. However, please note, that if you require emergency medical care, you can seek treatment first and notify your employer as soon as you’re able to.
Step 2: Seek medical treatment
Your health should be your top priority, so again, it’s important to seek medical treatment as soon as possible. If your injuries are serious, you should go to an emergency room or urgent care immediately. Don’t worry about finding an employer-approved doctor as emergency care is generally covered by workers’ compensation. Any gap in time between your work injury and seeking treatment can put you at risk of having your workers’ compensation claim denied.
Once you have notified your employer, they should provide you with a list of approved treating physicians (ATPs). Specifically, you’ll be provided a “panel” with three different doctors on the list and you are to pick one of those doctors to be your treating physician. It’s important to note that once you’re given this panel it’s vital that you treat only with that doctor. If you go outside of the workers’ compensation doctor and say visit your primary care physician for a follow-up appointment, workers’ compensation is unlikely to pay for that treatment.
A common theme I see among my clients is their distrust and/or dislike of the treating physician. Except for very rare circumstances, there is no way to get a new doctor. However, I encourage you to contact your attorney to help address any of the issues you may be facing.
If your claim is denied:
There is the option to appeal the denial and for that, I would highly recommend hiring legal counsel to assist. When a claim is denied, it means your employer’s workers’ compensation insurance adjuster believes your injury is not compensable, meaning that your injury was not caused by the work that you performed and is not covered by workers’ compensation. If your claim is denied you will receive a Notice of Denial form in the mail. You have a right to challenge the denial.
Another thing that many injured workers experience is having certain treatments recommended by the doctor denied. For example, despite the doctor’s recommendation for surgery, the workers’ compensation adjuster denies that surgery. Again, you can challenge the denial. When this happened, consult with a workers’ compensation lawyer to discuss filing an appeal.
Next time we will address the benefits you can and should receive while you are treating for the work injury.
If you have questions or are seeking counsel to represent you during this process, you can contact us by calling (615) 933-8000 or emailing firstname.lastname@example.org.
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