We all know that work injuries happen every day to other people. What happens when you are the one who is hurt on the job? In this post we will cover the six steps you must take to ensure that you get the appropriate medical care you need to help you recover from your injury and how to document permanent impairment if appropriate.
1. Inform your employer
- Inform your employer of your injury as soon as possible.
- Fill out the necessary paperwork called a C-1 form or incident report. Be as detailed as possible in describing the mechanism of injury and the body parts involved.
- Make sure to get statements from anyone who witnessed your injury.
2. Go for an evaluation and get treatment recommendations
- Do not wait to get evaluation and treatment. It is important that your injuries are assessed promptly so that you can start any necessary treatment. Delays in treatment or gaps in treatment will negatively impact your recovery.
- In an emergency situation an ambulance will transport you to the nearest hospital. In non-emergent cases your employer will direct you to their contracted facility for evaluation and treatment recommendations.
- The first doctor who sees you is required to fill out a form C-4. Again, it is important that you give a concise description of the mechanism of injury and absolutely crucial that you detail each injured body part. I highly recommend that you get a copy of the form C-4 after the doctor finishes and verify that each injured body part is included. This simple step is so important and can save you a lot of time and misery later on. It can be an absolute nightmare to add an injured body part on to a claim once certain deadlines have passed.
- Make sure when you see your doctor that each body part is addressed in her/his notes and match them to the included diagnosis list. The records will not be available for immediate review so give them a few days but they are your medical records and you are entitled to review them once they are finished.
4. Consider Legal Representation
- If you have a significant injury at work then I highly recommend a consultation with an experienced attorney who specializes in workers compensation law.
- A qualified legal representative can help you navigate the deadlines and paperwork involved in a work comp case. A missed deadline or exclusion of an injured body part can have significant consequences down the road in terms of treatment, scope of claim and future benefits in the event of permanent impairment.
5. Follow Treatment Recommendations
- You actually need to show up for your appointments and then do what your doctor asks you to do so that they can monitor your response to treatment.
- Don't be scared to ask questions when you see your doctor. If doctors visits make you nervous then come prepared with a short (<5), legible list of questions for your provider.
- As an impairment rating doctor one of the most frequent complaints I hear from injured workers is that every time they go to their work comp treatment facility they are seen by a different provider. This lack of continuity can cause lots of confusion for the patient and may lead to inconsistent medical records and treatment. Simple statements like, "today I am here for evaluation of x,y and z body parts" can help to mitigate confusion and keep everyone on the same page.
- Adhere to the work restrictions given to you by your treating doctor. In the event that your symptoms worsen due to following these restrictions or you are physically unable to work within the assigned restrictions then you should return to your provider for further evaluation and recommendations.
- If you are doing what your providers have asked you to do and for whatever reason you are not improving, worsening under care or are simply not satisfied with the care that you are receiving then you can request that your insurer send you elsewhere.
- In the event that you request a change of provider it will not happen quickly, if at all. You need to do your best to be compliant with the directions of the previous doctor until a new one is assigned.
6. Claim Closure
- In a perfect world you will continue with treatment until your symptoms have resolved and you have returned to your pre-injury status. Unfortunately we all know that this is not a perfect world and some people are left with permanent problems following an injury.
- In the event that you are unable to return to your pre-injury status then the insurer should send you for a permanent and partial disability examination (PPD).
- As a designated impairment rating doctor for the State of Nevada I am asked to evaluate injured workers as an impartial third party. The purpose of the PPD exam is to determine two important factors.
- The first objective is to decide if the injured worker has reached maximum medical improvement (MMI). In plain English this means that you are as good as you are going to get with the treatment available to you at this time. If the examiner decides that you are not at MMI then they should recommend further evaluation by another provider.
- The second objective of a PPD exam is to determine if you have sustained any sort of permanent impairment as a result of your work injury. In the event that permanent impairment is detected then an impairment rating is assigned to the injured worker.
I hope that this brief overview of the process for injured workers will help you to navigate the work comp system so you can get the care you need. Of course I would love to see everyone return to their pre-injury status but that is not always the case. In the event that you require a PPD examination then you as the injured worker have the right to request an examining doctor by name and then come to an agreement with the insurer as to who that will be. I strive to be thorough and accurate in my examination and documentation and have worked hard to establish this reputation with insurers, injured workers and plaintiff attorneys. If I can be of assistance to you in any way don't hesitate to contact my office.