Understanding Work-Related Injuries

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Understanding Work Related Injuries
HCR230

Understanding Work Related Injuries
Claims Process
When an injury occurs on the job, it must be reported verbally and in writing to the employer within a certain time period. Once notified the employer must notify the state workers’ compensation office and insurance carrier, within a certain time period. In some cases the employee is given a medical service order to take to the physician for treatment (Valerius, Bayes, Newby, & Seggern, 2008). Responsibility of Physician of Record

Responsibility of the treating physician or physician of record is to treat the injured or ill employee. This physician treats the patient’s condition and evaluates the percentage of disability and the return-to-work date. The physician of record files a progress report with the insurance carrier each time there is a substantial change in the patient’s condition that affects their disability status or when the state requires (Valerius, Bayes, Newby, & Seggern, 2008). Responsibility of Employer and Insurance Carrier

Providers submit their charges to the workers’ compensation insurance carrier and are paid directly by the carrier. Charges are limited to an established fee schedule. Patients cannot be billed for any medical expenses. The employer may not be billed for any amount that exceeds the established fee (Valerius, Bayes, Newby, & Seggern, 2008). The employer or physician of record is responsible for the First Report of Injury form within a certain time period. The amount of time varies with each state, but ranges from twenty-four hours to ten days. The form contains information about the patient, the employer, the injury or illness. This report can be filed electronically or mailed (Valerius, Bayes, Newby, & Seggern, 2008). According to the website (Idaho State Insurance Fund, 2012) when an injury occurs in the State of Idaho, the employer should immediately provide prompt medical attention, transport the injured...
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