Insurance companies are one of the major sources of workers’ compensation patient referrals. For physicians who accept work comp cases, having a steady source of new patient referrals is essential. However, there are instances when referrals from insurance companies stop all of a sudden, and most doctors are left asking why.
So what should you do if that happens?
The first step is knowing what the problem is. Though it may vary from one adjuster to another, the following are the most common reasons why insurance companies stop sending work comp patient referrals.
Consider for a moment the position of workers' compensation adjusters and case managers. It is their job to help get injured employees back to work. For this reason, they are keen to avoid doctors who appear to be prescribing excessive treatments and surgeries which will keep the patient out of work for long periods of time. The fact is doctors who repeatedly over prescribe are subsequently viewed as "not work comp friendly".
As a doctor, therefore, it is important that adjusters and case managers regard you as a doctor who adheres to objective medical evidence and only prescribes medically necessary treatments and surgeries.
Of course, on occasion, an injured worker may have a serious injury and require extensive treatment. At this point, it is important to call the adjuster and explain the medical necessity. Most adjusters will be willing to approve necessary treatment if the doctor takes the time to explain it to them.
Even if you are the most talented doctor in the world, adjusters and case managers may still stop sending you cases if they have a poor experience with your office staff. Of course, there are some basic standards for office staff, such as being friendly, helpful, and providing adjusters with what they need as quickly as possible. However, sometimes it goes beyond personalities and is a wider, systematic issue.
For example, do you have a dedicated Workers' Compensation Coordinator? After all, it can be frustrating for adjusters to speak with a different person each time they call. Having a dedicated point of contact can make the process easier and more efficient, plus leads to a trusting relationship over time.
Unfortunately, in the world of workers' compensation, sometimes the squeaky wheel gets the grease. What this means is that it is the doctors who are the most visible who are, understandably, more likely to be at the front of the adjuster's mind. For this reason, we recommend that doctors are easy to find online, take the time to speak with adjusters, plus provide educational talks or webinars to insurance companies, employers, and law offices.
Knowing the reasons why insurance companies stop sending you workers’ compensation patients is only half the battle. Ensure that you have a good working relationship with adjusters and case managers. And make sure that you’re always on top of their mind by having an effective workers’ compensation marketing plan.
Workers-Compensation-Doctors.com is the only national directory devoted to listing all work comp doctors in the US. The directory is browsed by thousands of adjusters, nurse case managers, attorneys, and self-referring patients.
If you are a physician who wants to grow your practice, increase your work comp patient referrals by signing up today! And for more information, please do not hesitate to contact us.
At some point during your workers’ comp claim, there is a fair chance that adjusters will hire an investigator to double check if your injury is genuine. In order to retain the workers’ compensation benefits to which you are entitled, this blog post provides a list of things you should NOT DO.
Before we forget, though, it’s important to remember that you should also read up on the work comp laws related to your specific state, because these laws usually vary for each of the fifty states.
Were you injured on the job and have not reported it to your employer? If so, stop reading right now and report it immediately! Most states provide that an employee has to report the work injury within 30 days to qualify for work comp benefits. That’s a generous window but it would really help your case if you actually report it immediately, or at the latest, within 24-48 hours of your work injury.
And we’re not even talking about just verbally telling your boss or your HR department about the accident. You must ensure that a First Report of Injury is filed. It’s quite common for injured workers to overlook this and it has caused major problems. One of the best reasons is that the longer you delay in letting your employer know about your injury, the more likely they will become suspicious.
Tell your doctor everything you can about the details of the injury you suffered from your accident at work. When the work comp doctor asks “how are you?” don’t respond with “I’m okay” or “fine.” Be aware that it’s not simply about exchanging pleasantries but rather he/she is actually asking from a medical perspective.
Recall as best you can exactly what happened and be absolutely honest about your symptoms or injuries and any changes related to it, no matter how minor you think they are. Don’t skip any details - be sure to provide a thorough and accurate medical history. A lot of patients think that pre-existing conditions may discredit their claim, but being genuine and sticking to the facts lends integrity to you and your case.
The point is, if you are not feeling better, let your doctor know. Don’t downplay your injury or put off medical treatment either. The insurance company or your employer will think your injury is not as serious as it is. Furthermore, if your injury is getting worse, no need to exaggerate (more on this below). Just be honest and straightforward about the entire thing.
Yes, it can be tempting to exaggerate your injury or symptoms in an attempt to strengthen your work comp injury claim - but DON’T DO IT! If your employer, doctor, or adjuster finds out it may mean the end of your work comp case.
Always remember that work comp doctors will perform several tests to examine your injuries and they will definitely know whether you’re exaggerating or not. Worse, you will potentially destroy your medical record by being labeled as a ‘malingerer’ which means someone who fakes or exaggerates injuries.
This essentially not only weakens your claim but you may create cause to dismiss it altogether. Bear in mind that insurance fraud is illegal in all 50 states.
Choice is a fundamental right and, depending on the state, that includes choosing the doctor who will treat your work injury. This is a common mistake especially in large companies where there are staff doctors or those on retainer for work-related injuries. While it may be well-meaning, it’s imperative that you select a doctor that you know and trust will help you get back to work. You must know that neither your employer nor their insurance company can force you to go to a specific doctor of their choosing.
If you’re choosing your own doctor, though, make sure they are certified to handle work comp cases. There are websites such as Workers-Compensation-Doctors that are 100% devoted to listing doctors qualified to work in this area of practice.
A lot of patients tend to think of treatment to be like aspirin - take one or two and you'll be better. That’s a big no-no that can totally diminish your work comp claim.
To put it simply, follow your doctor’s advice. If your doctor requires you to undergo therapy or do follow-up tests, it is imperative that you comply even if you think you are feeling better. It is also quite normal to feel better during treatment but your injuries or symptoms may return or even worsen once treatment is discontinued.
If you wrongfully assume and end up discontinuing care, your employer or the insurance company might think that you did not need to file a work comp claim in the first place making it easy for them to argue that your injuries are not as bad as you made it out to be.
Your treating doctor may allow you to return to light-duty work. If so, it would be best to follow that advice. Failure to do so will make your employer think you simply do not want to get back to work.
However, if you have any concerns or if you think you cannot perform any of the duties being asked of you, discuss it with your doctor. If your doctor still feels otherwise and sends you back to work, do so but document any discomfort, pain, or other symptoms that arise so they can make adjustments to your duties as necessary.
Patients sometimes tend to think they are actually feeling better even when they’re not. In such cases, they become tempted to do more than the doctor allows them to. And it’s not necessarily limited to when you’re inside the workplace.
It could be menial tasks such as carrying a heavy bag of groceries, picking up a heavy package you just received, over-exerting your body to get something for your top shelf, etc. If your doctor hasn’t given you clearance, wait for necessary help. Those who are living alone are always encouraged to seek a friend or a relative’s assistance to look after them while recovering to their pre-injured state.
What’s worse is that if you get caught in the act of picking up a heavy package by an overzealous insurance adjuster or you overexerted your injured limb by getting an item from the warehouse and forgot about the CCTV camera at the end of the aisle - they may sound extreme but these rare instances may end up discrediting your work comp claim altogether.
Insurance companies may ask you to sign a medical authorization or give a recorded statement. Don’t do it. In fact, patients are not required to do any of those even if the insurance company tells you they can’t proceed with your work comp claim unless you sign certain paperwork.
You may hear all kinds of reasons such as “it is part of our procedures,” or “your employer requires your signature before you get paid,” or “we need your recorded statement to push through with the claim.”
Just know this: there is no state rule or law that requires you to sign a medical authorization or give a recorded statement. While it may in fact be the insurance company’s policy or procedure, that does not necessarily mean you must do so.
The workers’ compensation system is full of obstacles and pitfalls and has caused patients to become frustrated, intimidated, or just plainly unsure of what to do - more so when the insurance company accuses you of workers’ compensation fraud. Remember that it is part of insurance companies’ jobs to look for loopholes in your case in order to deny your claim. Therefore, it is important to follow the tips mentioned above so as to avoid any hiccups in your work comp claim.
Workers-Compensation-Doctors is the go-to directory that’s 100% devoted to listing the best Work Comp Doctors in one place. You can choose Work Comp Doctors according to specialty, location, and services from an IME in the East coast to an orthopedic surgeon in the West. We guarantee that ALL doctors listed in our directories accept Work Comp cases. This website will be your favorite tool to help you find the right specialist related to your workplace injury. Workers-Compensation-Doctors.com will connect you with the doctor YOU need.
Ever wondered if workers’ comp insurance pays for a doctor’s visit? Well here’s the short answer: YES. Let’s take a look at some of the details.
If an employee suffers a work-related injury or sickness, work comp benefits are mandated to cover the following:
If an employee gets sick or injured at work, workers’ comp benefits pay for medical expenses related to the resulting injury. Those expenses include doctors’ visits, medical tests (e.g. x-rays, blood tests), rehabilitation, emergency room care, hospital stays, and in some cases, even transportation costs.
These same benefits are revoked once it is proven that a worker's injury or illness were obtained outside of work. The same goes for any accidents occurring as a result of intoxication, or worse, if employees were found to have intentionally caused the injury themselves.
In a normal setting, however, it’s important to keep in mind that regulations and guidelines for approval of medical expenses in relation to a work comp claim varies from state to state. But in a general sense, all states’ work comp programs pay for every injured workers’ doctor visits but it’s not without its limitations.
States have certain statutory limits for the different forms of treatment injured workers receive - doctors’ visits included. The point is, there is no fixed number of visits to which a patient can actually ‘use up’.
The main idea is that the workers’ compensation system will pay for an injured worker’s doctor visit as long as it is still necessary for their case. The same goes for treatments that require multiple sessions, such as physical therapy. In most states, additional sessions will also be paid by the work comp system if the doctor deems that further treatment would be beneficial to the injured worker.
Alternatively, the employer may also disagree and seek a second opinion to assess whether said additional treatment would really improve your condition. While the patient may not agree, it is well within their rights to do so and injured workers must comply otherwise your work comp benefits will likely be suspended.
Any standard treatment will most likely be covered by an injured worker’s work comp benefits. But alternative treatments such as oriental medicine (e.g. acupuncture), naturopathy, Ayurveda, etc. or experimental treatments are usually not part of the coverage, although it can depend on state guidelines. Nevertheless, these types of treatments are allowed as long as the injured worker is able to pay for it out of his/her own pockets.
Ultimately, the onus of paying for an injured worker’s doctors’ visits (or any medical expenses, treatments, etc.) falls on the employer.
Regardless of the state, it is the employers who pay for workers’ compensation insurance. Employers may purchase this coverage through two types of recognized entities namely (1) state-run insurance programs and; (2) private insurance companies. It differs from health insurance in such a way that work comp insurance is not deducted from employee payroll.
If, for instance, an employee’s work comp claim is denied, he/she can pay for his/her own bills and seek reimbursement from the insurer once the denial is reversed on appeal. Alternatively, there are work comp doctors who might agree to treat patients on a lien basis. It means that any bills incurred will come out of recovery acquired through workers’ compensation.
On the other hand, there are states that offer a temporary disability insurance program where injured workers may be eligible to apply in order to cover up some out-of-pocket expenses.
Any open work comp claim should have the bills shouldered immediately by the insurance company whether it’s private or state-run. The same bills will continue to be paid as long as the patient continues to receive treatment and the claim is still open.
Are you looking for a doctor who accepts workers’ compensation cases? You have come to the right place. Browse from thousands of workers’ compensation doctors here. Workers-Compensation-Doctors.com is the only national directory 100% dedicated to listing workers’ compensation doctors across all 50 states. Our website is trusted by thousands of Adjusters, Nurse Case Managers, Attorneys and Patients to find the work comp doctors they need.
Since the World Health Organization (WHO) declared the global COVID-19 pandemic, the impact across various industries globally has been profound. It has been hugely challenging for businesses in unimaginable ways. But what about the Workers’ Compensation sector? Many health providers have found themselves asking: Will this mean that work comp cases are decreasing or increasing during the pandemic?
The pandemic has brought about an abrupt shift in the way we earn our livelihood. Telecommuting (or work-from-home) has become the order of business the past year while an unfortunate number of people have found themselves without a job. Meanwhile, certain industries such as hospitality, transportation, construction, aviation, supply chain, retail, healthcare, and manufacturing are industries that cannot, for obvious reasons, transition into telecommuting.
People in these industries, by default, are more at risk of sustaining a work injury but moreover, they are substantially exposed to the dreaded coronavirus through close contact with coworkers, customers, and other external factors. In addition, these same workers pose an even greater risk as they may be working longer hours than usual which could possibly lead to claims due to overexertion. Injuries in this regard are valid claims under workers’ compensation systems.
So what does this mean for workers’ compensation claims? Initially, industry observers saw an overall decrease in work comp cases when the pandemic was announced for the plain reason that fewer people will be working - be it outside their homes or because they were laid off. Then again, no industry is the same and as mentioned, many employees of essential industries are still out in the fold, working.
However, we can’t substantially claim that work comp cases are either increasing or decreasing. Like the work comp laws that cover each of the fifty states, the data on pandemic-era work comp claims varies per state. For example, the state of Florida shows that there was an actual increase in workers comp cases in 2020 from the previous year.
2020 saw the height of the pandemic as it was within that timeframe states started declaring statewide stay-at-home orders (or lockdowns). Case in point, California ordered its residents to stay home on 19 March 2020 unless one is a member of the essential workforce or will be shopping for essential needs. In the Midwest, Indiana declared a lockdown to take effect on 25 March of the same year. All other states followed roughly the same timeframe in declaring their own measures to minimize the movement of people in an effort to curb the spread of the virus.
What we’re trying to illustrate is that the downturn in total work comp cases across states should have taken effect in 2020. However, states such as Florida have experienced an increase of work comp cases versus the year prior. Florida reported a total of 63,387 work comp cases in the state and was up by 3% in 2021 at 63,387.
| WCD Claims Database Statistics (Florida) | |
| YEAR | TOTAL CASES |
| 2011 | 58,829 |
| 2012 | 58,347 |
| 2013 | 58,464 |
| 2014 | 59,878 |
| 2015 | 61,124 |
| 2016 | 61,642 |
| 2017 | 62,246 |
| 2018 | 63,047 |
| 2019 | 61,500 |
| 2020 | 63,387 |
But Florida provides only a small sample size of work comp claims increase as most states have not released their 2020 data. According to OliverWyman, a global management consulting firm, they reported an 11.4% dip in overall work comp claims, particularly noting that “medical-only claims dropped precipitously in March through May and have remained lower year-on-year in every month since COVID started.” In contrast, “Indemnity claim counts have actually increased year-on-year in every month April through July 2020, despite the overall downturn in reported claim counts,” the report said.
All things considered, the workers’ compensation market remains competitive. What’s safe to assume is that there are still multiple sources of work comp claims given the current climate. For one, it has been recently published that ergonomics may become a sleeper issue for work comp cases. The article mentioned that many Americans are suffering from physical pain in wrists, backs and shoulders potentially caused by poor ergonomics in work-from-home setups.
Two out of every five telecommuting Americans are reportedly feeling new or increased pain in the shoulders, back, and wrists and was much more prevalent in those aged 20 to 35 years old. Seeing that remote work will be the name of the game in the foreseeable future, this issue is expected to increase in the coming months.
On the other hand, ergonomic challenges are not only limited to telecommuters. Essential workers are working more shifts and toiling longer hours which leave less time for recovery placing greater strain on their bodies as a result.
Let’s get one thing out of the way - telemedicine did not rise solely due to the disruptive effects of the pandemic. In fact, it has seen steady growth the years prior as both patients and medical providers understood the convenience of telemedicine. But according to Mitchell’s work comp bill review data, it’s also worth mentioning the glaring 91% upsurge in telemedicine visits in the first week of April 2020 alone. Now, we can only wonder if this current year will be able to sustain the all-time high telemedicine usage rates.
With social distancing guidelines in place, telemedicine, in essence, virtually takes the patient inside the doctor’s office for minor inquiries, re-checks, or after-hours consultation - all thanks to the internet. No need for lengthy travel and staying inside cramped waiting rooms where one could incur a potential exposure to the virus. Face-to-face visits would then be reserved for those who really need it.
As we continue to navigate through this pandemic, it’s important to understand that risks in workplace injuries are still present which means patients will need someone to run to during the time of need. One of the ways to get your name out there is by getting your practice listed in the only national directory that is 100% dedicated to workers’ compensation doctors (and you can do it for free). Workers-Compensation-Doctors.com also offers a proven way to increase your work comp referrals to get your practice going by getting patients back to good health.
The state requires employers to provide a reasonably safe and healthy work environment for every employee. Of course this is not a fail-safe system and sometimes a work injury will still happen despite employers’ best efforts. It could be a broken bone, a back injury, an occupational illness, psychological injury, or even the aggravation of a pre-existing condition. If you have been injured at work, then you may be wondering what you should do. In this blog post, we’ll provide some guidance for injured workers, including:
First off, you must report your injury to your employer. If you are able, you must get in touch with your immediate supervisor or the HR manager in the soonest possible time - this is the easiest and most important way to protect your legal rights. This is because most states require that you notify your employer regarding your injury within a given time frame which is typically the same day or within a few days of the incident.
This is because states also require employers to report any work-related injury as soon as possible (via phone or email). For instance, the state of California (per the California Code of Regulations; Title 8, Section 342) requires employers to report the incident no longer than 8 hours (or no longer than 24 hours as long as the employer can demonstrate that pressing circumstances exist).
In contrast, the state of Florida provides that you must report your work-related injury immediately or no longer than thirty (30) days. The point is, we must note that the threshold varies from state to state.
It is important to understand that workers’ compensation laws vary from state to state. Albeit in a general sense there are a few legal rights that are common across most states which includes:
Understanding your right to act is just as important as understanding your right to refuse offers or requests. This means that you have the right to refuse any form of settlement made by your employer. Or in some cases, if your employer coerces you to use your personal health insurance to fund your medical treatment, you have all the means to say no.
It is quite common for employees to worry about how making a claim affects their job. In some cases, you may be placed under pressure by your employer not to pursue a claim for personal injury compensation.
Your employer might offer you some form of incentive meant to dissuade you from filing that workers’ compensation claim, you have the right to simply say no. More so if you feel that your boss is taking extraordinary measures (e.g. coercion) to make you do otherwise.
Employers have no right whatsoever to prevent an employee from pursuing a claim stemming from work-related injuries. State laws provide that employees can pursue workers’ compensation claims without fear of reprisal or harassment from your employer. If your employer, manager, or supervisor makes it difficult for you to exercise these rights, they will face severe consequences.
The decision whether or not to pursue a claim rests on YOU. In some cases, an employee may just suffer a minor injury that does not cause long-term problems, allows one to work normally therefore does not incur lost wages - you may well decide not to pursue a claim. However, if the injuries are more serious resulting in an inability to work, a claim for compensation is clearly in order and is a right afforded to everyone.
There are cases wherein an injury is caused by a third party. For example, this third party may be an erring delivery truck driver or faulty equipment design that led to your injury. So you ask, “what are my rights against parties other than my employer?”
If the injury was caused by another party, you have a right to file a claim against that person or company - these are called “third party claims.” However, these claims are not filed in workers’ compensation courts but rather take the form of civil lawsuits filed in state or federal courts.
Work-related injury civil lawsuits differ from workers’ compensation claim because you can seek additional personal injury damages from the latter. A workers’ compensation claim is intended to reimburse you for lost wages and medical expenses - not non-economic damages which, in layman’s terms, mean seeking compensation for the “pain and suffering” the resulting injury from third party claims have caused.
We must remember that the ability to choose a workers’ compensation doctor for treating your work-related injury depends on the state where you claim is filed.
Some states require an injured employee to be seen by a doctor chosen by the employer or the work comp insurance carrier. Meanwhile, other states allow injured workers to choose any doctor within a given network whereas the admission to the network is determined by the state, the employer, or the employer’s insurance company. There are also cases whether you can choose a work comp doctor for the initial treatment visit as compared to the continuing treatment for your workers’ compensation injury. Read a full list of states and who chooses the doctor in each state.
Not all physicians treat injured workers. There are rules in place for workers’ compensation cases, which is why a doctor you prefer may not necessarily treat injured workers.
Delaware, Oregon, and New York are examples of states that allow injured workers the right to choose his/her own treating doctor, provided the employer does not have a provider plan or managed care arrangement. It is commonplace for injured workers to choose from a list of state-approved doctors or health care providers for treating work-related injuries.
The most important thing here is to exercise due diligence in order to find the best workers’ compensation doctor to treat your injury, even if you are provided a list of physicians. Here’s some criteria to help you consider whether the doctor is the one for you:
It’s also critical to understand the role your doctor plays in this entire endeavor. He/she is not only responsible for treating your work injury but he is also able to sanction paid time off or mandate any physical work restrictions you should have.
At the end of the day, choosing a doctor you feel that you can trust is key. If you need help finding one, you may confer with your workers’ comp lawyer for recommendations or you can start browsing our national directory of workers’ compensation doctors here.
Technically speaking, workers’ compensation doctors are not free. They are, in essence, paid by employers or the state. This is not done directly, however, as these are often done through the state government, an insurance company, the employer (self-insurance), or a third party administrator.
Smaller employers or those that have a low rate of work-related injuries use this program. These programs are administered by the departments of labor, industrial relations, or commerce. What happens is employers pay a premium to these state-run programs and when a claim arises, the department that oversees the program handles the payment which is taken care of by the government.
Utilizing private insurance companies is also an option employers choose. Oftentimes, larger insurance companies have a wide range of plans available for employers regardless of scale. Any workers’ compensation claim, complaints, or issues with regards to payment would be coursed through these companies.
This type of program is often adopted by larger corporations (more in a scale of Coca-Cola, Chevron, etc.) whereas they should be big enough to have assets to ensure coverage of any workers’ compensation payouts. The state then adapts an oversight function to ensure that all necessary payments are made. Employers who self-insure generally use a third-party administrator who takes care of all the administrative work.
But to put in simpler terms, you do not have to pay anything to a workers’ compensation doctor because your employer or the state ultimately takes care of it for you.
Scheduling an appointment with a workers’ compensation doctor can be done by finding a work comp doctor on our workers’ compensation doctor directory where you can then schedule a face-to-face or telemedicine appointment.
Are you a doctor looking to increase workers’ compensation patient referrals? You’ve come to the right place! Increasing work comp patient referral volume is a nice way to keep a diversified payer mix and makes for sensible strategic planning from a risk management perspective. Why? Because work comp referrals are usually “all year round”. Increasing your percentage of workers’ comp patients means “future proofing” your practice to survive should your other referral sources (i.e. Medicare, Medicaid) dry up.
Most of all, there’s no better feeling than helping patients report back to work. In most states, employees collecting work comp benefits earn less when compared to their respective salaries. This only means that the majority of patients actually want to get better and go back to work. Getting back to work essentially helps their livelihood, their family and by a grand scale, the economy.
So, how do you exactly increase workers’ comp patient referrals?
Case Managers and adjusters work directly with injured workers in finding the suitable clinics for their needs. One good trick is to contact these Case Managers / adjusters and schedule a time to explain your practice’s approach to workers’ compensation and, ultimately, how such an approach can help get their clients back to work. Remember, in most states they also require CE credits for their licenses, so providing CEU Webinars is another way to get in front of them and position yourself as the authority of your specialty in your area.
Case Managers and adjusters are one of the best sources of new business for your clinic. All it takes is doing some research and getting in touch with those near your area.
For starters, you can check out a case management industry directory such as this one.
Alternatively, Workers-Compensation-Doctors.com has an extensive national directory of adjusters and nurse case managers.
Apart from Case Managers, it’s also important to establish relationships with employers in and around your area. You can start by getting in touch with HR personnel or a company’s medical staff to let them know what your clinic can offer.
One key aspect to establish a relationship with employers is explaining how your practice’s services are well-suited to the specific needs of the employer. For example, do they need onsite drug testing? How quickly do they need paperwork back? What else can your practice provide which they need?
If you’re looking for a place to start, you can check out Yellow Pages or LinkedIn to see which businesses are near you.
Once again, another alternative is our national database of employers and Risk Managers.
Yes, you read that right. We’re the only national directory dedicated to listing work comp doctors in the USA and listing here is absolutely free.
Workers-Compensation-Doctors.com is the go-to website for thousands of Adjusters, Nurse Case Managers, and Attorneys who use our website daily to look for the work comp doctors they need. We have a search feature that allows viewers to narrow down work comp doctors according to their specialty, services, and location.
We offer both free and paid listings which you can compare to avail whichever suits your needs. Do you want to just get listed? Try our free plan. Do you want to get to the top of search results and a slew of other features? Try our paid listings.
So, if you’re a doctor who’s looking to increase your work comp patient referrals, join us today!
Read more about workers' compensation marketing for doctors here.
If you’re a work comp adjuster or a Nurse Case Manager, you know how big of a challenge it is to find a good doctor that accepts work comp cases. Every single member of this community can share their horror stories of cases that just wouldn’t go away because they made the wrong choice when selecting a physician. Some doctors simply lack experience with work comp. Others are plain difficult to work with. In some cases, the office staff is the problem - they neglect to return the necessary paperwork on time, are unresponsive, or unorganized - basically making your job a living nightmare. Is there a way to avoid referring patients to such practices and make sure you choose the right doctor every single time?
As a case manager, you have a few ways of locating work comp doctors that handle cases in your area:
1. Work Comp Plans and Networks
First, you are sometimes obliged to choose a doctor within a specific network. Your employer has either an internal list of Preferred Providers, or cooperates with a work comp network, for example Coventry, Corvel, etc. The only problem is, the network doesn’t always cover every area - what happens if you happen to have a case in a location where there aren’t any doctors contracted with the network your company uses?
2. Google
You can of course google doctors in the area, however, how can you be sure the office accepts work comp cases? You sometimes spend hours browsing doctors on the internet, and then on the phone, trying to find out if they handle work comp. And even if they do, how can you be sure that they know what they’re doing and you’re not sending your patient to a doctor with no work comp experience?
3. Workers-Compensation-Doctors.com
As a directory dedicated specifically to physicians that accept work comp cases, Workers-Compensation-Doctors.com is your best choice and the quickest AND the easiest way to locate doctors that accept work comp in the area you’re looking for. Our recruiters work tirelessly to make sure our database is up to date. Every doctor is our directory is confirmed as a doctor who accepts workers' compensation cases.
However - we need help from people like you who work with doctors and can share their opinion about specific providers. If you take your time to review the doctor with whom you have had a good - or bad! - experience, you help other case workers make an informed choice. Help the community by reviewing doctors on Workers-Compensation-Doctors.com - it takes less than a minute!
Here are just a few examples of reviews that your colleagues have left for the doctors they’ve worked with:
COVID-19 is one the biggest health crisis our country - and the world - has ever had to face. In the US, we have one of the highest number of confirmed cases, and according to researchers, we are not out of the woods just yet. The virus has had a big impact on the workers' compensation industry. Work Comp professionals find handling cases in the pandemic era more challenging than ever, and it’s not always due to the actual injury of the worker. But what are the main challenges adjusters and Nurse Case Managers face?
One thing that is a common problem in the processing of a claim are various delays. Factors include the government-imposed restrictions, such as shutting down non-essential businesses, social distancing, etc. Of course, the goal of these limitations is to flatten the curve and stop the spread of the virus, nevertheless, it can significantly prolong the processing time of a work comp case. Another factor is of course the physicians’ limited availability - some practices had to shut down or drastically reduce the number of treated patients, others work in a modified system, or switch to telemedicine appointments only, which may not be suitable for some types of injuries. On average, a pre-existing case that would normally cause the employee a 12-day absence from work can stretch up to 14 weeks1.
Lori Ilgenfritz from Gallagher Bassett is proposing solutions to help move claims along. They include telemedicine (in an effort to minimize the worker’s and the doctor’s exposure to the virus and reduce waiting time), virtual physical therapy, leveraging workers’ “essential” status and reviewing medical records (IMEs). To find out more about these solutions, click here to read Lori’s full article.
Although the COVID-19 crisis may seem far from over, eventually we will go back to normal, or rather adapt to the ‘new normal’. There are of course precautions we can all take to help speed our country’s recovery process. The easiest way to do that is to follow the health department’s guidelines: practice social distancing, wear a protective mask, and be m ore mindful when interacting with others. Remember to wash your hands often and sanitize when in public. Stay safe and keep others safe by practicing these simple rules.
We all knew that one day telemedicine for work injuries would become more common. What we didn't know is that it would be so soon. With the arrival of COVID-19, and the subsequent lockdown, telemedicine has never been as popular as it is today. This is, in part, also thanks to a relaxing of regulations by the AMA, allowing doctors to use any software and treat patients online in any state. This applies not only to regular healthcare appointments, but also for workers' compensation appointments. But, for many patients, all this change can be confusing. Whey are not sure about how to schedule a telemedicine appointment for a work injury, who pays for it, how much it costs, what happens if surgery is required, among many other questions. This page aims to answer some of these questions.
Yes, certain work injuries can be treated via telemedicine. Of course, this does not apply to all injuries, for example those requiring emergency medical treatment or surgery. However, for many non-emergency work-related injuries, telemedicine appointments can be conducted online.
If you would like to schedule a telemedicine appointment for a work injury, you can do so at Workers-Compensation-Doctors.com. For doctors who accept telemedicine appointments, there is a separate button on their profile, allowing you to schedule an appointment online, instead of an in-office visit.
The cost of a telemedicine appointment will depend on the doctor's office. The fee, however, is usually paid for by the insurance carrier or employer.
Of course, if surgery is required, then this cannot be done online! A separate, in-office appointment will need to be scheduled. Your doctor or surgeon will be able to provide you with more specific information.
In 2001, the Joint Commission of Hospital Accreditation (JCAH) created a Pain Management Standard that made pain a fifth vital sign. The JCAH required hospitals, surgical centers and healthcare providers to ask every patient about his/her level of pain and provide adequate treatment of that pain. Hospitals and physicians were expected to provide patients with pain medication after injuries, surgery and painful conditions. This created a major philosophic change in the use of narcotics in the United States. At the same time, pharmaceutical manufacturers were creating new and more powerful opioids and increasing the opioid supply in accord with the increased need created by the JCAH requirements. Associated with the increase in opioid prescriptions, psychotherapeutics, tranquilizers, stimulants, and sedative requests and prescriptions also increased. The perfect storm!
A National Survey in 2006 on Drug Use and Health reported that 7.0 million or 2.8% of all persons aged 12 or older had used prescription type psychotherapeutic drugs nonmedically in the previous month, 16.387 million, or 6.6% of the population, had used in the previous year, and 20.3%, or almost 49.8 million, had used prescription psychotherapeutic drugs nonmedically during their lifetime.
Physicians and the medical establishment have been purported as a major cause of the medical to nonmedical increase in the availability and use of opioids. Although there are many more reasons for the increase in opioid use, the medical establishment can help to significantly reduce the use of opioids and other psychotropic medications. Alternatives to these medications should be considered first in the treatment plan. Patient and medical provider education as to alternative therapies can create a major change in the concepts and direction of care. Interventional procedures can be developed that can save money and substantially minimize pain. Some alternative treatments will require more time and work, however, the changes in outcome will have a profoundly positive effect for our patients and their families.
- By: Lawrence Gorfine, MD
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