What's Different About Getting Medical Treatment on Workers' Comp?

If you were injured at work and are receving benefits, you may be getting treatment for the first time and feel confused about all of the differences between just getting medical care and getting medical care when you're on workers comp.

Here are some basics about getting medical treatment after a work injury.

First of all, your treatment requires authorizations and all of your providers (there may be one or several) will need to have the authorizations to treat you in their records. They have to carry the authorizations so they have the authority to bill workers' 'comp. When scheduling your treatment, you may need to be prepared for extra administrative measures, evaluations, and paperwork that you might not have to deal with when using your regular insurance. Give yourself a little extra time before your first appointment wth a new provider to make space for these types of tasks. And call ahead of time to make sure that the office has indeed received the auhorizations from your workers' comp adjuster.

Second, when you are seeing your treating physician (not your physical therapist or occupational therapist) you will need to get a disability note from him or her whenever you see them. This disability note, which says whether or not you can return to work (or return to work with restrictions) will be the piece of paper that triggers whether or not you keep receiving financial benefits while you are out of work.

Look at your slip before you leave the office and make sure it says what the doctor said to you. Doctor's offices sometimes make clerical errors so you want to make sure that the paperwork matches what you discussed with your doctor. And don't leave the office without it in your hand!

You also need to make sure that you have received all of your referrals from your treating physican to see other doctors related to your treatment. Typically the doctor will give you an order that states that type of treatment he would like you to seek - like physical therapy, and MRI, or a referral to a specialist..

The referrals have to match the type of treatment exactly. For example, if the referral says "physical therapy" and you want to get "aqua therapy," you will have to get an order specifically for aqua therapy.

Third, you need to make sure you have all of your office visit notes from your treating physician, and reports from any surgeries and special treatment. We recommend that you keep a copy of all of your own records, but for our clients we order and keep track of all of the records associated with their treatment and we seek authorizations on their behalf.

These records, especially from your treating physician, are the trail of paperwork that we use to show continuity of care and continuation of treatment, so you will also want to make sure that your visit notes reflect everything that you talked about with your doctor. Sometimes doctors offices inadvertently leave in visit notes things that don't correspond with the doctor's orders, such as "claimant can go back to work," when the doctor actually put you out of work for another month. These mistakes are not fatal, you just need to call the doctor and ask them to correct the visit notes. Sometimes your adjuster will want to see your visit reports, so you want to make sure they are accurate.

If you have a new workers' comp claim and are just getting started, you will absolutely need to order our free book "Protect Your Rights - the Ultimate Guide to DC Workers' Compensation." This book, written by premier workers' comp attorney Frank R. Kearney, gives you insight into what you need to know about DC workers' comp. And if you have further questions don't hesitate to give us a call at 202-393-3320. You will speak with a real person today who can get you started.