Workers’ Compensation injuries (workers’ comp) affect millions of Americans every year. If you haven’t had to deal with this type of problem and paperwork before, consider yourself fortunate, as it can be a very daunting experience. This blog will shed some light on what to do if you get hurt at work and answer the question, “How does workers’ comp work?”
How Does Workers’ Comp Work and Who Is It For?
If you’re injured at work and it’s not life-threatening, report the injury to your supervisor immediately. For life-threatening injuries, seek medical help right away. You have 45 days to report the incident, but the sooner, the better. It’s also important to note that the number of days varies by state. Some states give as little as 10 days, such as in Colorado. Workers’ compensation covers medical benefits and wage replacement for injured employees.
Once you report the incident, your HR department will provide a case number, and your employer may require you to see a specific doctor. There are two main types of coverage:
Coverage A: Medical expenses and wage replacement.
Coverage B: Employer liabilities.
Although this might be technical, it’s important to know that workers’ comp is different from disability insurance and unemployment benefits. Disability insurance provides benefits when you cannot work due to a non-work-related injury or illness, while unemployment benefits support those who have lost their jobs through no fault of their own.
If you feel that the company’s specific designated doctor is not acknowledging the severity of your situation, you do have the option of seeking another opinion from a doctor of your choice. In fact, you have up to two doctors of your own choosing in the state of Illinois. This ensures that you get the care you need and are not limited to the company doctor’s assessment.
What Is Covered and What Is Not Covered with Workers’ Comp?
Workers’ comp insurance typically covers injuries that occur in the course of employment. This includes musculoskeletal injuries such as back, disc, neck, knee, or shoulder injuries. However, not all injuries are covered. For instance, injuries that occur while commuting to or from work, or those resulting from employee misconduct, may not be covered.
Navigating the Workers’ Comp Claim Process
The actual claim process involves several steps, including reporting the injury, getting a medical evaluation, and filing a claim with your employer’s workers’ comp insurance. It’s important to get approval or a referral from a primary care physician to strengthen your workers’ comp claim. Regularly updating your workers’ comp with treatment records ensures transparency and ongoing approval.
Consistent attendance and adherence to treatment plans are also crucial. Workers’ comp may have limits on the number of chiropractic visits, so staying within these limits or seeking approval for additional sessions is important.
Who Pays for Workers’ Comp & How Does a Claim Affect the Employer?
Once you’ve reported the incident to the Human Resource department at your work, you will be given a case number. Your employer has the right to send you for an examination to a doctor of their own choosing, and yes, you are obligated to go. Workers’ comp insurance is typically paid for by the employer, not the employee, and covers the medical bills and other costs associated with the injury.
For employers, workers’ comp insurance helps protect against lawsuits from injured workers. Filing a workers’ comp claim can affect an employer’s insurance premiums. However, workers’ comp is in place to protect both employees and employers by providing a structured process for handling workplace injuries.
The Role of Health Care Providers Such as Chiropractors
In the state of Illinois, you can seek an evaluation from a Doctor of Chiropractic (DC), Doctor of Osteopathy (DO), or a Medical Doctor (MD). Considering that many of the work comp injuries are musculoskeletal in nature (back pain, neck pain, shoulder or knee pain), a chiropractor is often the best choice to start for many people. Chiropractors deal with these types of injuries on a daily basis and have the freedom to order any diagnostic test deemed appropriate to better help your situation.
Collaborating with Workers’ Comp Adjusters
Chiropractors often play a significant role in helping injured workers navigate the paperwork and claims associated with workers’ comp. Collaborating with workers’ comp adjusters can help ensure that the necessary treatments are covered and that claims are processed smoothly.
Chiropractors can provide clear, detailed, and timely reports on the patient’s condition, treatment plan, and progress. Regular updates help adjusters understand the necessity and effectiveness of ongoing treatments, making it easier to get approvals for continued care. Chiropractors can help by providing information like:
- Thorough initial evaluations and follow-up reports.
- Documenting the link between the injury and the workplace incident.
- Justifying the need for specific treatments and their expected outcomes.
- Highlighting any progress or setbacks in the patient’s condition.
Legal Assistance in Workers’ Comp Cases
Many people get their information from TV commercials by attorneys hoping that you will call them to take your worker’s comp case. In most situations, the system may work better if you do not have an attorney involved. However, if your boss is not acknowledging your injury, if you took the company doctor’s advice but don’t notice improvement, or if you should be getting temporary disability pay and you’re not, that’s the time to retain a lawyer. It’s important to work with one who understands the system and has integrity.
Workers’ Comp Local Specifics for Frankfort, IL
In Frankfort, IL, like the rest of Illinois, workers’ comp laws provide specific rights to injured workers. Finding a local healthcare provider who understands these regulations and can guide you through the process is very important.
Unfortunately, there’s only so much information we can cover in a brief blog such as this, but I hope that you have gotten an idea of what to do if you’ve been injured at work. I used to work for Mr. Henry Ford back in Michigan, and I’ve seen what being injured at work can do to a person. It’s always best to follow through on care recommendations; not doing so can have a negative effect on your case.
If you find yourself in this situation, you need to find a doctor that is familiar with the workers’ compensation system and offers the best type of care for your injury. In many cases, that’s a chiropractor, and we are here to help.
Have more questions on how workers’ comp works? Call us TODAY at (815) 469-7472 or schedule your appointment today!
