Can the Claims Adjuster Discuss My Medical Care with My Doctor?
There are several subjects the claims adjuster is allowed to discuss with your doctor, but your medical care is not one of them. Unless you give the adjuster permission to speak with your doctor they may not call and ask questions concerning your care.
There are many complicated rules regarding communication with medical providers. Defendants are allowed to obtain medical records, medical bills, and address non-substantive matters, but they can not discuss important matters like treatment without the authorization from you, the injured worker.
The statute is clear about the type of written communication that is allowed as well, and provides specific questions that can be asked without your consent.
It can be confusing when an adjuster calls you and asks if they can discuss a certain topic with your doctor. What you say in an unplanned moment may hurt your case. If you suspect improper communication has occurred you should contact an attorney to discuss the issue.
Call us today for a free consultation. With more than $275 million in awards and settlements, Oxner + Permar has the experience to stand up for you.
What Happens If I’m Injured While on Medical Restrictions?
After you’ve been injured at work, it’s very likely that you’ll be given work restrictions by your doctor. If this happens, you’ll be able to return to work in a light duty job. This job is likely a modified version of your old job, or an alternative job that complies with your restrictions. In many cases this is a good situation, and there are no problems. However, just because this job falls within your work restrictions, that doesn’t mean additional injuries won’t occur.
It could be that you end up overusing one body part to compensate for your injury. For example, let’s say you injured your shoulder while at work. When you start your light duty job, you’re probably going to have to work one-handed while your injured shoulder recovers, and it is quite possible for you to injure your other shoulder.
If this happens, it’s likely the insurance company won’t agree to pay for the injury to the other body part. But don’t let that stop you! We have had success at the Industrial Commission in getting compensation and medical treatment for this kind of injury. In the past we’ve been able to show that since the second injury was a direct and natural consequence of the original injury, it should be covered.
It is possible to earn compensation for an injury that occurs while you’re on light duty restrictions. If you’ve experienced a similar work related injury, give us a call for a free consultation.
When Should I Get a Second Opinion?
As workers’ compensation attorneys, we get asked a lot of questions everyday. I love getting these questions because it shows that my clients and potential clients are engaged in their cases and are working to understand the workers’ comp process. Never be afraid to ask your attorney questions.
One of the questions I hear most frequently is, “When should I get a second opinion on my medical treatment?”
When it comes to workers’ comp claims, there are a couple of ways to obtain a second opinion evaluation.
- Ask the defendant (your employer/insurance carrier) to provide one
- Request the Industrial Commission to order a second opinion
Generally you would ask the defendant before seeking help from the Industrial Commission; however, it’s always a good idea to follow the advice of your attorney when it comes to what’s best for your case.
As for when you should ask for a second opinion — it’s going to depend on your case. Typically, unless there is a dispute about the medical treatment, it’s probably best to wait until the end of your treatment. This is because you can get the most bang for your buck since the second opinion doctor can review all of your treatment.
Of course, if there is a dispute about your treatment, you should seek a second opinion when the problem arises. That way the dispute can be resolved as quickly as possible, and you can be properly evaluated, treated, and compensated. Your attorney should be able to help you through a situation like this.
If there is any dispute over your treatment, seek a second opinion; otherwise wait until your treatment ends. If you are dealing with a workers’ comp case and require a second opinion, contact Oxner + Permar for a free consultation.
Help! The Insurance Carrier Isn’t Paying Me the Correct Amount!
When you’ve been injured at work, workers’ compensation is a vital part of your recovery process. You’re reliant on that money to pay for everything from food to bills to medical expenses. It’s important that the amount in your check is correct. Your weekly checks should be for 66.66% of your pay the year before your injury.
There are several reasons the amount might be incorrect. For instance, it’s possible that the insurance carrier just didn’t calculate your income correctly. In some cases we have seen, the insurance carrier has not accounted for overtime pay, bonuses, or other pay that falls outside of your normal work hours.
It should be fairly easy to clear up any mistakes by reviewing your pay records. Here are some things you should make sure you include in the calculation of your income:
- Overtime pay
- Additional allowances such as a company vehicle or travel stipends
- Any pay that falls outside of your normal work hours
If the carrier still refuses to agree to raise your pay to meet your income after reviewing your records, an attorney can help you ask for a hearing or file a motion to clear up the underpayment. Every little bit counts when you’re out of work due to an injury. Make sure you’re receiving the compensation that’s owed to you.
Hiring an attorney can help clear up any discrepancies in pay. If you’ve been injured at work, be sure to contact an attorney at Oxner + Permar. With more than $275 million in awards and settlements, we have the experience to get you the benefits you deserve.
My Insurance Carrier Didn’t Authorize the Referral of My Doctor: What Should I Do Now?
When dealing with a workers’ compensation case, we often hope that everything follows procedure: that we can read attorney’s blogs and find step-by-step online “How to File for Workers’ Compensation” guides and that everything will work out fine. Unfortunately, this isn’t always possible. Sometimes things don’t always go according to plan.
What should you do if your insurance carrier fails to authorize the referral of your treating doctor? When you find yourself in this scenario, chances are you’re in need of additional medical treatment or medication, and waiting around isn’t really an option. However, there are steps you can take to get the treatment you need.
- An attorney can secure additional treatment and authorization of further medical care from the Industrial Commission in an expedited hearing or in an emergency hearing, depending on how dire the situation is.
- You can get your own care and then ask the Commission to authorize it.
Recently we helped one of our clients deal with this situation. We advised them to take option two and encouraged them to seek their own medical care when the carrier did not authorize it in a timely manner. As it happened, instead of going to litigation, the insurance company agreed to the doctor that they selected. It can be difficult to know what to do in situations like this, so we recommend seeking advice from an experienced attorney.
If the insurance carrier does not approve of your doctor, be sure to contact an experienced attorney. There are steps you can take to ensure that your rights are protected.