can my workers comp doctor put in consult for work related injury

Workers' compensation rates have been on the rise across the country. Wouldn't you like to know if you are being overcharged? Insurance companies are notorious for giving people the runaround when it comes to analyzing their workers compensation premium amounts or the calculation of their experience modification rating. It's in the insurance company's best interest to keep you ignorant about your policy. If you knew about these mistakes you would be demanding a refund on your overpaid workers' compensation premium. Lack of One Entity Overseeing the Process: The insurance company will only do as much as they have to according to the state insurance laws. They do not calculate the experience modification factor or develop classification codes. This is done by rating bureaus like the National Council on Compensation Insurance (NCCI) or in California the Workers Compensation Insurance Rating Bureau (WCIRB). The insurance agency or broker is paid by the insurance companies and are subject to contracts with them.

Because everybody works independently of each other, too many hands touching your data can lead to mistakes that cause you to be overcharged! Large Insurance Companies Don't Make Mistakes: The entire system is based upon a method of reporting data that almost guarantees mistakes. First, is simply the "human element" - people making mistakes, which leads to the "garbage in - garbage out/overpaid premium" problem. Second, there is the timing issue, with reporting the data to the bureau that calculates the experience modification. Lastly, as we have discussed above, no one is performing a quality control check on themselves or on each other. There Are Errors in The Calculation of Your Audit Premium: Unfortunately, many insurance company premium auditors are under tremendous pressure to audit as many policies as possible. On top of that, they are poorly trained in workers compensation laws and auditing procedures. As a result, payrolls are often reported incorrectly. They either are overstated, not limited by legitimate audit rules, or misclassified. Either way, it is costing your company money. Insurance Companies Would Never Recommend an Independent Audit: The workers' compensation insurance industry is burdened with errors from wrong classification codes to simple incorrect calculations, costing your business money. Because of the complexity of the workers compensation system and the various entities involved, there is no universal method to correct these errors. An independent audit would reveal these errors, entitling your company a refund, which would make the insurance companies look bad. Would you allow an IRS agent to conduct an audit without an expert at your side? I don't think so! A worker's compensation audit performed by the insurance company may actually cost you more than an IRS audit. Typically a workers' comp audit occurs every year, whereas you may never get audited by the IRS.

Whenever possible, companies should pay expenses like medical bills themselves. That way, they won't have to file a claim and their premium modifiers are affected. This will, however, entail a little paperwork as the incident still has to be reported to the insurance company. It's in any company's best interests to keep records updated anyway, especially because insurance for different kinds of employees can be just as different. Similarly, companies should try to find positions that don't require physical activity, to be filled by the injured or recovering employees. Doing so diminishes claims of loss of ability to work and earn, which in turn reduces how much a company will need to pay an injured employee. That will eventually translate into a very good premium modifier for the next year or so. It'd be a wise move for any company to hire a specialist who will examine current processes, diagnose potential problems and provide solutions to those problems. That kind of outside advice will go a long way towards making a company's workplace safer for the employees. Efficiency will also be improved so that profits and productivity are maximized. Workers compensation insurance isn't just a convenience. It's a necessity for almost every company out there that wants to stay in business and comply with the law.

If the IME physician disagrees with your treating physician’s report, you can always arbitrate these claims. If your treating physician is a reliable doctor with a good reputation, his or her report may be determined to be more reliable than the IME physician. What Should I Do at My Doctor’s Visits to Ensure the Success of My Claim? Workers’ comp doctor visits are an important part of the workers’ comp claim process. Helping your physician to do his or her job will ensure the success of your claim and your recovery. Be completely honest. Your workers’ comp doctor cannot do his or her job effectively without access to the full information. Disclose any health history or symptoms you have, even if you are scared, it might hurt your case. Pre-existing conditions will not hurt your recovery, and you are still entitled to compensation if your workplace accident worsened a pre-existing condition. Report any new or worsened symptoms or injuries.

If you have any developments in your injuries, report these to your doctor right away. Your doctor will document these so that you have a paper trail of your injuries’ developments, and he or she will modify your existing treatment plan as appropriate. Keep copies of your medical documentation. It is not uncommon for people to see multiple doctors when dealing with workplace injuries. This can include primary care physicians, specialists, or physical therapy. Keeping a file of all your medical documentation from each visit will not only be helpful for your case but will also be helpful to your doctor. It is often a lengthy process to request medical records from other treating physicians, so having the documentation on hand will help your doctor immensely, and he or she will be better able to assist you with your treatment. If you have been injured on the job, you need a trusted Workers’ Compensation Physician on your side to make sure you get the treatment you need.