Injured employees in need of workers’ compensation benefits often worry about how their employer may react to a claim. They think of their employer as the party with most of the authority regarding the benefits they receive after getting hurt at work.
However, employers actually have limited control over the workers’ compensation claims process. It is their responsibility to provide coverage and to report certain matters when they learn about a worker’s injury or work-acquired illness. Overall, the business plays a relatively minor role in the claims process.
The party with the greatest degree of direct influence on the success of a workers’ compensation claim is often the physician overseeing the worker’s treatment. What are some of the most important responsibilities that fall to the healthcare professional overseeing a workers’ compensation claim?
1. Diagnosing conditions and recommending treatment
Basic medical responsibilities are a key component of a workers’ compensation claim. Specifically, workers need a doctor to affirm their diagnosis and to recommend a treatment plan.
Once a physician recommends certain types of care, workers can then count on medical benefits to cover those costs. In some cases, employees may need to seek out a second opinion or choose a different doctor because of differences of opinion regarding either the diagnosis itself or the treatment plan developed.
2. Establishing limitations and support needs
Returning to work with an injury or work-acquired illness could lead to worsening symptoms in some cases. A physician needs to establish what, if any, functional limitations a condition creates for an employee.
In some cases, workers may require on-the-job accommodations. Assistive technology, work-from-home arrangements and possibly a change of job responsibilities are all ways for employers to get workers back on the job before they fully recover from their condition. A physician’s recommendations play a big role in a worker’s ability to access the support they need.
3. Deciding when treatment ends
A physician can deem that a worker is fit to return to their job without limitations or with limited restrictions. Other times, physicians may recognize that the worker may never make a full recovery. They may always have some lingering symptoms.
A doctor may determine that a patient with ongoing symptoms has achieved maximum medical improvement (MMI) and is unlikely to improve with additional treatment. In such scenarios, workers may require on-the-job support to continue working. Other times, they may need to change professions. They may be eligible for permanent partial disability benefits due to their lingering symptoms.
Having the right medical support during a workers’ compensation claim may be as important as having legal guidance. Workers who know their rights and who have help with the technical aspects of the claims process may get the care they need to return to work.