Workers Compensation

Workers’ Compensation is insurance, paid for by your employer, that provides benefits and medical care if you become disabled because of an injury or illness related to your job. All employees are covered by the Workers’ Compensation Law.

If you get hurt while you are at work, your employer is required by law to pay for wokers’ compensation. This can be due to falling on the job, pain in your neck, back, hands, etc. from repetitive motion over and over again, or getting hurt in a vehicle while making delieveries.

Benefits from Workers’ Compensation

• Medical care: Paid for by your employer to help you recover from an injury or illness caused by work.
• Temporary disability benefits: Payments if you lose wages because your injury prevents you from doing your usual job while recovering.
• Permanent disability benefits: Payments if you don’t recover completely.
• Supplemental job displacement benefits (if injury is in 2004 or later): Vouchers to help pay for retraining or skill enhancement if you don’t recover completely and don’t return to work for your employer.
• Vocational rehabilitation (if injury is in 2004 or later): Job placement counseling and possibly retraining if you are unable to return to your old job and your employer doesn’t offer other work.

If You Have a Job Injury

Report the injury to your employer by telling your supervisor right away. If your injury developed over time, report it as soon as you learn or believe it was caused by your job. Reporting prompltyl help prevent problems and delays in receiving benefits, including medical care you may need. If your employer does not learn about your injury within 30 days and this prevents your employer from fully investingating the injury and how you were injured, you could lose your right ot receive workers’ compensation benefits. Next, get emergency treatment if you need it. Your employer may tell you where to go for treatment. Tell the health care provider who treats you that your injury or illness is job-related. Then, fill out a claim form, called a DWC form 1, and give it to your employer. Your employer must give or mail you a claim form within one working day after learning about your injury or illness.

Workers’ Compensation and Chiropractic Care

If your date of injury is in 2004 or later, you are limited to a total of 24 chiropractic visits unless the claims administrator aurthorizes additional visits.

Medical Provider Network (MPN)

Your employeer should be set up with a medical provider network (MPN) which is a group of health care providers set up by your employer’s insurance company and approved by the Department of Workers’ Compensation (DWC) administrative director to treat workers injured on the job. Each MPN includes a mix of doctors specializing in work-related injuries and doctors with expertise in general areas of medicine. If your employer is in an MPN your workers’ compensation medical needs will be taken care of by doctors in the network unless you were eligible to pre-designate your personal doctor and did so before your injury happened.

Pre-Designating a Personal Doctor

This is a process you can use to tell your employer you want your personal physician to treat you for a work injury. You can pre-designate your personal doctor of medicine (M.D.) or doctor of osteopathy (D.O.) only if: your employer offers group health coverage; the doctor has treated you in the past and has your medical records; prior to the injury the doctor agreed to treat you for work injuries and; prior to the injury you provided your employer the following in writing: (1) Notice that you want your personal doctor to treat you for a work-related injury and (2) Your personal doctor’s name and business address. The DWC has a form for pre-designating a personal physician on the forms page of its Web site.

In order to see a chiropractor for work related injury, your primary care physician (PCP), whether it be an M.D./D.O./Orthopedic surgeon, must prescribe you chiropractic care. Your usual doctor (pre-desinated doctor) will be more willing (than the MPN) to refer to chiropractic care because he/she will not be confined to refer within the MPN.

*Notice to California Residents! – Making a false or fraudulant workers’ compensation claim is a felony subject to up to five years in prision or a fine of up to $50,000 or double the value of the fraud, whichever is greater, or by both imprionment and fine.