How should you handle your first visit to the Workers' Compensation doctor. (Part One)
When you are first sent to the workers' compensation doctor there are certain very important steps that you must take to protect yourself. You have already told your supervisor about your accident. He or she called it in to their superior or, possibly, the insurance company. You are being sent to "their" doctor. You are understandably nervous. You just got injured. That's not exactly fun! What is going to happen next? Well, you have to understand first of all that the way the workers' compensation system works in Florida, the employer and the insurance company pick the doctors. Unless it is an emergency and you are going to a local hospital emergency room, the insurance company has the right to select your doctor. Unfortunately, you can't just go to your own favorite doctor.
This creates an uncomfortable situation, but there are strategies that help. First of all, if it is an emergency, then go to the emergency room! You are entitled to call 911. Don't be intimidated by either your boss or the situation. You are entitled to either call for an ambulance or go to an emergency room if it is an "emergency." Don't be afraid to go to the local ER. Don't be macho (or the female equivalent). If you do go to an emergency room, be sure to tell them that you got injured on the job. Do not allow them to take your health insurance information. You are there for a workplace injury, leave it at that.
We want you to have the knowledge to protect yourself and get ALL of the medical care you require. If you give your health insurance information at the emergency room, they will often rather bill the health insurance company and not the workers' compensation company. You need to understand their bias. The hospital often gets paid more by health insurance than by workers' compensation and they get paid faster and with a lot less headaches; administrative details. Why do you care? What difference does it make to you? You have insurance, so why bother? Here is your answer. If health insurance pays for it, you may end up being personally responsible for the bill because by law the health insurance company is not obligated to pay for treatment due to a workplace injury. You may not get that bill for months, but you are likely to get it. Plus, you will then have a lot of trouble getting the workers' compensation company to pay for that bill. Plus, it is just plain more honest to tell the triage nurse, the clerk at the front door or office, and the doctor all the same story. Tell them the truth; that you got hurt at work.
Now, whether you go to an emergency room or the clinic doctor that either the insurance company or your employer sends you to, you must tell them ALL of your symptoms. Do not just tell them the most important or serious symptom. Tell them all of your injuries or symptoms. In that way they are all documented and you should be covered in the future. You can certainly tell them what is the most painful or significant symptom, but be sure to tell them everything.
If the doctors don't document all of your injuries, the insurance company adjuster is not going to authorize treatment for something that is not documented. You will need a competent and experienced lawyer early on in the process and, certainly, if the insurance company is ignoring some of your injuries. You must tell everyone in the process all of your injuries and how the accident occurred on the job. Insurance adjusters look for inconsistencies as an excuse to deny benefits. They also look carefully at the initial medical care records to see if you forgot to mention a symptom or an injury. The adjuster really "isn't out to get you." That is their job! If they can deny you benefits, their company is more profitable. Your job, however, is to protect yourself and make sure that all of the medical records; especially the initial ones; list all of your symptoms and injuries. Sitting there that first day in the clinic or in the ER, do you know which of your injuries will need the most long term care? Your crystal ball may not have sufficient polish on it. We have in our practice seen many situations where the injured worker goes in, mentions their knee that is killing them, for example, and fails to mention that their back is also hurting. The knee gets the treatment and gets better, but the back remains a problem and not having been documented, it does not get treatment! Don't let that type off scenario happen to you. If it does or if you need guidance at any stage, you need an attorney who actually practices workers' compensation to help you resolve this problem.