Injuries at Work: Successfully Navigating the Workers Compensation Process to Benefit Everyone

When injuries occur at work, it can be challenging to know how to navigate the process of workers compensation for both employers and employees. Our orthopedics practice specializes in treating workman’s comp injuries.

Here are a few tips to help everyone come out on top when someone gets injured at work.

Prompt and Professional Care

The most important factor in ensuring employees receives prompt and professional workers compensation care is to direct them to a healthcare provider who understands workers compensation. Often times an employee will begin with a primary care doctor or an urgent care clinic. The ideal place for them to start is at a clinic that specializes in treating people who are injured while at work. There are several clinics to choose from throughout the valley.

After someone has been treated with a provider two times, that provider becomes their physician of record for the duration of their claim. If conservative care is unsuccessful for an orthopedic issue, that provider could request a referral to an orthopedic surgeon from the insurance carrier who is handling the claim. It is important that the employee is directed to an orthopedic surgeon who understands workman’s compensation.

Understanding and Alignment

As an employer, you will be required to complete a 101 Form that documents your understanding of the events surrounding the injury. Your employee will also complete a form called at 102 Form that details their summary of events. The 102 Form will be provided by the clinic specializing in treating work-related injuries. These forms will go to the Industrial Commission of Arizona (ICA). Both forms will be received and reviewed by your company’s workers compensation insurance carrier.

Success and Healing

Once the employee is established with a “provider of choice” for their care, the medical provider will supply “work status reports” to you as the employer. These reports will include information about treatment such as diagnosis, whether any procedures are needed or if physical therapy is recommended as well as the patient’s next appointment, if scheduled.

The updates will also inform you about any restrictions the employee may have at work. This will assist the employer in designing a light duty position so the injured worker can continue working and being productive during their recovery process.

It makes good sense as an employer to work collaboratively with your employee and their healthcare provider to get them back to work as soon as possible and make any recommended accommodations for them. If someone is off of work for more than 9 days due to a work related injury, the insurance company will start paying for some of their lost work time. Those indemnity costs may cause the insurance premium to go up. Unfortunately, when premiums rise, it impacts the employer and employee adversely – something no one wants!

Many times employees don’t think their employer will work with them to make adjustments to their work hours or work duties so that they can return to work. Communication with the employee’s healthcare provider and willingness to make work modifications, as recommended, will ensure a successful return to work for the employee.

Communication and Collaboration

Managing workers compensation can be challenging. Communication and collaboration among the key players is critical. These include the employer, employee, the healthcare provider and the claims adjuster or nurse case manager at the insurance company. By keeping everyone in the loop on progress and status:

• An employee can receive the best possible care and be on the road to recovery.
• An employer can provide the necessary support to an employee for a successful return to work and avoid an increase in their insurance premiums.

At Integrated Orthopedics, we have a dedicated staff resource for coordinating all of the critical communication involved in the workers compensation process. We provide:

• Same day/week appointments
• Same day work status reports

Dr. Brian Gruber treats workers compensation patients. He is a board certified physician in orthopedics and sports medicine, has significant experience performing independent medical examination (IMEs) and is CIME certified. Dr. Gruber currently performs IMEs in our Phoenix, Arizona office and is available to travel on selected dates.

If you are an employer, worker’s compensation professional or nurse case manager and would like to learn more about working with us, please contact us at (602) 734-1824.