FIVE MAJOR PITFALLS TO WATCH FOR WITH WORK INJURIES
Ensuring Proper Documentation
What they don't write can hurt you..
Most patients do not realize that modern electronic medical records have been created to make documentation easy and fast for medical providers. What that can sometimes mean is that by default, patient complaints may already be pre-populated to be negative incorrectly. For example, if you tell your doctor at the first visit that you have “neck pain” but you don’t elaborate that you also have tingling and headaches, then many times your medical record will show “Patient complains of neck pain. Denies tingling and headaches.” Did you notice the difference? The proper way would be for the provider to ask and clarify each question and symptom to properly document your symptoms. Sadly, that is usually not the case. If at the next visit you report these previous symptoms to your doctor, there is a chance that your work comp insurance company may deny a claim for these more serious symptoms. What this means is that you must be proactive, and detail every single symptom at your first and every visit. You may want to consider writing this down on paper and bringing it with you to your doctor’s visits and going over it in detail or submitting a copy of your history and symptoms.
Surveillance is Always on the Table
You are not imagining things, they may be watching...
Keep in mind that it is well within your Workman’s Compensation insurance company’s rights to have 24 hour surveillance on your activities. Sadly, there are cases where someone goes on a work injury claim and is found to be playing sports or working another job without any difficulty. That is not fair to all the injured workers that genuinely need care and are doing everything they should. But it does mean that sometimes the wrong person is being monitored unnecessarily. If this happens to you, do not engage your investigator at any time. Let them do what they want to do on public property. What you can do is ensure that you are following your doctor’s restrictions not only at work but at home and with your everyday activities.
You have a Choice in Choosing Your Provider
It's Your Health That is on the Line
The Illinois Worker's Compensation Act requires employers to not only pay for related and necessary medical care for injured workers but it also allow you to choose two doctors and then receive medical care from that doctor and any other physicians, specialists, diagnostic tests, or physical therapists to whom you are referred. Having the right to make a choice of which doctor you are going to see is an important right for injured Illinois workers. It ensures that you are receiving care from someone who has your best interests. Not all doctors and physical therapists are experienced in how to treat and document work injury claims and that can make all the difference in your claim and/or settlement. Most big box physical therapy chain centers use new graduates who do not have even a basic understanding of the laws and intricacies of work comp claims and many times their treatment and documentation reflect that, unfortunately to the detriment of their injured patients. Choosing your own qualified doctor and healthcare providers based on the strength of his qualifications and experience in treating work injuries improves your odds of making a good recovery from your injury and returning to as close to full health as possible at no cost to you. In addition, we can even help injured workers that have been denied coverage to still get the medical care they need from our team of Doctors, Specialists, and Physical Therapy centers at no cost to the worker.
Beware of Those Contracts!
The Devil Really is in the Details
One of the biggest secrets in Workman’s Compensation injury claims is the rise of third party management of an injury claim. While many companies go to great lengths to provide the proper care and payments for their insured, there are more and more cases of aggressive adjustors that are putting up barriers and bureaucracy to create headaches and ultimately close the claim prematurely. Many insurance companies have contracted with third party management companies to drastically reduce claims approval, claims length, and design obstacles for the injured worker. When it comes to physical therapy, this has become very pervasive. The vast majority of physical therapy centers, especially the larger big box chain centers, are contracted with these third party companies or the insurance companies themselves and are bound by their rules and regulations. While there may not be a direct order to discharge a patient earlier than appropriate or document against the injured worker, it is very easy for the third party management company to tell a provider that they may not refer patients in the future or may even have their contract canceled if the facility does not “improve.” This is especially true of Independent Medical Evaluations (IMEs) but it happens at every level, including with physical therapy.
Over the last 20 years, at Emery Physical Therapy, we have made a decision to NOT contract with any third party management or Workman’s Compensation companies to ensure our independence and make the injured worker our priority. This allows us to make sure we focus on the best interests of the injured worker. We have treated over 5000+ patients and many of them refer their injured family, friends, and co-workers because they have seen first-hand the difference between a biased ,contracted facility and what we offer. We see injured workers from over 10-15 miles away because they know we can give the care they truly deserve. (We also provide transportation*)
When An Attorney May Be Needed...
You aren't supposed to know but the law is on your side
Because we are not contracted with any Workman’s Compensation companies, we do not hesitate to inform injured workers of their rights if we feel the injured worker is not being treated fairly. We have had a few injured workers fear getting let go from work so they went back to work prematurely and ended up getting injured even further. We educate our injured workers that no one wins if they get injured further and it is in fact illegal for any company to take any such action against you while you are under a work injury claim. We don’t think an attorney is required for all cases but in situations where it is necessary, we refer patients to attorneys that we know have been successful nearly every single time, not an attorney who claims they know how to do work comp cases (many are just learning as they go).
AT EMERY PHYSICAL THERAPY, OUR FOCUS IS ON THE INJURED WORKER
We Do Things Differently...
People who have been injured on the job have a unique set of circumstances. They need to overcome injury and return to normal work and home life as soon and as safely as possible; often the well-being of the patient’s family depends on that. Being injured at work can cause significant stress, pain and aggravation affecting your ability to effectively work and provide adequate income for your needs. Our number one priority is to ensure your pain is relieved fast and you can safely return to work as safely as possible. At Emery Physical Therapy, we understand what is involved because we have extensive experience with treating worker’s compensation injuries and as an independnet provider, our only goal is to get you better, everytime.
You have the right to choose or switch over to a unbiased, independent, and experienced physical therapist for your injury. We also provide transportation services* for patients that may require it. Call us today at 847-786-2014 to learn more.
* Transportation outside of our service area will be evaluated on a case-by-case basis *