Category Archives: doctor

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What Medical Expenses Are Covered In A Workers’ Compensation Case?

Today’s post comes from guest author Roger Moore, from Rehm, Bennett & Moore.

In Nebraska and Iowa, as is the general rule, an employer is liable for all reasonable medical services incurred as a result of a work injury. This is interpreted fairly broadly to include plastic or reconstructive surgery, prosthetic devices, and medicines, among other treatments. As long as the treatment is designed to relieve pain or promote and hasten the employee’s restoration to health and employment, the employer is liable. When a treatment meets these conditions, an injured worker should not be responsible for any portion of the medical bill.

The main difference is in Nebraska, as long as the worker elects a prior treating doctor to treat their injury (for example, the worker’s family doctor), that doctor can dictate the medical care and refer them to others for treatment. If no election is made, then like in Iowa, the employer can choose the doctor to treat a work injury as long as the employer accepts compensability for that injury. However, in Iowa, if the worker can establish that the medical care furnished is unreasonable, then the worker can choose another medical provider.  In both states, if a claim for a work injury is denied, the worker can choose their own doctors to treat with.

If no Petition is filed in Nebraska, an employer continues to be responsible for medical care as long as there is less than a two-year gap in the payment of a medical bill by the employer or insurance company or the payment of temporary or permanent benefits to the injured worker. Also, if the Court enters an order finding the injured worker entitled to future medical care, there is technically no time limit for seeking medical care.

In Iowa, medical benefits cannot be used to extend the deadline to file a claim for benefits. There is no time limitation in seeking medical care relating to an injury either before or after an Award for benefits.

However, in practical terms, large gaps in treatment will likely be met with skepticism from the employer – and possibly the Court – concerning the relationship between the work injury and the medical care. We recommend you seek consistent medical care where there is a need for it to avoid such issues.

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Take Someone to the Doctor with You

Today’s post comes from guest author Jon Rehm from Rehm, Bennett & Moore.

Having a work injury is incredibly stressful. Sometimes when a worker is under stress, they won’t understand what a treating doctor is telling them, which leads to frustration and anger on the part of the worker directed toward the doctor. In turn, the worker’s attitude will lead many doctors to not cooperate in a worker’s case. This is especially true if the insurance company has a nurse case manager working on the claim.

One solution for an injured worker is to bring a trusted friend or family member to the doctor with them to medical appointments. I see at least two advantages to bringing in someone else:

1) another person would be able to help you describe symptoms and how the injury happened and

2) the other person can help you understand what the doctor is telling you.

But not every friend or family member is the right choice to go to an appointment with you. You should choose someone who is level headed so that they do not get into an argument with the doctor. You should remember that the doctor is taking down a record of your visit and that that written record will likely be looked at by the judge deciding your workers’ compensation case, should your case go to trial. If you or a friend or family member gets into an argument with a doctor, it will likely hurt your case.

Injured workers who are non-English speakers can present more challenges to effective medical treatment. Not only is there a language barrier but there is often a cultural barrier as well. The language barrier is often used to the advantage of the employer and insurer, because they will often provide interpreters to the doctor. Non-English speakers should try to bring along a fluent interpreter in their language. A bad interpreter can almost be as bad as no interpreter. However, the same rules about temperament and judgment apply for those who go to doctors with non-English speakers. Sometimes doctors get frustrated with language and cultural barriers of non-English speaking injured workers. Employers and insurers know this and use this to their advantage.

If I am Hurt on the Job, What Should I Tell My Doctor?

Today’s post comes from guest author Todd Bennett from Rehm, Bennett & Moore.

One of the most important parts of any case is the history of your injury that you provide to your doctor when you first see him or her.

If you were hurt during a specific incident, make sure to tell your doctor how you were hurt, when you were hurt, where the injury took place, and who else was present. Tell him about the pain and symptoms that you have been experiencing. Also be sure to describe in detail all of the body parts that you have injured. Even if one injury hurts more than the others, make sure to tell your doctor about every single injury.

If you have been hurt by repetitive-work activities, be specific about the number of movements that you make. For instance, tell your doctor about the number of times you lift or grip things in an hour, day, or week.

If you have been hurt by exposure at work, whether it is to a hot, humid environment, chemicals, or any other environmental condition, be specific when you tell your doctor about the pain and symptoms that you have due to that exposure.

If you leave work and become better, and then return to work and experience an increase in your symptoms, be specific when you tell your doctor about any changes in your condition.

It is important to be accurate and honest the first time that you seek treatment with your doctor, for both your health and your workers’ compensation claim.