<em><strong>By <a rel=”author” href=”https://plus.google.com/+EdwardLoniewski?rel=author“>Dr. Edward Loniewski, DO</a></strong></em>
By: Dr. Loniewski, DO JointHealing.com
With all the confusion about health care insurance, many may falsely assume that the Affordable Care Act (AKA Obama Care) will cover all injuries regardless of where, when and how an injury occurred. The truth is that if you are employed, and you have an injury while on the job or even in the parking lot coming or going to work, your personal health care insurance should not and will not pay for the care of this injury. Your employer is required to pay insurance premiums to cover such injuries. Failure to pay for this insurance will result in steep fines for the employer.
One mistake we see patients make in our own office is when patients are asked by an employer not to make a claim for an injury. They are told by their employer that they should cover this on their own personal insurance, or even worse, they are informed that the employer will pay them cash to cover the injury. There are many problems with being the “nice employee” and trying to save your employer the expense and hassle of filing a claim. The biggest problem is that it is illegal. This is actually insurance fraud and could result in the loss of your personal insurance. Another problem is that this will more than likely result in a delay in your treatment especially if you require surgery or expensive testing such as an MRI. If your personal insurance discovers that your accident or injury occurred at work, they will deny your claim. If the workers compensation insurance provider determines that the injury may not have occurred at work, or the injury may have a component of a pre-existing condition such as arthritis of your knee or a history of back pain, they will also deny the claim. The result is a legal battle between the two insurance carriers and you end up having to hire and pay a lawyer to settle the issues. In the meantime, you are stuck with the medical bills and a delay in your treatment.
In order to avoid this dilemma, be honest with your employer and if the injury did occur while in the act of your normal duties as an employee, remember to do the following:
- Report the injury immediately to your employer.
- Have the employer or your manager file a workers compensation claim.
- Seek medical treatment as soon as possible. Some employers have a relationship with an existing industrial clinic.
- Make sure you are clear about the details of your injury including exactly how the injury occurred and the exact symptoms you are experiencing. You may even want to write down these symptoms for easy reference.
- Keep track of your appointments with physicians, therapists, and tests. Do not miss any appointments. If you do miss an appointment, please explain why you missed them to the place of your appointment as well as to your assigned case manager (if applicable). Failure to report to appointments or testing may result in delay or denial of your claim.
- Work with your physician and therapists on a reasonable return to work plan along with an estimated date of return to work. Your case manager and/or employer will appreciate this team effort. The goal of your treatment is to return to your job as soon as possible but in a safe and efficient manner. Working with your health care providers and employer only makes this a positive event.
- If you do not agree with the diagnosis or treatment, inform your employer and case manager and ask for second opinion.
Overall, an injury caused at work can become a positive experience if you are clear and honest about your injury and work along with your health care team for a speedy recovery. JointHealing.com is here to help with this recovery with simple and effective braces, rehabilitation kits and even cryotherapy units designed to help you recover in the quickest manner possible. We can work with your Worker’s Compensation insurance carrier, physician, therapist, and case-worker to provide you with any of our high quality products at prices one third the cost of other providers. Next day delivery is available for most of our products. We look forward to serving you soon.