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Understanding Work Related Injuries

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Understanding Work Related Injuries

Before the 1900's, when employees were injured on the job his or her family had to suffer the loss of much needed income. The rigorous process to receive compensation from employers for missing time off work often involved proving the negligence of an employer. If the employer proved to be negligent, the employees' only option for compensation was to sue his or her employer. As a result, workers' compensation was developed to protect the employee and employer. The employee could receive compensation for on-the-job injuries, and the employer would be protected from employees' lawsuits. By 1947, all states required employers to purchase workers' compensation insurance (Valerius, Bayes, Newby, & Seggern (2008).

According to The Department of Labor's Office of Workers' Compensation Programs, workers' compensation is a social insurance program that provides medical care, cash benefits, rehabilitation services, and other benefits to workers who are injured on the job or acquire occupational diseases (Solis, 2011). The employee, employer, physician, and insurance carrier must follow the claims process before a workers' compensation claim is eligible to be paid. The first step in the claims process is for the employee to report his or her injury or illness. The report must be made in writing within a certain period of time of the occurrence. Afterwards, the employer is responsible for filing a claim with the state workers' compensation office and the employees' insurance carrier within a certain period of time. The employer or insurance carrier often chooses a network physician where the injured employee must be treated. If the employee chooses not to use the recommended physician or chooses to use an out-of-network physician then he or she may not qualify for benefits. As a result, the employee would have to pay for his or her medical care also.

The responsibility of the chosen physician, also called the physician of record, is to treat the injured employee. The physician is required to access the employee's injuries to determine the percentage of disability and the return-to-work date. During this process, the physician keeps the insurance carrier and employer informed of the patient's progress. The physician is required to report any changes in the injured employee's progress that may affect his or her disability status or workers' compensation payments. As a result, the first report of injury form can be filed by the employer of the physician (Valerius, Bayes, Newby, & Seggern (2008).

The state requires the first report of injury form to be filed with the insurance carrier in a timely manner. The amount of time varies between twenty-four hours and two days. The first report of injury form contains pertinent information about the employee, his or her on-the-job injury



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