When to ReferWhen an employee gets hurt at work, his workers’ compensation insurance company should provide a list of approved doctors able to treat workers’ compensation injuries and illnesses. These doctors will have been vetted through a review process in accordance with their jurisdictions’ requirements. In an emergency, an injured employee may receive treatment from a doctor who is not on the workers’ compensation approved list. The physician must then refer the patient to an approved doctor (this procedure varies depending on the jurisdiction). States and other jurisdictions also have the option of relying on the American College of Occupational and Environmental Practice Guidelines (ACOEM), Official Disability Guidelines (ODG), state laws, or a combination of all three.
The Role of the Physician in Workers’ Compensation InjuriesA physician treating a patient for a work-related injury generally has three stages of involvement in helping the injured worker navigate through the workers’ compensation system:
- Initial and/or ongoing treatment of the injury
- Documentation (medical and administrative)
- Return to work planning
To ensure continuity of care, a single physician will typically handle each of these three stages. Providing the best care to patients is any physician’s top priority. To achieve the best outcomes, he must also know the what, when, where and how about the injuries he treats. By knowing the administrative regulations and processes for treating workplace injuries, physicians can also help the workers’ compensation process work properly for all parties in the system.
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