When you’re injured in the workplace, you may be tempted to brush it off or recover on your own. However, medical treatment is critical to your workers’ compensation case. To understand the importance of going to the doctor because of workers’ comp benefits, it’s important to know what the doctor can contribute to your case.
You Get the Medical Treatment You Need After a Workers’ Comp Injury
When you see a doctor after a workplace accident, you’re protecting your health and safety. Some injuries don’t appear immediately, and you could miss important signs of dangerous, life-threatening conditions. A timely doctor’s visit could ensure that all your injuries are assessed and treated appropriately. California law governs workers’ compensation cases using an established Medical Treatment Utilization Schedule (MTUS). MTUS uses evidence-based medicine to ensure uniform and effective treatment for workplace injuries. While some exceptions apply, your treatment should fall within these parameters.
Medical Records Support Your Workers’ Comp Case
California employers must cover reasonable medical treatment for workplace injuries. Although workers’ compensation insurance exists to support workers after an injury on the job, many carriers balk at paying out claims. The workers’ compensation insurance claims administrator will request injury documentation before they cover the treatment cost. Medical records help substantiate your claim by providing evidence of your injuries, detailed invoices for your care, and an established treatment plan for your recovery. You’ll likely need to see a specific doctor for work-related injuries who can provide these documents upon request. Medical records also provide evidence to support disability claims, should your injury result in short- or long-term impairment. If your workers’ compensation claim is wrongfully denied, you can use medical records to appeal the decision or seek compensation through an employment law or personal injury lawsuit.
You Have a Limited Time to Seek Medical Attention Following a Workplace Injury
In California, you have 30 days to report your workplace injury to your employer and one year to file a workers’ compensation claim. By seeking medical attention immediately, you ensure that your injury is reported and documented within the required time frame.If your injuries prevent you from working, you have even less time. Your employer must file a temporary disability claim through workers’ comp within 14 days after you report your injury or illness. A treating doctor must also confirm in writing that your injury prevents you from performing your normal work activities.
Your Treating Doctor Must Confirm Your Condition for Temporary Disability Benefits
If you are disabled due to your workplace injury, you have the option to file for temporary total disability (TTD) or temporary partial disability (TPD) as part of your workers’ comp claim. These provide approximately 2/3 of your lost income for a maximum of 2-5 years. TTD is meant to help individuals who cannot work at all, while TPD is for those who can continue to work part-time or for lower wages. Your doctor must provide clear documentation supporting your disability claim. Workers’ comp administrators may request copies of medical records and treatment plans to confirm the severity of your injury and verify that your treatment is consistent with the MTUS. Temporary disability coverage only applies while you recover from your injuries, so your medical records are critical for continued coverage.Once you are cleared to return to work, whether on a full-time or limited basis, your doctor must submit a Physician’s Return-to-Work & Voucher Report to your employer. This report outlines your limitations and disabilities, so your employer understands which work you can perform.
Your Doctor Must File a Report for Your Permanent Disability Benefit Claim
If your doctor determines that you are permanently unable to return to your previous job, they must provide this information in writing to support your application for permanent disability (PD) benefits. Permanent disability applies if you will never completely recover from your work-related injury, or you have permanent limitations on the type of work you can perform.
When your condition has stabilized, your physician will determine that you have reached maximum medical improvement (MMI). If you are still disabled at this point, your physician can complete a Permanent & Stationary (P&S) report detailing:
- Your medical condition and ongoing issues
- Your workplace limitations
- Expected future medical care for your workplace injury
- Your ability to return to work
- Estimated percentage of your disability caused by the workplace injury
This report helps the claims administrator determine the extent and severity of your disability. They use it to determine the amount of your PD benefits, so it’s crucial to see a doctor after a disabling workplace injury.
Medical Records Support Your Supplemental Job Displacement Benefit Application
If your work injury causes enough disability that you cannot return to your previous position, but could foreseeably work elsewhere, you may qualify for the supplemental job displacement benefit (SJDB). SJDB helps pay for educational retraining or skill improvement at accredited institutions. SJDB can be used for certification fees, examination prep courses, and licensing costs, as well as tuition, books, and other educational program expenses.
Your doctor’s participation is necessary for you to obtain SJDB benefits. To qualify, you must show that:
- You are permanently disabled due to your work injury
- Your employer does not offer appropriate work for your limitations within 60 days of receipt of the Physician’s Return-to-Work & Voucher Report.
Through SJDB, you can shift your vocational focus to a job or career that is better suited to your needs and limitations.
A Workers Comp Attorney Can Help You Claim Benefits
When you are injured at work, you must go to the doctor to claim your workers’ comp benefits. An attorney at KJT Law Group can help you understand the importance of going to the doctor because of workers’ comp benefits. Contact our employment law attorneys online or dial (818) 507-8525 to schedule a free case evaluation and let us help with your workers’ comp claim.