By Donna Motley, Vice President of Claims
Does your employee know what to do if they sustain a work related injury? Whether your employee is a new hire or has worked at your facility for many years, the procedure is the same. All employees should be briefed upon hire of the steps to be taken should a work injury occur. Employees should be reminded periodically, no less than annually, of proper procedures or any changes in said procedures, should an injury occur. All employees, not just the injured person, play a part in work safety. All employees should be diligent in keeping the work environment clean; clean up or report oil spills, report unsafe practices, report faulty equipment and safety hazards. A co-worker may be a witness to an injury.
If injured at work, an employee should know to whom they should report the incident. A Supervisor, Leader, Plant Manager, Safety Committee Member or Human Resources Department? The injured worker should be aware that per the Michigan Workers’ Compensation Act, Workers’ Compensation exclusively controls medical treat for the first 28 days. So, the first point of treatment should be at the direction of the employer to the occupational clinic they utilize. Obviously, in terms of more serious injuries, the employer should direct the injured worker to the hospital of choice. Should the injured employee seek medical treatment on their own, without the approval of the employer or Workers’ Compensation insurance carrier, said charges will not be covered and the treatment plan will not be followed.
If an employee treats for a work related injury or condition with their personal physician or doctor of choice prior to submitting a claim with their employer, we, as the Workers’ Compensation insurance carrier, will have to obtain a signed Release from the employee and request all medical records from the treating physician/facility, before the alleged injury can be addressed by our department. This, obviously results in a delay of treatment.
When an injured worker is treated at an approved facility, they should provide the facility with MTMIC’s contact information as the Workers’ Compensation carrier. Invoices for services rendered should then be sent direct to our department. For an accepted Workers’ Compensation injury, the injured worker should not incur any expenses. Mileage and prescription receipts can be submitted for reimbursement. The provider cannot “balance bill” the injured worker or employer. If an injured worker is treated as an emergency and the hospital insists on health insurance information, we can always have those charges reversed. When the health insurance carrier sees the charges, they will most likely deny payment anyway. If an employee is billed for services, the bill or statement should be forwarded to our department for processing – before it gets to collection.
The injured worker is to supply the employer with a disability slip from the treating physician following all appointments. If restrictions are imposed, the employee should inquire whether or not the employer can provide work within those restrictions. If restricted work is provided, the injured worker has the responsibility to only work within those restrictions!
The injured worker has a responsibility to attend all medical appointments, give maximum effort while at physical therapy, take medication as directed, following imposed restrictions both inside and outside of work, perform home exercises and keep their employer informed of their progress!Employees have a responsibility to follow safety guidelines and not take shortcuts; employees should not be resistant to change or a “new way” of performing a function – even if they have been doing it differently for many years without incident. Employees should feel comfortable to make suggestions to their employer about changing the way a function is performed. Employees should feel comfortable that they can report a work incident without judgment or repercussion. However, it is the employer’s discretion whether or not an injured worker is sent for medical treatment – it is not the injured workers’ decision whether or not they “want” to go.
Prompt reporting of work related injuries results in prompt and proper medical care and treatment; and hopefully, a speedy, successful recovery for the employee!