Understanding How to Work with Workers’ Compensation Claims
During a typical employment tenure with an organization, the relationship between the employer and an employee is always considered to be professionally streamlined. Workers’ compensation claims are a natural extension of such a relationship.
Workers’ Compensation is a form of insurance that provides earnings substitute and medical benefits to employees injured during their tenure of employment. Plans vary according to state jurisdictions, but the basic premises are as described above.
There are many provisions for compensating workers injured during work. These include:
√ Weekly payments in place of monthly wages
√ Providing compensation for financial loss
√ Reimbursement or payment of medical and like expenses
√ Benefit settlement payable to the dependents of workers killed during the tenure of employment.
The hard fact is, if an employer is not particularly helpful, employees may have to face a lot of difficulties in getting their compensation claims reimbursed. Like most other health insurance claims, the claimant needs to supplement every claim submission with supporting documents that include, but are not limited to, a properly filled Employee Claim Form (C-3), Doctor’s Initial Report (C-4), the physician’s prescription, list of ingredients (in case of compound drug), LMN (Letter of Medical Necessity), pertinent medical notes and a formal patient consent.
Besides these, working with Workers’ Compensation claims also requires one to remember the following:
♦ Employer should have the information of employee’s work related injury or illness
♦ Employee and the Supervisor need to fill their respective sections on the Report of Injury or Occupational Injury Form
♦ Supervisor sends completed form by fax to Workers’ Compensation Coordinator within two days of injury