Medical Care Workers and Workers’ Compensation

After an employee has been injured in a workplace accident, he or she is likely to apply for and receive workers’ compensation benefits.  Although the type of benefits can range from treatment for acupuncture to replacement for lost wages, every workers’ compensation case will involve some sort of medical care for the injured employees.  There are a variety of medical care workers that may be involved in your workers’ compensation case.

One type of medical care worker that may be involved in your workers’ compensation case is the nurse case manager.  In some cases, the insurance company will retain the services of a nurse case manager to oversee a case.  The nurse case manager is usually a registered nurse and has several roles.  The nurse case manager will take on tasks such as arranging for transportation for workers having trouble getting to their appointments, scheduling medical appointments, and ensuring the proper prioritization and documentation of injuries.  The nurse case manager also is responsible for ensuring the correct care and treatment is being administered for the that injured employee’s particular injury.  They are responsible for communicating this information to the insurance adjuster and maybe in attendance at some medical appointments or court hearings.

Another type of medical care worker that may be involved in the workers’ compensation case is a home health care worker.  Home health care can be necessary for certain injured employees, but it can also be an exceedingly costly benefit.  Employees and employers should both be aware that California Labor Code § 4600(h) places important restrictions on the availability of this benefit.  Under this labor code, a licensed physician must provide a prescription for the home health services, and this prescription can only be used to get up to fourteen days of retroactive benefits.

Finally, a qualified medical examiner (QME) may be involved in workers’ compensation cases.  QMEs are doctors that have special certification from the workers’ compensation medical unit to examine injured workers.  A QME’s role is to evaluate the injured worker and determine the level of disability.  The level of disability will be used, in turn, to calculate the amount and duration of benefits for the injured employee.

If you have questions about the workers’ compensation process and the professionals involved, call us today.  We can talk with you about workers’ compensation and your business.

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