Actually, from an administrative roll, it is the position of the department and the state to save money, especially since it is self insured. Right off the get go the state sets you up by sending a nurse case manager to talk with you. The nurse case manager interviews you in length about prior injuries and activities that they WILL use against you in the future. Then they will have you leave your doctor to go to an industrial commission controlled physiatrist. They explain so nicely to you that this doctor will be better at controlling your case and treatment.
Ethically, I cannot say that all of these doctors are against you or biased on one side of another, but who pays them? Get what I mean. What is strange to me is that the doctor will ask the nurse case manager for approval for a procedure or treatment. The nurse, who is not a doctor, will determine if the doctor’s plan is good enough or warranted. What is really going on is that the nurse case manager is calling the industrial commission asking if it will be approved. The industrial commission looks at how much it will cost, how much it is going to continue to cost then approves or denies it. This person is not going on medical need but cost to the insured, in this case DOC.
You will not be treated as a law enforcement officer that was injured in the line of duty protecting the public but more like a expense that needs to be illuminated, so do not be surprised.
The nurse case manager will call every doctor to sway them that you are not injured or were not injured at work. Since the nurse case manager is a medical professional, ethical or not, doctors often side with them. The industrial commission is the ones that pay these doctors, hmmm.
The industrial commission will then send you to an independent medical examiner (IME) to review your files and make a determination whether you are injured and if so was it at work. These independent doctors all work for the industrial commission and have done so for years. I have sat with officers that have been denied for the last 20 something years and have seen the same names of doctors and there business fronts. So how are they independent? I have also looked up where my doctor lives and where one of their doctors lives. My doctor is the top heart doctor here in Phoenix; he lives in a $650,000 house that he is still paying on. One of the industrial commission’s doctors that has been “independent” but only see’s workman comp patients’ lives in a $1.7 million dollar house in Scottsdale. So who gets paid better by whom and for what?
The system is one sided, and until we all as workers change it, it will remain the same.
You have rights, cut and paste this or print it out because you will want it and give it to your friends and fellow employees.
When you are injured, you do not have to file a workman’s comp report of injury. You do have to report that you were injured, but you do not have to accept compensation form the state. What am I saying is if you except compensation you cannot and will not be able to sue the state. (This is only if the state was negligent) This includes your family, so if you were to die from the injury or illness your family will have to fight for benefits in court. You are on a 90 day time line to take legal action, so get an attorney.
If you do accept workman’s comp you are only required to go to the initial workman’s comp doctor once. Then you can go to your own doctor. You do have to go to the IME’s when ordered to. They will try everything to get you to go to one of their own regular doctors to replace your family physician, do not do it. Your doctor is on your side, and if he or she is not, find one that is.
When you go to the initial doctor for the first time of your injury, record the event. If you fell and broke your wrist, ask the doctor if they are a specialist in bone injuries. I had one of my Lieutenants hurt herself and was seen by a dentist for a broken finger she caught in a sally port. The dentist wrote that she could return to work the next day without a cast. The same dentist referred her to a workman’s comp podiatrist. The referral was in a month. One, what is a podiatrist going to do for her broken finger and the doctor would have had to re-break it after it had healed over a month. Do not go to the doctor they refer you to, go to your doctor and have them refer you to a specialist related to your injury.
You have the right to record and video tape each visit with the workman’s comp doctors or IME’s. You also have the right to all reports written by these doctors and should obtain them. Check them for accuracy, if they are not, dispute it. I have seen where a doctor said one thing and reported another to the commission. My secretary at the time one her case when she played the recording to the judge in court. The doctor was also disciplined by the board for ethical practices standards. Keep good records and provide good records. Go to the doctor with a complete list of symptoms that are related to your injury. If you fell off a ladder and broke your collar bone and bumped your head you would obviously complain about the broken collar bone. But what about the brain injury that you suffer and do not realize because you suffered a brain injury but do not realize it, hmmm. You may have headaches, dizziness, and slurred speech at times, or other symptoms that you should type out and share with the doctors.
You have the right to bar the NURSE CASE MANAGER from going in with you when you see the doctor. The nurse case manager will and can come see the doctor, but they do not have the right to hear your intimate details when you talk with the doctor. But, do have them come in afterwards so you can hear the BS they use try to sway the doctor.
These are just some rights. Now let me give you some suggestions.
Do everything you can not to get hurt at work. Do not be hazardous or act like a cowboy (or cowgirl) while at work. Of all my years I have never been hurt at work, I do have a heart condition and I believe it is related to the stress at work, but I have never been physically hurt. Most every person that has been hurt at work has been impatient, hurried, running to fast, or putting themselves in undue risk. Now, things happen and that is a different case, but the point is do not hurt yourself because they will fish it out and bring it to light while they deny you.
If you are hurt at work and feel you will be out for more than 30 days, GET A WORKMANS COMPENSATION ATTORNEY!!!!!!!!!!!!!!! Only an attorney can ensure you get the treatment you deserve, so do not be writing me for help. If you think the injury may be permanent, no matter how you feel now, in 20 years you may be in a wheel chair from it. I know of a medical person that accidently stuck themselves with a syringe from a diabetic inmate. Turned out the inmate had hepatitis- c. The CRN took the pills but they did not work, the CRN contracted hep-c. I stood by this CRN as they went through the workman’s comp system. They did not settle the case when they offered a couple of thousand dollars. The nurse being a nurse knew what was coming. They demanded life time medical treatment. This nurse was just put on dialysis because the hep-c that destroyed their liver has now destroyed their kidneys. Then it will be the heart and then that will be it. So, think of the futre and make sure your doctor does as well.
Before you are ever hurt at work, watch what you say to yours, or any other doctor you see. They tend to write it down or miss interpret what you mean. Obtain and review ALL of your medical records. Have any and all mistakes corrected. Case in point, my 81 year old mother had ladies surgery. We happened to have to fight Medicare because they refused to pay. The intake nurse wrote that she could see fine, she is actually blind. Another nurse wrote that she walked from the surgery room to the recovery room without assistance or difficulty. My momma has not walked in 15 years, and I doubt many ladies would walk after this type surgery. Then a nurse wrote that she urinated just fine, again my momma has used a catheter bag for 15 years, so she did not urinate just fine. So imagine if all these mistakes were written in your emergency room visit after you were hurt at work. So review and correct mistakes in your medical records.
If you hurt yourself and need guidance, please feel free to e-mail me at MOD 613 that is listed below. I will give you the best advice I can. I can also tell you how to find the attorneys in your area.