Differences in Medical Care and Workers Compensation Bill Review

The goal of any medical service review process is to ensure that everyone is satisfied. Bill review is a service provided by a third party that acts as an intermediary between the worker, the employer, and the insurance company to ensure that the needs of all of those involved are being met. These types of services can be used for anything medically related to ensure accuracy of charges. The key is that the information provided by the review provider is personalized to meet your specific needs.

Workers compensation insurance is a benefit provided to an employee who is hurt on the job. With workers comp, the employee will receive the care they need to recover from an injury or work-related illness. It is not designed as total wage replacement and eventually the employee is expected to return to work. Between the employee, employer and insurance company, keeping everyone satisfied is difficult. The care provided has to at least be adequate but not excessive so bill review is a great tool that can be utilized to ensure that everyone is satisfied.

Medical procedures and follow-ups with a medical provider can add up quickly and it's easy to get carried away. Medical bill review is used as a tool that indicates the approximate return to work date for the employee as well as highlights anything that the insurer or business may deem unnecessary for recovery. In terms of cost containment and accurate medical care, these types of analysis are extremely useful for workers compensation.

Medical service bill review in general differs from worker's compensation because it encompasses all medical bills, not just those incurred in relation to an on-the-job injury. For instance, if an employee goes to an out-of-network physician because they got hurt on vacation, the reviewer will catch the discrepancy and notify the concerned parties that this medical visit will be more expensive. It has nothing to do with being hurt on the job but since medical insurance is carried through an employer, management software or a review company is still utilized.

All of the aspects of medical bill reviews can be used generally for medical care or for workers compensation more specifically. The benefit of personalized review through a specialized provider is the customization of the information. Workers compensation requires return to work estimates whereas general medical reviews are utilized to highlight medical care discrepancies like using an out-of-network physician. No matter what the system is used for, it's a great way to ensure personal service and rigorous cost containment.

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9 Tips for Reducing Workplace Stress and Lowering Workers Comp Claims

Annual work-related stress claims cost U.S. companies $200 billion to $300 billion a year, according to the American Institute of Stress.

Stress can result in a number of secondary mental and physical illnesses and direct physical injuries, which directly affect health care costs, worker productivity and can even result in workers' comp claims.

In fact, workers' comp claims resulting from job-related stress last about four times longer, at an average of 23 days, than the average days lost from all nonfatal occupational illnesses and injuries combined, ac- cording to the U.S. Bureau of Labor Statistics.

And a study published by The Journal of Occupational and Environ- mental Medicine suggested health care administering costs were twice as high for workers claiming job-related stress.

The National Institute for Occupational Health and Safety defines work-related stress as emotional and harmful responses occurring when job requirements don't match a worker's resources, needs or capabilities.

Some employers still don't take work-related stress very seriously, but based on the numbers, the consequences and the costs for ignoring the issue, you would be wise to do so.

To combat the effects of work-related stress, you need to know what causes it in the first place.

There are a number of factors that cause stress in the workplace, but the most common, according to the National Institute for Occupational Health and Safety, are:

Poorly designed jobs and tasks from heavy workloads; shift work; long working hours; too few or too short rest and meal breaks; and tasks that don't have inherent meaning, that don't utilize the worker's skills or that don't give the employee a sense of control.

Job roles, expectations and responsibilities that are too broadly defined, vague, conflicting or unclear. Poor management skills, including inadequate communications skills, lack of encouragement or incentives to participate in decision making.

Career concerns, including few opportunities for advancement or a lack of job security. Poor workplace conditions, including inadequate ergonomics, air pollution, noise or even dangerous or unpleasant working environments.

If you are able to pinpoint the causes of stress in the workplace you can take steps to reduce those factors. Here are nine ways you can reduce stress among your staff:

Improve communications. Try to get your employees involved and let them know they are valued. Ask them for feedback and input on company plans, processes and management decisions.

Give staff more sense of control. Within responsible and reasonable limits, you should give employees independence in the day-to-day operations of their job. Let them think outside of the box and they may innovate and find a way to do their jobs better and more efficiently.

Create an open forum. Employees should be free to express their frustrations, concerns, and complaints without fear of retaliation from management or supervisory staff.

Keep employees in the know. Uncertainty can be eliminated by simply apprising employees about upcoming changes and what these changes will mean for them.

Reduce any excessive workloads. Don't overload your employees beyond their abilities. Try to spread out workloads and don't pile on too many projects at a time on one person..

Clearly define job descriptions. You should make sure that all employees have a thorough understanding of their roles in the company and the responsibilities of their position.

Create realistic schedules. Be as flexible and approachable as possible if a staff member needs to take time for a doctor's appointment or has a sick child. Remember that all of your employees have a life and demands outside of work.

Play to your employees' skills. A job should stimulate employees, challenge them and require as many of their skills as possible. Give your staff opportunities like advancement and cross-training if they show the desire to bring more value to their jobs and your organization.

All work and no play... Make sure you allow staff to let loose once in a while by organizing company picnics, parties or team sports like a softball league.

Above all else, in order to keep your workers compensation claims low, practice these tips for happier, more productive employees!

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Workers Compensation Insurance: How Safe Is Your Workplace?

A safe workplace is obviously essential for your employees' health and well-being, but it is also important when you consider the insurance costs for workers compensation insurance. Making sure your workplace is as safe as possible is typically inexpensive and takes very little time regardless of your business. Every penny and minute spent on identifying and preventing hazards can be worth thousands of dollars if there is an accident on your business premises for which you are found to be negligent. Depending on your type of business, remember that this applies for employees and customers alike.

The first step is identifying the hazards in your workplace. Knowing what potential hazards you, your employees, and the public may encounter is critical to implementing effective preventative measures and reducing workers compensation insurance costs. Here are a few of the ways you can identify hazards in your workplace:

--Ask employees: Depending on the nature of your business, employees may be your best source of information since they're responsible for carrying out the tasks your business needs to function. They are probably well aware of any risks and hazards in their daily duties, so they're your first line of defense.

--Perform safety checks: Assess the daily tasks that could cause harm and communicate these risks to staff that may not know the potential hazards.

--Review past on-the-job injuries: Examine any illnesses or injuries that you've already experienced, including their frequency and severity, so you know the best way to use your resources.

While all businesses have safety issues specific to their industry, there are many common hazards that can affect any company. Most studies place trips, slips, and falls as one-third of all major workplace injuries, the most common cause of injuries at work. Legal actions for failing to have insurance to cover workers compensation as a result of these types of injuries can be devastating to your business.

Whether you run a mechanic's shop or an office, pay close attention to these common workplace hazards that, if ignored, can result in a workers compensation insurance claim:

--Look for slip and trip hazards, such as uneven floors, trailing cables, and floors that are often wet. Make sure the workplace is cleaned regularly and that spills are cleaned-up immediately. Even if your business seems impervious to these risks, think about the worst thing that could happen to your business and how much you may have to pay in the event of an injury.

--Be aware of electrical hazards: If any employees interact with electrical machinery, you obviously need to ensure that regular maintenance is performed on all electrical areas of your business that may come into contact with your employees and customers.

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Long Term Workers Compensation

Workers compensation is something most people in a typical job won't have to think about. Usually, unless you work in a particularly dangerous work environment, you most likely don't even know the kind of coverage you have. However, if something happens then you'll be glad you are covered and have it. This form of insurance covers medical bills, provides financial aid and covers the period during which you are out, not working. So what happens if you are out of work for a long time, maybe forever? Long term workers' compensation can cover you as well.

First let's be clear on what exactly most workers compensation policies cover. The point of the policy is to provide help should something happen in direct relation to your work. That means when you're at your job site, whether it's a business office or a project ground of some type, and you're doing your assigned duty, then if an accident occurs, you'll be covered. It's important to note that in most situations, this is only the case if your injury came from your assigned duty. That means something in your job description. For example, if you were helping out someone else to create a make shift elevator on a construction site, when you were supposed to be painting walls, that probably isn't a very good idea. You could well find yourself on your own.

Once you know you're covered, what kind of injuries can lead to permanent disability benefits? Someone on a construction site could fall down and break his spine, for example, making him unable to walk anymore. This would prevent him from doing his job, and then he would be covered by the workers compensation. Someone in an office could be working on a computer, and a lamp falls on top of him, blinding him for life. This would also be covered. There are many more examples, but just think of something that would completely prevent you from doing your job, in which case workers compensation would be there to help. It's generally not a pretty picture when this happens, and it's not something anyone would want, but like any insurance, at least the coverage exists if you need it.

In actual real life situations, coverage does change from one place to the next, so if you're working in a dangerous environment, it's important for you to know what you're covered for, and what will actually be paid should something happen to you. It's always better to be prepared, than find out when it's too late that you would have been better off doing another job. Long term and permanent workers compensation is something that is much scrutinized, because it costs a lot to the employer, and only these extreme cases are considered.

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The First Rules In Workman's Comp

Lots of people everyday work at jobs which involve situations in which they could become injured. This is why employers are required to purchase workers compensation insurance. Workman's comp exists in every state within the United States. In most cases the system should involve a worker who is injured or has become ill due to the work environment. Instead of suing the employer they file a claim against their employers workers comp insurance.

Workman's comp is designed to help the worker. It is to help financially fund a worker who has been experienced some time of illness due to the work place. However, it does sometimes produce outcomes that are less than desired by the party injured or ill due to an employer's negligence. The system is complex. It is not an easy or fast process. Many people who file workers compensation claims find it in their bets interest to work with a lawyer that specializes in these issues for help on the claim. Some unions also offer legal support to victims.

There are requirements that must be met by the employee to even be considered able to file a workman's comp claim. The two basic necessities are as follows; the employee must have worked for a company that carried workers compensation insurance. All companies are supposed to have this insurance coverage but not all companies abided by the laws governing society. Also they must have been injured during work or have an injury specific to the job duty.

The most important step the employee can make in the claim against an employer for workman's comp benefits is notifying them immediately that a work place injury has happened. Many workers are afraid to do this obvious step in the process because of bonuses and incentives companies often put on the number of days that a work place has been injury free. However, this is absolutely no reason to let an injury go without being reported on.

Even if an injury is extensive, if an employee fails to report it right away that gives the carrier reason to deny the legitimacy of the claim therefore denying benefits to a deserving employee. It is without a doubt the very first key element in a long and lengthy battle to gain compensation under the laws surrounding workman's comp. It is also important to realize the longer it takes the more flags that will be raised and the carrier will look more thoroughly into the claim thinking it is perhaps fraudulent and without just cause.

Even after a worker has filed a claim with their employer there is still more work to be done to prevent any case they might have against the claim. The next step is to report the accident to the state workers compensation board in which the worker works and lives. This will make sure that all the necessary paperwork has been filled out and obtained to proceed with the claim.

It is important that an employee document the accident for their records also. Keep copies and records of all communication regarding the accident. Employers should also obtain information from the employee. It is important to describe the specific accident, the names of the people that saw it happen; when the accident occurred, under what conditions and where exactly did it occur.

This is just the beginning of a journey involving lots of documentation and paperwork. Most employers don't ever want to get involved in such situations because they are time consuming and expensive. However, even with the best employers who offer work places that are desired it is possible that an injury occur. This is why it is important even for small companies to carry workman's comp insurance.

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What If My Employer Doesn't Have Workers Compensation?

Today, there are a lot of employers that don't have workers compensation plans for their employers. It is extremely important to know what your employer is offering and, if you know that they don't have A compensation plan, you need to make sure that you are planning. Workplace accidents and injuries happen on a daily basis throughout the country. Make sure that you have a plan for what to do if you have to work without this type of coverage.

Ask Them to Get Coverage

Depending on who you work for, you may have union rights, if you do, use the bargaining options that they have to ask for compensation benefits. You want to make sure that you are taking a look at the bargaining rights that the union offers and use that to help you. Otherwise, you also want to make sure that you are working with your employer and the other employees to make sure that you are getting what you need for coverage.

Find Short Term Disability Plans Individually

If you are looking for an option that will replace workers compensation, you want to take a look at short-term disability plans. These are plans that will cover you for a set period of time if you are injured and will help you pay for bills. This is not a long-term solution, nor is it a workers compensation plan, but it is enough to help you get what you need.

Find a Group Sponsored Individually Paid for Coverage

When you know that your employer is not going to offer workers compensation, get together a group and make sure that you find what is out there. You will find that you can actually get some great group rates on individual coverage like disability or AFLAC (American Family Life Assurance Company) without actually having to have a workers compensation plan through work. It is a great idea to get coverage this way.

Get a New Job

Honestly, if your company doesn't offer compensation coverage, you may want to determine if you want to work there. Workers compensation is an extremely basic insurance coverage and not offering this is a sign that your employer may not be working in your best interest. If they are not offering insurance coverage in general, you want to make sure that you are deciding if you have an employer that is going to support you.

Getting the coverage that you need for your company is really important. Workers compensation is a basic coverage level; however, you may find that there are a lot of employers that don't offer it. If your company doesn't offer workers compensation, you want to make sure that you are finding a way to get what is going to work the best for you. You need to make sure that you have some sort of coverage in place that is going to take care of you in the event that you are hurt on the job and need coverage.

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How On-Site Medical Clinics Curb Fast-Rising Costs of Medical Care in Workers Comp

On-Site Clinics Decrease Costs

Many medium and large employers in their never-ending battle to reduce cost and to provide benefits to their employees are opting for on-site medical clinics. On-site medical clinics can decrease the cost of general health benefits programs and decrease the cost of medical care associated with workers' compensation claims. On-site medical clinics have proven they can curb the fast-rising cost of medical care for both personal and work-related injuries and illnesses.

Some employers are hiring clinicians themselves, and others are using contracted providers who also provide software, protocols and other tools to support the clinicians.

Medical Care Provided at Work Site, Convenient & Effective Treatment

With the on-site clinic, the medical care is provided at the work site, which is convenient for employees who otherwise would have to leave work for care. Injuries and illnesses are evaluated by the clinic staff; many cases can be treated on site. Employees are referred to off-site medical facilities only if the injury or illness is beyond the scope of the medical professionals in the on-site clinic.

On-site clinics often use a variety of staffing models, including RNs, nurse practitioners, and physician assistants - with physician collaboration and direction as needed. Depending on the employer's needs, on-site clinics can be staffed with a doctor. When properly managed, on-site medical practitioners can provide high quality medical care while reducing overall costs. They can also provide other health services such as wellness, and regulatory exams, etc. On-site clinics can include x-ray machines and pharmacy services, though costs and state regulations affect the feasibility of those services. Good providers of on-site medical clinics will tailor the services provided to the employer's needs.

Benefits to Employees

The benefits to the employee injured on the job include:

· Medical services available when the typical doctor's office is closed - evenings, weekends and holidays

· No appointment is necessary

· Immediate medical care following an injury

In addition to the workers' compensation benefits, the employee also enjoys easy access to medical care, assistance with chronic medical problems and healthy living guidance.

Benefits to Employers

The benefits to the employer of the injured worker include:

· Evaluate and treat employee injuries immediately

· Avoids unnecessary and off-site medical treatment

· Referral to appropriate and screened preferred medical providers when off-site care is needed

· Improved outcomes and faster return to work, increasing productivity

· Assist in keeping all workers healthy and productive

· Reduces absenteeism

· Significantly lower cost for medical services for workers' compensation claims

· Can provide physicals

· Drug screening

· Improved general health of employees

· Improved employee morale

· Increases employee retention

· Can coordinate pharmacy usage with your Pharmacy Benefits Manager

· Timely reporting of the injury and medical information to relevant parties.

· The First Report of Injury form is completed and filed with both the state and claims office.

Treat Workers Comp and Health Care

On the workers' compensation side, the on-site clinics can treat lacerations, strains, sprains, other minor orthopedic injuries, abscess drainage, minor skin infections and other routine acute medical conditions. On the health care side, the on-site clinics can treat the whole gamut of minor medical conditions that causes employees to lose time from work including strep throats, colds, ear and eye infections, skin lesion removal and vaccinations.

Clinics Used For Any Site with 1,000+ Employees

On-site clinics are not just for industrial sites like factories, and mines or large office centers. On-site clinics can be operated for just about any industry where there are 1,000 or more employees in one location. Mobile and temporary clinics are used for large construction projects such as skyscrapers, power plants, and highways. All clinics need to be equipped with the necessary furniture, supplies, equipment, and medications.

The cost of drug testing for both employee applicants and existing employees can be significantly reduced by using an on-site clinic. Drug testing due to reasonable suspicion, random testing and post-accident screening can be completed by the on-site clinic. In many states the timely completion of a post-accident drug testing can be used to deny workers' compensation benefits to employees under the influence of a drug at the time of their injury. A positive drug test result can be sent to a certified lab for further confirmation.

Be Sure to Select Quality On-Site Medical Provider

When an employer is selecting the on-site medical provider, select a medical provider who provides an on-going review of the quality of service they are providing. The service quality can be evaluated by patient reviews and comments, by clinic audits and by staff performance evaluations.

On-site clinics do carry costs and risks as well. To be successful, the staff needs to be trained for on-site work, and be supported with appropriate software, operating systems, supplies, medical direction, protocols, QA, and other infrastructure. The medical practice needs to carry malpractice insurance coverings the employer and be compliant with HIPAA, GINA, HITECH and other privacy regulations. In addition, some on-site providers may introduce conflicts of interest if they are financially tied to the off-site hospitals, clinics and pharmacies that they refer to.

For further information about on-site clinics, please contact us.

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Workers Comp Benefits You May Be Entitled to After a Work Related Accident

The United States Congress passed the Occupational Safety and Health Act (OSHA) in 1970 as a means of preventing work-related illnesses and injuries. OSHA is a federal agency that is part of the Department of Labor. Their primary job is to issue and enforce safety standards and guidelines to keep employees from being harmed in the workplace. Before OSHA was formed, it was common for employees to work in dangerous and noisy conditions or be exposed to hazardous chemicals. The primary mission of OSHA is to make sure the health and safety of all workers in America are kept to the federal standard. It is the job of OSHA to investigate complaints by inspecting the workplace when there is a possible hazard or danger, which could lead to serious injury or death.

Benefits You Are Entitled to Receive

When an employee becomes injured or disabled while on the job, they have the right to file a claim for workers compensation benefits. Each state has their own specific workers compensation laws that regulate benefits. However, in general any employee who is injured through no fault of their own is entitled to receive the following benefits:

• Reimbursement for all medical treatment needed. • Travel-related expenses going to and from medical appointments, including the cost of hiring transportation when they are unable to drive due to the injury. • Temporary or permanent disability benefits, which are usually based upon a percentage of the employee's hourly wage. • Lost wages if the employee is unable to work for a period of time. • Vocational rehabilitation costs to retrain the employee for a different job when necessary. • Survivor benefits for the family members if the employee was killed on the job. This includes a specific amount for burial expenses. • Attorney's fees for workers to hire legal help when their claim is denied. The actual amounts vary in each state.

Some states allow the compensation benefits to be retroactive if the disability continues for a period of time. The maximum weekly payment and the length of benefits vary in each state. For example, in the State of Louisiana, the maximum weekly benefits cannot exceed $577 and benefits only continue for 520 weeks. Employees who are out of work for over one year can apply for Social Security Disability Insurance (SSDI) benefits.

Who Chooses the Physician?

Some states allow the employee to choose the physician that will be providing care and treatment for their injuries. Employers in other states may make the initial selection of the physician or the insurer may have established a medical provider network that the employee can choose from after a certain period of time. In the State of California, an employee who has notified the employer prior to becoming injured that they have their own personal physician has the right to be treated by their doctor.

Before Filing Your Claim

Most employers have a certain protocol that employees must follow when they become ill or get injured on the job. These are some things to remember before filing your claim:

• Immediately seek medical treatment for the injury. Start by obtaining help from the employer's medical personnel. • Go to the local hospital, clinic or emergency room for treatment. • Report the accident immediately to a supervisor or manager. • Make a report that details exactly what caused the accident. • Find other employees that may have witnessed the accident who can give an account about what happened. • Collect evidence that can prove the accident was not the employee's fault. • Take pictures of the dangerous conditions that existed when the injury occurred.

The employer's insurance may require the employee to file a claim within a short period of time after the incident occurred. Therefore, it is imperative to take action right away by documenting the claim immediately.

Why You Need a Workers Compensation Lawyer

Workplace accidents can have a severe impact on the employee's life when they are left with serious and debilitating injuries. They may end up being hospitalized for months after surgery or require long periods of rehabilitation. When an individual has been denied workers compensation benefits, they have the legal right to appeal the decision. Many insurance companies will appoint a Claims Resolution Specialist whose goal is to resolve the issues. Sometimes a claim may be resolved through arbitration and an Administrative Law Judge (ALJ) will be appointed to oversee the hearing. If the claim is still denied after this hearing, an attorney can file a lawsuit in the state's Circuit or District court.

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Getting Income Insurance: What Options to Consider?

Most income protection policies are flexible and can be tailored to suit your personal circumstances. There is a wide range of individual options available offered by different companies. Some might be unique; however, there are some common options that are worth considering and these are:

Types of Cover: Agreed Value Policy or Indemnity Policy

1. Agreed Value Income Protection Policy

This is the most expensive option as the policies' premiums are approximately 20 per cent higher than for indemnity policies. It pays out a monthly payment in the amount that is agreed upon or stipulated in your policy that reflects your income at the start of your policy.

Any fluctuations in income do not affect the cover so there is the advantage that you know the amount you will receive, regardless of changes in your income. Moreover, this type of policy will cover you regardless of employment status, so this is particularly useful for self-employed people.

2. Indemnity Policy

This is the more common and less expensive income insurance policy. The monthly payment will be assessed through verification of your income at the time when you make a claim and may cause adjustment to your benefit accordingly which could be an issue if your salary fluctuates in instances when you have taken maternity leave, worked part time or became unemployed.

Superannuation funds can be used to provide for these indemnity policies. Premiums can be deducted straight from the member account. Superannuation funded policies are the cheapest option and indemnity value-based. However, this type of policy offers fewer features and less flexibility. Moreover, this type of policy is sufficient for those who have a reliable, regular income.

There are some superannuation funds that offer income protection insurance as default cover. This type of superannuation funded policy automatically accepts applications without medical checks - and provides an option for those who would otherwise not be covered.

Understanding Benefit and Waiting Period

Benefit Period

This is the period where, in the event of a claim, you will receive your income protection benefit payments. This could be from 1 to two or five years or to a specific age. For instance, this could be up to age 60 or 65.

You will be the one to determine the benefit period that suits you, so you must consider these:

The length of the benefit period depends on the amount of cover you are willing to pay for. The longer the Benefit Period the higher the premium. However, there is the potential for a long term claim. Choose a longer benefit period as much possible so that you can protect yourself in the event of long term disablement.

Waiting Period

This the time between a valid claim is made (when you are incapacitate and unable to work) and the time when you start receiving your first income protection payment. A waiting period from 14, 30, 60, 90, 180, 360 and 720 days are usually chosen. This means that if you chose a 30 day waiting period, then you will start receiving payments after 31 days from the day you made a valid claim.

In choosing a waiting period, you must also take into account these other considerations:

The waiting period chosen has a significant influence on the cost of a policy or the premium. You must remember that income insurance are undertaken for the express purpose of protecting you for the long term so choose a longer waiting period for a lower the premium, i.e. changing a waiting period from 14 days to 30 days can sometimes half the premiums. The longer the waiting period chosen, the lower the premiums. There are sick leave and accumulated annual leave and potentially long service leave that you can use before income protection would need to kick in. Accident Benefit - which will waive the waiting periods in the event of an accident offered by many companies will attract an additional premium. Insurance For Early Retirees   

Work-Related Back Pain: How to Pay Your Medical Bills

Suffering an injury is stressful: Will my work suffer? Will my quality of life suffer? When you are hurt on the job, one question should be answered for you: that of how to pay for treatment.

Many workers develop work-related back pain that progresses into a chronic pain condition. A European Union conference was told by the Fit to Work coalition in October of 2011 that more than 25% of the European working population suffers back pain due to the demands of their jobs. Given the fact that many instances of back pain worsen if not addressed, it is important to know how to pay for treatments.

Back pain can be caused by jobs that require repetitive motions, heavy lifting, stress and staying in one position for prolonged period of time. Some of our most important positions leave the people who work them prone to back pain: nursing, construction, firefighting, policing, cleaning, truck driving and office work are professions with high instances of back pain.

In the U.S., workers compensation exists to protect: 1) workers from being left with no money if a job-related health problem limits or destroys their ability to work and 2) employers from being sued by employees hurt on the job. Workers compensation is best known for paying disability benefits to those who can no longer work due to an injury or illness acquired on the job, but these benefits can also go toward medical treatments while you remain at work or take a brief hiatus to facilitate recovery. WorkCover is a similar program based in Australia. Many other countries have socialized medicine to ensure care is received by every citizen.

To receive workers compensation benefits, you must file a claim. Visit your doctor to determine the cause of your injury; if it is work-related and your treatment will require more than simple behavioral changes, you should file a claim. Also inform your doctor before making an appointment that you plan to receive workers compensation benefits, as some doctors do not accept these cases. Many private insurance companies refuse to cover the cost of injuries or illnesses acquired at work, so if workers compensation denies your claim, it will be necessary to seek the help of a lawyer. It is not easy for everyone to receive benefits. Back pain is a very widespread condition with many causes. You can expect some bumps in the road.

If your doctor confirms that your back pain is work-related, your employer may request that you receive a second opinion by a different doctor. Although this may seem like a way for your employer to back out of insuring you, it is still important to go for this second assessment, since benefits can be denied if you refuse.

Exact workers compensation regulations vary by state, but generally, benefits do not apply to alternative or experimental treatments. Massage, chiropractic and physical therapy sessions may be granted, but with a limit on the number of sessions covered. If a doctor informs the claims representative that more treatments are needed, he or she may grant them.

Prompt back pain treatment greatly increases your chance of recovery. Since back conditions can develop slowly, the pain may go unnoticed before the damage has escalated to a point of serious pain. Pay attention to your pain from the start, and keep track of the duration and severity of symptoms. Any back pain that persists longer than 2 days is not caused by simple muscle strain and demands your full attention.

If your job is causing your pain, work with your doctor and employer to identify behavioral changes that may help. If diagnostic imaging, chiropractic care, massage therapy, physical therapy or repeated doctor's visits are required, workers compensation should be footing the bill. Don't be fooled into thinking you can't afford to take care of yourself. For information on workers compensation laws by state, see http://www.workerscompensation.com/workers_comp_by_state.php.

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Smoothing the Way to a Successful Workers' Compensation Claim

Filing for workers' compensation, or long-term disability benefits through Social Security can be a daunting process. The following tips can help you avoid, or at least better deal with, common pitfalls such as lack of documentation, lost paperwork and slow response times.

Complete a "Benefit Review" as soon as you are injured or have received a diagnosis or other indication that you may not be able to work at some point in the future. The review helps you to understand what benefits are available to you, how you qualify for those benefits, and what your income will look like when you are no longer working. Completing your benefit review right away will greatly help your chances of being allowed to make changes to enhance your benefits in the future should you need to.

All employers that offer benefits are required to provide a Summary Plan Description to all employees. If you do receive benefits from your employer check with your personnel department and request a copy.

Beware of switching to a part-time employee as this can be a mistake. An employer must make "reasonable accommodation" for your condition to help you continue working under the Americans with Disabilities Act (ADA). Reduced hours and reduced pay are part of the accommodations in most cases. (LTD) long-term disability programs through work often tie benefits to what you were earning at the time you stopped work. If you reduce your hours at work this will also reduce your income and the benefits you're eligible for later on, and if your hours drop too dramatically, you may even lose eligibility for the benefits all together since they are usually only offered to full-time employees.

Make sure you are following up with every step of the claim process. Contact the examiner and analyst and make sure all the necessary forms were received, also follow-up with doctors to who have yet to submit their records. This will help you personalize your claim to the examiner and also reduce the time it will take to process the paperwork.

Maintaining a phone log can be a useful step. When you talk to the insurance company or Social Security or your employer be sure to keep a record of the call. Keeping written records is the best way to keep things in order. When people are asked to submit things to you in writing they are much more likely to be careful about what they say, and to be sure that what they are saying is accurate and will be done in a timely fashion. Anyone can say anything over the phone, by asking for things in writing you can feel a little more at ease.

It is easy to get frustrated with a process like this, but be careful not to threaten or get upset with the people you speak to. It will get you a lot farther a lot faster to be complimentary and ask as many questions as possible. Make sure to double-check what you are told; when it comes to your income and your continued health insurance, you can never be too careful.

Moving from work to disability due to an on the job injury or other medical condition is not an easy process. By using these tips you can make the workers compensation or long-term disability claim process a little easier and less daunting.

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Who Is Not Covered by Workers Compensation?

There are many examples of what is covered and what isn't covered by it; it is very important that you understand what will be covered and what won't so that if you have to make a claim, you know what to do. There are examples of people who will be covered by the workers compensation policy and that is important to know because you don't want to even waste your time gathering documents to file a claim if it will get denied.

People Who Are Not Employees

If you aren't employed by the company, you aren't going to be able to file a claim. Let us say that you are hurt on the job site, but you don't work there, you aren't going to be covered under what they have to offer to their employees. Know that this would go for visitors, family members, and other people who are not paid directly by the company. Their coverage would fall under other insurances the business may have.

People Who Are Subcontracted Employees

It is important to understand that if you are a subcontracted employer you are not covered under that particular employer's compensation plan. You may be covered under one that is offered through the company that hired you, but the company that you are working for is not responsible for you. Make sure that you know who has your workers compensation insurance policy if you are a subcontracted or a temporary employee.

People Who Are Not Performing Job Duties

If you take a company truck home and you get in an accident when you are off of the clock, your workers compensation policy will not cover it. In order to be covered by workers compensation, you must be working, you can't be off the clock and just hanging out, they aren't going to cover it. Understand this so that you are aware of when you should make a claim through this insurance.

People Who Are Under the Influence of Alcohol or Drugs

If you get hurt on the job and you are under the influence of alcohol and drugs, they aren't going to cover you with a workers compensation policy. The one thing that is specifically excluded on a workers compensation policy, and something that in most cases will almost guarantee that your claim gets rejected, is being affected by drugs or alcohol.

Knowing who is covered under a policy is very important. You want to make sure that you are well aware of the rules that go into a workers compensation policy so that you are familiar with it. You need to know what is covered and what isn't and who is going to be covered so that you are set in case you need to make a claim and know what you should make a claim for.

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Worker's Comp - How to Handle Your Employers

In the unfortunate event you should suffer an injury on the job, you may find comfort from co-workers who send their sympathies. You would hope, too, that your employers would understand your need to recover and the time involved. Sometimes, though, some workers have found that their bosses are more concerned about time and money lost to the company because of your injury. You may have done everything right with regards to filing for Workers Compensation, but depending on the nature of your injury you may discover your relationship with superiors is altered.

It's important to recognize that your company can dispute your claim if your bosses feel there is no cause to cover your injury. You work for a business, and as such you are responsible for helping your business remain solvent and profitable. When you become hurt on the job and are removed from the workplace, the company risks losing money and productivity, and should it be determined that your compensation claim is legitimate more money is spent to cover your bills. As more claims are paid out, your company may end up paying higher insurance premiums. Therefore, there is the chance that your workplace may challenge your claim if:

They feel your injury is not as serious as you claim it to be. They feel your injury occurred as a result of a pre-existing illness or injury that happened outside of work. They feel you do not require too much time to recover in hospital or at home, and can return to work.

What do you do? You may feel hurt or discouraged, and equate a challenge to Worker's Comp claim as an inference that you have not been truthful about your injury. One thing you do not want to do is arouse your employers' suspicion or ire, especially if you plan to continue working for the company. You will want to remain calm and consult with a personal injury lawyer with regards to your next steps:

Verify your injury through physician reports and X-rays where applicable. Your lawyer may wish to meet with co-workers who were witness to your injury in order to support your claim.

It is important, while your claim is still under consideration, to remain professional in the workplace and around supervisors and co-workers. If you are able to return to work before the claim is accepted or denied, perform your tasks to the best of your ability and try not to discuss your situation. Listen to your attorney, too, for he/she is there to help you get the compensation you need.

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Workers Compensation for the Employer - What to Do in the Event of an Accident

No matter how many precautions you take, no matter how much you implement the best safety program you possibly can, accidents are inevitable and a reality for all businesses that require some amount of physical risk to be taken by the employee. In the events after an accident, there are a lot of things you can do to speed up the claim and investigation process to make it easier on everyone involved. Here are some simple things you can do to help expedite the process and help your employee recover and return to work faster.

First of all, never try to dissuade your employee from filing a claim. It's true; some employers attempt to bully or frighten their employees into not making a claim. Resist the temptation to do this. This would put you in a very vulnerable position at a later date should an employee decide to take legal action against you outside of the parameters of workers compensation insurance claim. Never do this it's just not worth the risk.

By law, you are required to cooperate fully with the injured employee and all parties involved, so be very careful and cooperate as much as you can or you run the risk of being accused of trying to hinder a claim. There is always risk just after an accident when you may feel the temptation to be less cooperative in general; it's a natural instinct to feel that you may be incriminating your self if you do cooperate fully, however, nothing further could be from the truth.

Your involvement is very important since you carry first-hand pertinent information of the event in question. In fact, it's in your best interest to welcome and allow any investigation and participate as much as you can. After all, your business is insured with workers compensation insurance. Keep in contact with your injured employee on a regular basis; be obliging and cooperative as much as you can. Make sure that your employee is following through with their claim and find out what's happening throughout. You do not want to generate a, them and us situation.

Another thing to consider here is that you could actually learn a lot through this whole process which can help the resourceful business owner avoid unnecessary accidents in the future. The truth is no employee really wants to suffer an injury. Often from time to time, concerns will come up from your employees and they will want to discuss these issues with you regarding hazards in the workplace. Listen to them and ease their concerns by taking action. Make approaching you about these concerns easy and worry free, try to introduce a policy of no repercussions if an employee brings to your attention a problem that you may not be aware of. Never make employees afraid to come to you with their concerns.

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Can I Claim Workers Compensation And Social Security

Disability insurance benefits through workers compensation and Social Security benefits can work together provided that they meet certain guidelines. For some the hassle may seem very difficult to understand. This is a general article about an overview of the two topics.

Workers compensation is when employees are injured at work and benefits are given out for disability or injury. Rules are different in each state and they do affect your Social Security benefits. Workers compensation is administered bureaucratically in the United States through state government. Hence, when you combine the two payments, things can get really complex legally. General requirements are required before you can qualify for each benefit, and the law makes a good screening effort before it will provide you any compensation payments.

You have to be eligible for both in order to receive benefits from workers compensation combined. However, your compensation disability benefits might be reduced. The reason it's reduced is because there is a clause that says that the total benefits from disability either in workers compensation or Social Security cannot go over the limit of 80%. This number is seen in disability insurance as cap on benefits. There is a formula for figuring out your current earnings, to determine if you are eligible. The figure 80% place into effect all other types of disability payments that person is currently receiving.

For example, you need to report certain payments to the social security administration, which will affect your disability payments. If your workers compensation program benefits finish, for example, the payments may increase to compensate for your living needs. Of course, there are exceptions to this rule. There is an age limit to when you can receive disability benefits alone, and this limit may adjust your disability pay.

To throw an extra wrench in the mix, social security laws and disability benefits may have different requirements from state to state. This is because every state has its own different workers compensation laws. However, Social Security is a federal program, so there is the interaction of federal and state laws. That's why you may need a good lawyer to review the numbers before you submit any claims. Again we're not giving legal information. A lawyer will be able to examine the law code in depth, along with benefit requirements that are specialized information. He may also be able to advocate for you in a unique situation, should you need to appeal your social security case.

Social Security and workers compensation are both complex legal structures that need to be dealt with professionally. This is a disclaimer saying that we're not giving any legal or professional advice, and is merely a general audience article. If you need assistance, it is necessary to find a good attorney. You should not try to get through the paperwork by yourself if you do not have expertise. Finally, this general article is not responsible for any incorrect information, and situations will vary from state to state.

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