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Workers' Compensation Employee Medical Guide : How To Receive Appropriate Treatment Under Any Workers Compensation System in the United States. - Softcover
Synopsis
This no-nonsense guidebook was written specifically for workers from the perspective of an experienced occupational medicine physician.
The book is unique in the fact that there is currently no other book on the market that covers all of the important medical issues of workers' compensation in such a comprehensive fashion.
Workers will learn:
-The basics of workers' compensation law and when to seek legal counsel.
-How workers' compensation determines work-relatedness.
-How to deal with managed health care.
-How to prepare for the Independent Medical Exam.
-How to access personal health and safety records.
-How to get assistance from local and national affiliation labor unions.
-How be protected when returning to work.
-When to seek compensation outside of the workers' compensation system.
This book gives workers the knowledge that they need in order to receive the most appropriate treatment for their work-related injuries and illnesses.
"synopsis" may belong to another edition of this title.
About the Author
David F. Scaccia, D.O., M.P.H., received his bachelor degree in psychology from the University of Connecticut, medical degree from the Philadelphia College of Osteopathic Medicine, and Master of Public Health degree in Occupational Medicine from the Medical College of Wisconsin. He is also a U.S. Naval Flight Surgeon graduate of the Naval Aerospace Medical Institute and NASA Flight Surgeon Training Course.
Dr. Scaccia (pronounced "SKASH-sha") is board certified in occupational medicine by the American Board of Preventive Medicine and board certified in family practice by the American Osteopathic Board of Family Practice. With more than fifteen years of experience, including the directing of occupational and aerospace medicine for major US industry, Dr. Scaccia has personally treated thousands of work-related injuries and illnesses.
From the Back Cover
Medical/Self Help/Reference
Confused and Frustrated by Workers' Compensation?
As a worker you will learn this and much more:
-The basics of workers' compensation law and when to seek legal counsel.
-How workers' compensation determines work-relatedness.
-How to make managed health care work for you.
-How to prepare for your Independent Medical Exam.
-How to access your health and safety records.
-How local and national affiliation labor unions can help you.
-How to protect yourself when returning to work.
-When to seek compensation outside of the workers' compensation system.
Dr. Scaccia is board certified in occupational medicine by the American Board of Preventive Medicine. He has more than 15 years experience directing large occupational medicine clinics for major industry.
Workers' Compensation Employee Medical Guide gives you the knowledge needed to receive the appropriate treatment you rightfully deserve.
Excerpt. © Reprinted by permission. All rights reserved.
Chapter 1 (sample) Workers' Compensation Law Review
Overview
In this chapter, we will review the general principles of workers'compensation law that are found in all systems. It is very important for you to have a good "working knowledge" of these general principles whether or not you are currently being treated for an occupational injury or illness.
Throughout this book, we will use certain conventions. Since your employer is ultimately responsible for your workers'compensation benefits, we will reference your employer as the point of contact for these benefits. In a large company, you will usually deal with the workers' compensation administrator in your human resources office. This person acts as an intermediary between you and the insurance company. He or she should be able to answer questions and assist you in processing your claim. In a small company, you may deal directly with the workers' compensation insurance adjuster. Keep in mind that your employer, unless self-insured, is an entirely separate business from the insurance company.
We will also reference a number of federal laws that are important to you as a worker. In some instances, these federal laws will be replaced with state or other governmental laws. These laws, however, will be at least as stringent as the federal versions.
Workers' compensation laws.
The laws, as they currently exist, are the result of a historic compromise that took place between employers and employees. That compromise established what is commonly referred to as the "no- fault" workers' compensation insurance program. Simply stated, if you suffer an injury or illness that "arises in and out of the course of employment," you will be guaranteed timely and appropriate compensation from your employer for your:
-Medical bills and related expenses (e.g., medical related travel).
-Time lost from work.
-Any permanent impairment if the applicable law provides for a separate permanent impairment award.
In the case of a fatality, your survivors will receive the appropriate death benefits.
Your employer may either "self-insure" or provide this benefit through an insurance carrier.
The important point here is that you do not have to prove that your employer was at fault for your injury or illness. In return, your employer is granted immunity from any further legal action in the form of a lawsuit. Except in unusual instances, you cannot seek damages from your employer for:
"Pain and suffering."
"Punitive damages."
Generally speaking, this is the "law of the land" in the 50 United States and in all of its territories including:
-America Samoa.
-Guam.
-Puerto Rico.
-The U.S. Virgin Islands.
There are some important exceptions to using only the workers' compensation system and these will be addressed later in the book. However, for the vast majority of cases, compensation is handled exclusively through the workers' compensation system.
As stated previously, there are workers' compensation laws in all fifty of the United States as well as its territories. There are also separate U.S. Federal and District of Columbia workers' compensation laws that cover:
-Workers in the District of Columbia under the District of Columbia Workers' Compensation Act.
-Federal workers under the Federal Employees Compensation Act (FECA).
-Longshoremen and harbor workers under the Jones Act. This covers both public and private workers who do maritime work.
-Mine workers under the Federal Black Lung Act and the Social Security Administration.
-Merchant marine and railroad workers engaged in interstate commerce under the Federal Employer's Liability Act (FELA).
-Military veterans under the Veterans' Administration (VA).
It's important to realize that there is no single "national" workers'compensation set of laws. The various state and federal systems all have separate laws. There are, however, more similarities than there are differences. Throughout this book we will concentrate on the general principles of workers' compensation law that are found in all state and federal systems.
Coverage.
Almost all employees are covered under some kind of workers' compensation system. However, employees that are not commonly covered - as defined by statute - include:
-Some farm workers.
-Most domestic service workers.
-Certain "casual" employees.
Some workers' compensation systems also do not cover other specific types of employment.
Exclusions.
Workers' compensation generally will not cover you if your injury or illness:
-Was self-inflicted.
-Occurred under the influence of alcohol or drugs.
-Occurred while violating company policy.
-Occurred during a fight at work.
-Occurred while committing a serious crime.
Benefits provided.
As stated previously, if you suffer a work-related injury or illness, you will be guaranteed appropriate compensation for your medical bills, time lost from work, and any permanent impairment if it exists. Your medical bills are paid, with no deductible or co-pay required from you, as long as you follow the rules of the workers'compensation system. Health care providers may be subjected to approved fee schedules and frequency of treatment guidelines. Otherwise, there are generally no specific dollar or duration of treatment limits for your active and ongoing worker's compensation case.
Defined payments are made for certain "scheduled" conditions involving:
-Loss of function.
-Loss of a body part.
-Disfigurement.
Payments are made even if there is no lost work time. With a "scheduled" condition, future wage loss is presumed and compensation is specified by law. The payments, however, may be offset against any weekly compensation benefits that have already been paid.
Workers' compensation systems are now also providing benefits for vocational rehabilitation or "voc rehab." These services are offered to you if you are permanently unable to return to your regular job. The goal is to retrain you for a new job so that you can again join the workforce. If you do not accept vocational rehabilitation benefits, you may suffer a loss or reduction of your workers' compensation benefits.
Coordination of benefits.
As a general rule, workers' compensation benefits are coordinated with:
-Social Security benefits.
-Payments under a disability insurance policy provided by your employer.
-Employee pension or retirement payments....continued
"About this title" may belong to another edition of this title.