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FAQ
  FAQ
What happens in the ordinary case?
 
Answer:

In the ordinary case, the worker immediately reports an injury to his or her immediate supervisor. If the problem is not the result of a single event but rather caused by exposures or repeated events that happen over a period of time, the injury is reported to the immediate supervisor as soon as the worker is aware that there is any problem and that the problem might be caused or related to the employment.

 

Depending upon the facilities available, the worker is either seen at the company first aid station or medical department or referred to a private physician or other medical facility. At this point the company doctor or the private physician takes responsibility for the ongoing medical care of the injured worker. If the help of a specialist or hospitalization is needed, the proper arrangements are made.

 

If it appears that the disability will last for more than one week, the employer files an Employer's Basic Report of Injury (Form WC-100) with the Workers' Compensation Agency.

 

If the employer is insured, its insurance company is informed of the situation. If it is a self-insured employer, it may handle the problem through its workers' compensation department--either at the local plant or at the company headquarters--or it may refer the case for management to a "third-party administrator." This is a separate company that specializes in handling workers' compensation claims for self-insured employers.

 

When the worker has been off for a week, the company begins the payment of workers' compensation disability benefits. The payments are made by the self-insured employer or the insurance carrier to the injured worker. Payments are not made by the state or the Workers' Compensation Agency. The employer or insurance company does report to the agency that it has begun paying benefits.

 

If disability lasts for an extended period of time, the employer may request that the worker be examined by special physicians to evaluate his or her condition. The employer may offer, or the worker may request, vocational rehabilitation services.

 

Payments to the doctors and hospitals are ordinarily made directly by the employer or its insurance company to those providers of medical services.

 

When the worker recovers sufficiently, he or she returns to work. In many cases the worker is given some restrictions when he or she first goes back. Often this will be a limitation on how much the worker can lift but many other factors can be involved.

 

When the worker returns to full wages, benefits stop and the employer files a Form WC-701  with the agency reporting that benefits have ended.


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