Coordination

Coordination of Benefits
The accident that you had or the occupational disease or illness that lead to your workers compensation claim, may be so severe that you become entitled to social security disability benefits or disability benefits through a disability policy. If that is the case, it is necessary that your workers compensation settlement is properly apportioned over your lifetime so that any offset against the disability payments is minimized. At Dean Law Office, LLC we make certain that your workers compensation case is settled in your best interest.

If you are now covered or when you are covered under Medicare, you may be denied Medicare benefits for work-related injuries. It is important that future medical be left open or that a medical savings account be established to cover future medical benefits due to your on-the-job accident. If any of your bills were paid for by Medicare or Medicaid or under your group health insurance, they will seek reimbursement.

Make the Most of Every Doctor’s Visit
Every doctor is extremely busy so you need to maximize the time you have with the doctor. If you are having problems, be prepared to tell the doctor what the problems are. Think about the words that best describe your problems ahead of time. If you have questions about your treatment, it is helpful to write out the questions ahead of time.

Case Managers: Blessing or Curse?
Often the insurance company will assign a case manger to your workers compensation case. Generally, the case manager is a nurse. The case manager can be a benefit or can be an obstacle to getting medical care and in aiding in your recovery.

Case managers often request permission to be in the examination room with you. The case manager has no right to be in the examination room and it is your option to decide whether you want the case manager in the examination room. Unless you decide otherwise, you and your doctor should be the only individuals in the examination room.

Always remember that the case manager works for the insurance company or employer.

The case manager can be helpful in scheduling appointments especially in cases where you are seeing a number of specialists or need numerous tests.

Companies that provide case managers generally mention as a benefit to the insurance company or employer that a case manager can control costs. One way a case manager can control costs is by advocating an early release. For example, the doctor may want four additional weeks of physical therapy. If the case manager can convince the doctor that three additional weeks of physical therapy is good enough, the case manager has just saved the employer or insurer some money. If you need the four weeks of physical therapy, you haven’t benefited from the case manager’s tactics.


Copyright © Dean Law Office LLC, 2010

Margaret Dean 816-753-3100