• You were on the job when injured
• You were not on alcohol or drugs when injured
• You did not cause the injury to yourself on purpose

Your employer may try to influence you to seek treatment under other insurance programs. Using other insurance to treat a work injury is illegal!

If you fail to file a claim and lose time from work as a result of your work injury you will not receive any Worker's Compensation disability pay. If your work injury results in permanent injury that causes you to take a lower paying job you will get no wage replacement benefits. Filing a claim assures you that ongoing treatment for permanent injury will be paid for by Workers' Compensation.

What's Wrong?

Some patients with spinal complaints believe that their pain is the problem. It is not. What's wrong is the condition that caused the pain. This is usually a failure of the spine to function properly. This can come on gradually over time, or begin suddenly with an injury.

Which Doctor Should I See For Treatment?

Your employer may suggest that you must be treated by a certain doctor, possibly not a chiropractor. This is improper and illegal! Nobody can force you to be treated by any particular doctor. The choice of which doctor you see the treatment of your work injury is yours alone, guaranteed by law. If anyone tries to make you see a certain doctor, demand that they put that in writing. If they will not do so you have your answer. Even in cases where the employer uses a "managed care" plan for Worker's compensation, you still have the right to consult any doctor you choose for your initial treatment.

If a company doctor treats you at the plant you are not obligated to be treated by that doctor alone. You retain the right to consult any other doctor - outside of the plant doctor - for addition examination and/or treatment.

While you can visit any doctor for the treatment of your work injuries. You cannot see two doctors of the same discipline at the same time, i.e.: two different chiropractors (DC) or two different MD's. But it is permissible for you to be treated by two doctors of different disciplines at the same time, i.e.. a chiropractor (DC) and a medical physician (MD) for the same complaint. You can also be treated by a chiropractor and physical therapist (who works at the prescription of the MD) at the same time.

What Are My Responsibilities?

• You must report your injury to your employer. You should be certain it is written down. Obtain a copy of that written injury report if possible and save it. Verbal acknowledgment of injury are often forgotten. This can cause trouble late. There must be a written report of your injury. If your employer does not have or will not create such a written report, you can create one yourself by filing a C-3 form. This is a special State form for injured employees to report an injury. It is available from the NY State Workers' Compensation Board or from your doctor's office.
• Carefully file all paper's regarding your case: Various forms pertaining to your case will be sent to you. These papers contain important information. Share various forms or letters that come to you with your chiropractor. Your file of Workers' Compensation papers will become more important with time. You may need them for court. Paperwork can go on for years.

What About Insurance Company Examinations?

• Your right to necessary treatment is assured by law. However, the insurance company or your employer has the right to have you examined by their doctor. You must keep the appointment for this examination. If you fail to keep the appointment for this examination by the insurance company doctor, the insurance company may cause your case to be "closed" for "failure to prosecute." That means you failed to do your part. This will affect payment for your treatment and your disability pay. Again, you must keep every appointment the insurance company makes for you to see their doctor for an examination.
• You have a right to obtain a copy of the report from the insurance company examining doctor. Ask or write to the insurance company for a copy. If you find serious errors in that report you can correct them by creating a notarized letter to the Workers' Compensation Board. Your letter should point out the errors and correct them.
• Your treatment appointments are recommended to obtain the maximum benefit in the shortest possible time. If you miss your treatment appointments your case may be jeopardized. Remember, each case must eventually be decided by a judge. It is difficult for a judge to believe you have a problem if you fail to treat.

Things To Watch Out For

• You may receive a form from the insurance company that says in bold print "Notice that need for medical care has terminated or authorization for medical care has been refused." This for may frighten you into thinking that your tight to further treatment has ended. This is not true. This form represents nothing more than the insurance company's opinion. It is not binding. Only a Workers' Compensation judge can end your treatment.
• You may receive a phone call or visit from an individual that works for the insurance company. This may be a claims adjuster, a "rehabilitation nurse," a "human resource manager." This individual may suggest you see certain doctor(s) for treatment. If this happens, ask for that request in writing. If it is not in writing it is not binding.

What If I Need A Referral To Another Specialist?

If you need referral to another specialist for examination or treatment, your chiropractor has the training to recognize that need and respond to it. If you have any questions, ask your chiropractor's opinion.

How Long Will I Need Treatment?

Some injuries clear up in a few weeks or months. Others take longer. In some cases there is an element of permanent injury that causes chronic residual symptoms or recurring episodes. In those cases a patient may require some sort of supportive treatment for years.

Disability Pay

• Disability pay is not paid for the first 7 days you are off work. However, if you are off work for two weeks and one day (11 working days) you will receive disability pay for all your lost time.
• You are entitled to receive up to 2/3 of your average weekly wage over the 52 weeks preceding the injury up to a maximum of $400 per week. However, this amount may be modified by the court after considering the facts in your case.

What About Returning To Work? "Light Duty"

• The body heals better if you are engaged in meaningful activity that does not re-injure it. An early return to work with light duty is better than many weeks or months out of work. Because disability benefits are always less than you usual wages, staying home can become expensive as well. The scientific literature advises that an early return to work with light duty is the best approach.
• If you are off work, your primary task is to get better. If you are inactive you may begin to weaken and gain weight. Avoid this. Regular exercises, from walking to yoga, within you tolerance, are strongly recommended. These should be done several times each day. Your chiropractor will offer suggestions.

What If I Should Fail To Recover Completely?

The first objective of treatment is to restore you to your pre-injury status. If you continue to experience residual discomfort, that will be documented by your chiropractor's reports to the Workers' Compensation Board. If time shows that you have some degree of permanency, that will also be reported. Any need for ongoing treatment will be documented by your chiropractor. The court may allow it, modify it, or disregard it as it sees fit.

Do I Need A Lawyer?

The Workers' Compensation law guarantees you the right to hire a lawyer at no (direct) charge to yourself. The lawyer will be paid from any benefits that come to you. So if you are not working and there are some funds coming to you, an attorney will likely take your case. If you are working there will be no cash benefits coming to you. It will therefore be difficult to find an attorney who will take your case. Many claimants do quite well without a lawyer. If you are un represented, the judge, in effect, becomes your lawyer. However, if you are off work and are having trouble getting disability pay-or you are having trouble with your employer - a lawyer can be of great help.

Going To Court

Your case will eventually come before a judge or a conciliation officer. Each reviews the facts of the case. You may or may not have to appear personally. You have the right to reject ay proposed conciliation agreement. If so, your case will be decided by a judge. The judge is impartial and is interested in seeing that you are fairly treated. Be certain to bring accurate records of all the time lost from work. Answer all questions truthfully and briefly. Think before speaking. You must accept a judge's decision or appeal it. You can appeal with a letter to the Workers' Compensation Board that sets forth the reason for your appeal. Be certain to include your WCB case number. If you appeal fails, the judge's decision stands.

Persistence Needed!

Worker's Compensation benefits are guaranteed by law but must be pursued with a certain degree of vigor and discipline. If you fail to receive disability pay or if your treatment is interfered with in any way, you can write to the Workers' Compensation Board, seeking a court hearing to address that issue. If you disagree (for good reason) with a court ruling in your case, you have the right to appeal that decision with a notarized letter to the Workers' Compensation Board stating the reason(s) why you wish to appeal that decision.
© 2003, The NY Completter

Let Dr. Swick find, diagnose and treat your subluxations today. Restoring the proper nerve function to the spine is the key to better health. Fix the vertebral subluxation and the body will start healing itself, if left untreated the problem could deteriorate to the point where it cannot be treated. Swick Chiropractic Center specializes in drug free treatments. Call and make an appointment for a free consultation today, call (315) 655-8008.

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