{"id":167216,"date":"2023-05-15T02:00:00","date_gmt":"2023-05-15T02:00:00","guid":{"rendered":"https:\/\/www.mtmic.com\/blog\/?p=167216"},"modified":"2023-11-08T01:35:09","modified_gmt":"2023-11-08T01:35:09","slug":"everything-has-a-cost","status":"publish","type":"post","link":"https:\/\/www.mtmic.com\/blog\/2023\/05\/everything-has-a-cost\/","title":{"rendered":"Everything Has a Cost"},"content":{"rendered":"\n

By Donna Motley, Vice President of Claims<\/em><\/p>\n\n\n\n

Seems like \u2013 what used to be simple, is not so simple anymore! Procedures are established for a reason \u2013 to simplify things!<\/p>\n\n\n\n

In an ideal world, when an employee is injured at work, the injury is reported to the Supervisor, Safety Representative and\/or Human Resource personnel. A claim is filed on the appropriate forms with your Workers\u2019 Compensation carrier (MTMIC !). The employee is sent to the Occupational Clinic where treatment is rendered; the injured worker may be referred to a specialist. The injured worker will treat until the injury is resolved, then discharged from care, and the employee is released back to work. The steps seem pretty cut and dry and while medical care is not considered \u201ccheap\u201d by any means, Michigan Workers\u2019 Compensation includes a fee sched-ule resulting in 40-60% savings on most medical bills. As an employer, I\u2019m sure you are astounded at times, when you see the dollar amount spent on some work related injuries.<\/p>\n\n\n\n\n\n\n\n

There are \u201chidden\u201d costs. When I say \u201chidden\u201d I mean there are costs associated not related to actual medi-cal \u201ctreatment\u201d. When injured workers take it upon themselves to treat with their primary care physician, our office has to then request the primary care physician medical records. Approximately 50% of the time, the primary care physician will charge a fee for the records. (As a side note \u2013 this also delays treatment for the injured worker.) When an injured worker sustains an injury or an aggravation to a body part for which they sought treatment in the past, our office has to request the medical records covering the past treatment. Again, there is usually a charge for the past records. When past treatment involves a hospital, there is always a charge for medical records.<\/p>\n\n\n\n

If the injured worker does not speak English and there is no family member to interpret for them, we have to hire a translator. <\/p>\n\n\n\n

Per the Workers\u2019 Compensation Act, injured workers are compensated for mileage to and from medical appoint-ments. If the injured worker does not have a driver\u2019s license, does not have a vehicle, or does not have some-one to transport them to the medical appointments, we pay for transportation through a service company.<\/p>\n\n\n\n

When a motor vehicle accident occurs in the course of employment and a claim is filed with the auto carrier, the auto carrier will pay bills and services without question and then subrogate against the Workers\u2019 Compensation carrier. If the injured worker and\/or their auto car-rier file a lawsuit against the other vehicle involved in the accident, the Workers\u2019 Compensation carrier is entitled to file a lien against monies paid to the injured worker. However, typically if we are able to collect, it is usually only cents on the dollar; and if settlement is made to the injured worker to compensation for \u201cpain and suffering\u201d, Workers\u2019 Compensation recoups nothing as Workers\u2019 Compensation does not pay for, or cover, \u201cpain and suf-fering\u201d.<\/p>\n\n\n\n

In serious injuries where the injured worker cannot care for themselves at home (i.e., they live alone, they don\u2019t want attendant care in their home, they cannot ambulate steps, etc.), Worker\u2019 Compensation would have to send the injured worker to an in-patient Rehabilitation facility until they are discharged and able to care for themselves in their own home. <\/p>\n\n\n\n

If an employer is not able to accommodate light duty restrictions placed on the injured worker by the treating physician, Workers\u2019 Compensation has the authority to place the injured worker in \u201ctransitional work\u201d. Tran-sitional work can be minimum wage employment or an assignment with a charity. Workers\u2019 Compensation continues paying the wage loss benefits to the injured worker and a fee is charged by the company finding and arranging the restricted or light duty work.<\/p>\n\n\n\n

And finally, in cases where the injured worker has insurance coverage through Medicaid or Medicare, and medical bills for treatment have been processed through Medicaid or Medicare, by law, Workers\u2019 Compensation has to reimburse said entities at 100%.<\/p>\n\n\n\n

It is a positive for the injured worker that these accommodations can be accomplished, but the price of same is over and above the actual medical treatment of the injury. As we age, it seems everything gets more compli-cated!<\/p>\n","protected":false},"excerpt":{"rendered":"

By Donna Motley, Vice President of Claims Seems like \u2013 what used to be simple, is not so simple anymore! Procedures are established for a reason \u2013 to simplify things! In an ideal world, when an employee is injured at work, the injury is reported to the Supervisor, Safety Representative and\/or Human Resource personnel. A…<\/p>\n","protected":false},"author":1,"featured_media":167218,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[1],"tags":[],"class_list":["post-167216","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-uncategorized"],"jetpack_featured_media_url":"https:\/\/www.mtmic.com\/blog\/wp-content\/uploads\/2023\/11\/iStock-1189596119.jpg","_links":{"self":[{"href":"https:\/\/www.mtmic.com\/blog\/wp-json\/wp\/v2\/posts\/167216","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/www.mtmic.com\/blog\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/www.mtmic.com\/blog\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/www.mtmic.com\/blog\/wp-json\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/www.mtmic.com\/blog\/wp-json\/wp\/v2\/comments?post=167216"}],"version-history":[{"count":1,"href":"https:\/\/www.mtmic.com\/blog\/wp-json\/wp\/v2\/posts\/167216\/revisions"}],"predecessor-version":[{"id":167219,"href":"https:\/\/www.mtmic.com\/blog\/wp-json\/wp\/v2\/posts\/167216\/revisions\/167219"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/www.mtmic.com\/blog\/wp-json\/wp\/v2\/media\/167218"}],"wp:attachment":[{"href":"https:\/\/www.mtmic.com\/blog\/wp-json\/wp\/v2\/media?parent=167216"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/www.mtmic.com\/blog\/wp-json\/wp\/v2\/categories?post=167216"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/www.mtmic.com\/blog\/wp-json\/wp\/v2\/tags?post=167216"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}