Posts From April, 2022

How Does Workers Comp Pay Doctors

Many times, the question of how workers comp pays a doctor is asked by a client involved with a workers comp claim. Many times a doctor who sees a workers’ compensation patient will be hesitant to see them. The reason is that getting the payment for providing treatment will not be easy. Often, a call to the insurance company may not be answered. The doctor will likely not have any claim documents available to submit.

Not being able to contact the insurance may even make matters worse, such as the bills remaining unpaid and the patient requiring follow-up. Often, a doctor will not blame the patient and continue to provide necessary treatment. For the doctor to be paid by workers comp, there are a few things to be aware of first.

Being Familiar with the Workers Comp Fee Schedule

Many states may have a workers comp fee schedule that doctors must follow regarding procedures they conduct. The fee schedule represents the max amount chargeable to the patient. If the cost is higher than a fee schedule amount, it will likely be cut in half. When a doctor makes a claim for payment, it must be made using form UB-92 or CMS 1500. If a dispute arises, they must have it settled with their state agency covering Workers’ Disability Compensation.

Requesting Payment from Private Insurance

If your workers’ comp patient uses their private insurance for treatment, then submitting a payment claim directly to the insurance carrier can be made. Ensure that the dispute form is obtained by the doctor conducting the treatment. When a settlement is received, the patient will be responsible for the payment.

Getting Ahold of the Attorney for the Plaintiff

As you give the patient’s attorney a call, it must be understood that you should cooperate with them as much as possible. Make sure that the claim forms are completed fully and have appropriate medical documents along with them. By submitting the claim forms in full, the doctor is able to be fully paid what they are owed. Refrain from charging for administrative processes, which may slow the process. Forgo making any collection effort against the patient. This will only lead to a recovery amount that will be significantly less. It is essential to have the medical bills protected as part of the case.

Discounts should be sought by the doctor seeking payment and have the payment sent to them out of any settlement amount. A lot of times, when a discount is negotiated, it will be a higher amount than what the fee schedule will state. Frequently, a doctor will need to provide an opinion concerning disability. When these opinions are obtained, the doctor will be compensated. Despite this, it is essential that the fees are not in excess because it may delay obtaining an opinion.


When a doctor needs to see a workers comp patient, there may be several stressful situations for the doctor as they try to get paid. By getting ahold of us today, we will explain the entire process of getting paid from workers comp.

  • Posted on: Apr 29 2022
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Should You See An Attorney or Doctor First Concerning your Injury

Following the contact of your employer concerning your injury, you should also be in contact with an experienced workers comp attorney. As you talk to the attorney, they will be able to review your case and advise you of your options. You should understand that both the workers’ comp insurance and your employer are not obligated to assist in your case or ensure that you are protected.

Experiencing an injury at work can cause the employee more stress than they should be experiencing. Plus, having this stress on top of the pain that is present will only make matters worse. When an employee is waiting to hear back concerning their workers’ comp claim, they will not be earning a paycheck due to being out of work. Often, a claim will get denied when it should have been approved. This is due to the insurance provider not wanting to pay a claim. Also, if the injury claim is not as simple as others, then you need to have representation that has your interest in mind.

An employer and claim adjuster does not have your interest in mind. This is why you should contact an experienced workers comp attorney to handle your case. A lot of times, an adjuster will manipulate the case by using their in-depth knowledge of the law surrounding workers comp. When you have an attorney evaluating claims on a daily level, they will be able to ensure that the compensation you obtain is fair.

Regardless of having an adjuster’s word of being fair, you need to have great legal representation to have a truly fair case. You should explain to your attorney all of the details surrounding your accident and injury. The attorney will be able to decide if legal representation will be warranted. Your appointment with your attorney needs to be done so that you have a basic understanding of the rights you have. Although you may not always need an attorney to help with your claim, you should find out what certain rights are available.

Getting ahold of an attorney specializing in workers comp will make your entire claim process much easier to understand. It can even help the claim get approved quicker. You will also have an idea of what to expect shortly after submitting your claim.


When you have a work-related injury, you need to get ahold of an attorney to advise you and a doctor in regards to your injury. As soon as you do, you can get your claim process started. By getting ahold of us now, we will also quickly go over your injury to ensure that you are treated so that you can heal and return to work.

  • Posted on: Apr 15 2022
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