Does Your Injury Qualify For A Workers Compensation Claim?

does your injury qualify for a workers compensation claimWhen you feel a sharp pain in your back after a box lift, a reasonable person would know it was caused by the heavy load. A doctor diagnosed a sprain so how does one prove their injury was actually from the heft?  Does your injury qualify for a Workers Compensation claim?

When filing a Worker’s Compensation claim, the connection between an injury at work and the specific condition must be clearly made. The Office of Workers’ Compensation Program (OWCP) has strict requirements about what must be specified in order for claims to be accepted.

The case may become more challenging when the worker is unclear. Workers Compensation claim examiners use documented factors in order to determine whether an injury resulting from work is indeed compensable. One of these factors is the dog bite case which can be determined by both parties involved with this issue.

When you’re injured, things aren’t as clear for those who put their bodies on the line. That is why filing a claim as soon as possible after an injury is important. OWCP claims specifically require that you provide evidence that your work caused your injury and to find a doctor both DOL certified and experienced with your type of condition will boost your chances of success even more!

An Occupational Disease and Compensation Act Claims examiner is trained to ask the following questions when evaluating the doctor’s evidence to prove this causal relationship.

Along with the intricate details of the work environment and situations surrounding injuries, there are some things needed to write a medical report that will be acceptable for your workers compensation OWCP claim.

To formally state that a Worker’s Compensation claim exists, the medical opinion must be well-reasoned and well-rationalized. The doctor must use objective evidence such as examinations, lab tests, X-rays, MRI, etc to explain how the injury was caused by work factors. It isn’t enough to document symptoms; rather, the demonstration of the condition must be supported by accompanying medical testing. For example, when diagnosing a back sprain in order for OWCP claims to exist and states.

With an injury experienced by a Department of Labor (DOL) worker resulting in musculoskeletal pain, the opinion of a medical expert will more likely be counted. If the spine is misaligned, it is important to get this documented with an X-Ray. OWCP only accepts medical opinions by doctors, not physician’s assistants or nurse practitioners. However, there are some urgent care facilities and hospitals staffed by physician’s assistants and nurse practitioners that can diagnose these injuries.

When making a qualification for a worker, the physician must take into consideration any preexisting conditions that could be related to a current injury. The OWCP regulations allow a claim to be approved even if the condition was aggravated by work conditions as long as it is compensable. It is important to discuss this beforehand with the physician.

When it comes to Workers Compensation claims, you want to make sure that the doctor’s opinion is certain. According to OCWP standards, reasonable medical certainty– not absolute certainty– is enough to satisfy an OWCP claim. The doctor should also not use language like “may” or “could” in order to avoid sounding speculative.

Ensure the next step in your treatment is covered entirely. Make sure to communicate with your physician and double-check for accuracy. Reviewing a doctor’s report could help avoid any future problems with the claim process.

Being able to document your injuries from the time they occur will help you avoid pitfalls that may jeopardize your worker’s compensation benefits. Upload your medical report as quickly as possible to avoid these traps.

Have questions?  Please contact us.