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Workers Comp/Workplace Incident - California California

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  • Workers Comp/Workplace Incident - California California

    I was told about an incident this morning that did not involve any of our employees, so I'm not involved with the details. But I was told an employee was injured at work and went to the local care facility. The employee was given a prescription for medication that the employee happened to already have at home. The employer representative examined the prescription and asked the doctor to take back the prescription due to this fact.

    I'm bothered by this. Had it been one of our employees, I would have been very unhappy to hear this as I feel it is an invasion of privacy. Is that the case? Does this employer have any right to know what was prescribed and to ask the doctor to do so?

  • #2
    The employer representative is out of line on this.
    The employEE (presumably) filed a First Report of Injury/DWC-1 with the employER.
    The EE was then directed where to seek treatment, as required by the provisions in the labor code, where there is a MPN/Medical Provider Network in place by the employer/carrier.

    That is the process. The ER is required to file a claim with their carrier where there is any injury that requires more than basic first aid, and/or time loss.

    After that, the ER has no input in the claim. ER has no ability to control the medical treatment, those are medical decisions, to be made only by a Dr/PTP... Primary Treating Physician. Once the claim is filed with the carrier, the CA/Claims Adjuster takes over as the "employer" for the duration of the claim.

    As an "hrstudent", it would serve you well to be familiar with the DIR/Dept of Industrial Relations, DWC/Dept of Workers Compensation fact sheets for employers/employees available here http://www.dir.ca.gov/dwc/InjuredWorker.htm

    And, you should be commended on your observation here...and recognizing the actions by this person as being out of line. Good for you ...

    Comment


    • #3
      Ok, I went back to the person that told me about this incident for more information. This company's rep wanted to make sure it was recorded as a first-aid record, not an actual incident. I certainly do not agree with it, I just wanted to make sure my first instinct about it was correct. Again, this isn't the company I work for; I just happen to be friends with the person who does work for that company.

      Comment


      • #4
        That ER rep is trying to have this as a 'first aid only' injury, claims history have a distinct affect on the employers WC premiums and claims surcharges.

        This has nothing to do with attempting to manipulate the employees treatment or PTP approach to "cure and/or relieve from the effects of the injury or illness".

        And, if you want to get technical about this... the person is attempting to deny benefits this EE/IW may be eligible for... which could be fraud, at the least harrassment/discrimination.
        If this IW wishes, where the action continues, a claim could be filed under section 132(a) of the labor code...
        132a. It is the declared policy of this state that there should not
        be discrimination against workers who are injured in the course and
        scope of their employment.
        (1) Any employer who discharges, or threatens to discharge, or in
        any manner discriminates against any employee because he or she has
        filed or made known his or her intention to file a claim for
        compensation
        with his or her employer or an application for
        adjudication, or because the employee has received a rating, award,
        or settlement, is guilty of a misdemeanor and the employee's
        compensation shall be increased by one-half, but in no event more
        than ten thousand dollars ($10,000), together with costs and expenses
        not in excess of two hundred fifty dollars ($250). Any such employee
        shall also be entitled to reinstatement and reimbursement for lost
        wages and work benefits caused by the acts of the employer.
        (2) Any insurer that advises, directs, or threatens an insured
        under penalty of cancellation or a raise in premium or for any other
        reason, to discharge an employee because he or she has filed or made
        known his or her intention to file a claim for compensation with his
        or her employer or an application for adjudication, or because the
        employee has received a rating, award, or settlement, is guilty of a
        misdemeanor and subject to the increased compensation and costs
        provided in paragraph (1).
        (3) Any employer who discharges, or threatens to discharge, or in
        any manner discriminates against any employee because the employee
        testified or made known his or her intentions to testify in another
        employee's case before the appeals board, is guilty of a misdemeanor,
        and the employee shall be entitled to reinstatement and
        reimbursement for lost wages and work benefits caused by the acts of
        the employer.
        (4) Any insurer that advises, directs, or threatens an insured
        employer under penalty of cancellation or a raise in premium or for
        any other reason, to discharge or in any manner discriminate against
        an employee because the employee testified or made known his or her
        intention to testify in another employee's case before the appeals
        board, is guilty of a misdemeanor.
        Proceedings for increased compensation as provided in paragraph
        (1), or for reinstatement and reimbursement for lost wages and work
        benefits, are to be instituted by filing an appropriate petition with
        the appeals board, but these proceedings may not be commenced more
        than one year from the discriminatory act or date of termination of
        the employee. The appeals board is vested with full power, authority,
        and jurisdiction to try and determine finally all matters specified
        in this section subject only to judicial review, except that the
        appeals board shall have no jurisdiction to try and determine a
        misdemeanor charge. The appeals board may refer and any worker may
        complain of suspected violations of the criminal misdemeanor
        provisions of this section to the Division of Labor Standards
        Enforcement, or directly to the office of the public prosecutor.

        http://www.leginfo.ca.gov/cgi-bin/di...file=110-139.6
        If there is any penalty ordered by a WCAB judge, the money comes directly from the employer, the WC carrier does not provide legal representation for this, or pay the penalties/fines for the insured party...the employer.

        It would be so much easier for the employer to just allow the employee to file the claim for benefits, turn it over to their WC carrier and let the system play out as intended. The carrier will investigate the claim, and determine to accept/deny based on the medical evidence. That costs the employer nothing. That's what carriers do. This ER rep could screw up the works for the employer... all due to ignorance of the laws.

        Comment


        • #5
          It is up to the physician to determine the injured worker's needs. The doctor must order whatever meds or treatments he feels is necessary.

          No one can ask the doctor to take back ordered medication. The doctor must document that he provided adequate care.

          Do you know what the medication was? Was it an over the counter med?

          Comment

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