When a work injury happens, employers are quick to send an injured employee to an “occupational clinic” such as Concentra, US Healthworks, Nova, or Caduceus. According to a 2017 interview with Concentra’s Chief Executive Keith Newton, 1 out of 8 workers will be seen at a Concentra practice for injury care. However, patients routinely make mistakes before, during, and after their visit to an occupational clinic.
We asked the top Georgia injury attorneys to provide opinions on the mistakes that prevent workers from getting the best care, and things that injured workers can do to avoid permanently damaging their workers’ compensation claims.
Let’s take a look at the top 5 mistakes that injured workers make related to a clinic like Concentra.
1. Going to Concentra for a Serious Injury or Emergency.
Sure, if your work injury is truly minor, then any occupational clinic can patch you up and send you back to work. However, for serious injuries, many workers’ compensation attorneys that represent injured workers agree: choosing Concentra is almost never the right decision. Here’s why:
First, if you need emergency care, you should head to the hospital, not an occupational clinic. In a true emergency, such as a broken bone, torn muscle, amputation, traumatic brain injury, or serious spinal damage, the workers’ compensation insurer is required to first pay for your emergency care at a hospital. Simply explain to the hospital that you had a work accident, and include that on your intake paperwork, listing every injured body part. Once you get out of the hospital, you can work with your attorney to pick an appropriate specialist to provide care.
Don’t let your employer, or some crafty insurance adjuster, send you to Concentra in this situation. They may claim that you are required to see Concentra first, for various reasons, all of which are legally false. If your employer, or its insurance company tries to pass off this lie, and is dishonest to begin with, consider hiring an attorney right away.
2. Allowing the Employer, or the Insurance Company, to Limit Care
For various reasons, our best injury attorneys recommend against consenting to care with an occupational clinic. However, if you do choose Concentra, and consent to treatment there, there are some steps which you can take to protect yourself.
Before an injured worker ever gets care at Concentra, the employer or its insurance company will contact Concentra to identify which injuries are “compensable”. That is, the Employer/Insurer will tell the occupational clinic which body parts their doctors are allowed to treat. Injured workers often don’t know that care can be limited this way, and they may be surprised when their new doctor (or the nurse handling care) refuses to provide treatment for certain injuries from the work accident.
To avoid disputes about which body parts you actually injured at work, make sure to properly document every single injury. When you fill out your accident report at work, list every injury and every injured body part, no matter how small. An injury that seems minor while your adrenaline is pumping after an accident may turn out to be much worse than you originally believed. Likewise, when filling out intake paperwork at the clinic, identify the correct date of your injury, the fact that you were hurt at work, and all of the injuries you suffered. Don’t rely on your clinic doctor to document your injuries correctly. They may not, or they may leave off any mention of “unauthorized” injuries.
Likewise, occupational clinics typically provide only the most conservative care – the kind of care that is cheapest for the insurer. Some occupational clinics may even have “treatment protocols” or “policies”, where you are not allowed to get critical testing or care, no matter how injured you may be, until after you have tried other, cheaper care. For example, you may have terrible pain in your shoulder, suggestive of a rotator cuff tear. However, some clinics may require you to complete weeks of physical therapy before they will allow you to get a shoulder MRI – which is the testing necessary to determine whether your rotator cuff is actually torn. If you continue to have serious pain after an injury, and your clinic doctor is not ordering testing, referrals, or work restrictions that you need, then it’s time to hire an attorney.
3. Not Requesting Testing or Referrals
Good doctors rely upon tests and imaging to help them diagnose your injury, and make you well. However, occupational clinics may delay or fail to recommend testing when that testing is expensive or discouraged by the workers’ compensation insurer. For example, a clinic like Concentra may take x-rays of your injury, rather than referring you for an MRI. However, an x-ray is primarily useful to determine whether you have a broken bone. X-rays are inexpensive tests, so the insurance companies do not typically object. However, x-rays usually cannot verify whether you have a torn ligament, spinal disc herniation, or many other serious injuries. For that, you would need an MRI, CT Scan, nerve testing such as an EMG, an ultrasound, or some other form of testing. It all depends on exactly how you got hurt. Keep in mind, the insurer does not want to confirm whether you have a serious injury, because that would make your claim more expensive for them. Employers and Insurers can exercise more control over occupational clinics, because they send lots of business to those clinics.
If you have an injury, and you aren’t quickly getting better, do not be afraid to demand proper medical testing. A clinic doctor who tells you that you don’t need testing, or that testing is not appropriate until after physical therapy, may be more interested in saving some insurance company money than getting proper testing. Likewise, if you don’t like your clinic doctor, consider requesting a referral to a specialist, such as an orthopaedist. If your doctor won’t authorize the testing or refer you to a specialist, it’s time to hire an attorney.
Sadly, our top Atlanta injury attorneys have been notified by more than one client that their occupational clinic took x-rays, but missed seeing a fracture. These clients only learned about the broken bone after demanding a referral to an orthopaedic specialist.
4. Filling out Forms Incorrectly or Incompletely.
Always remember: when you fill out forms at any doctor’s office, you are creating medical evidence. What you write will eventually be seen by a judge or jury. If you leave out important details, or fail to document your injury completely, that judge or jury may not believe your story. After all, you filled out the form yourself.
For example: Let’s imagine that Jane suffered an injury at work when she was hit by a forklift. Her biggest complaint is that her right arm hurts like crazy, and it might be broken. She also got knocked down, hurting her low back. However, at the clinic, she’s in pain, and filling out the forms completely is an annoying hassle, even without the pain. She quickly jots down that she hurt her arm, moving on. Her arm gets treatment and feels better after a week. Turns out, it was sprained but not broken. But her back is killing her, and she is having trouble lifting her foot. So she returns to the doctor, only to learn that all care for her back has been denied by the workers’ compensation adjuster. “If you hurt your back in the accident, why didn’t you tell anyone,” the adjuster says. “I looked at your medical records, and there is nothing about a back injury. You must be faking!” But Jane isn’t faking; she has a serious back injury. Her failure to fill out the medical paperwork correctly has become a serious problem. “I told my clinic doctor about my back pain,” Jane tells her lawyer, “but when I looked at the medical notes, there’s nothing about my back. I guess I focused on my arm. I was counting on my doctor to write down everything I said.”
Look carefully! On medical intake forms you will also often find a box to check, stating that your accident happened at work. Be honest, no matter what anyone else tells you. Some employers may try to convince you to document that the injury happened somewhere other than work. This is a trap, so don’t fall for it. If you personally document that your accident did not happen at work, how can you expect a judge to believe that it happened at work? By making this one mistake, you could cost yourself $100,000.00 or more.
The first doctor’s visit following a work accident is often the most important moment in a workers’ compensation case. What you say to the doctor and write down on your intake forms can make or break your case.
5. Waiting Too Long to Hire an Attorney
As the old saying goes, “an ounce of prevention is worth a pound of cure”. Hiring an attorney early in your claim can help prevent mistakes that are unfixable. Unless you are on your way to the hospital, your first call after a serious work accident should be to an experienced Atlanta workers’ compensation attorney. Most people do not realize that you pay the same amount for a workers’ compensation attorney to fight for you, whether you hire them on “day one” or near the end of your case. Workers’ compensation attorneys work on a “contingency fee”, which is set by law at 25%. So, when you search for an “Accident attorney near me” or “Injury attorney near me” on Google, choose a reputable firm like Morrison & Hughes, where there are no fees unless your case is won or settled. An experienced Atlanta workers’ compensation attorney can manage your care, build the value of your case, and help to protect you against harassment.
If you are like many of our clients, you may conclude that your occupational clinic is biased and unhelpful. If Concentra seems to care more about keeping the insurance company happy than providing quality care, give us a call at 404-800-LAWS (5297). Don’t go up against the insurers, or their doctors, unarmed. Call the “Big Guns” for a free, no obligation legal consult.
*All statements above are solely the opinion of the attorneys at Morrison & Hughes Law. Not all statements are applicable to every occupational clinic or doctor.