By Jeff Francis, Assistant Administrator, Nashville
The Bureau recently revised its General Rules. The revised rules took effect on May 31 and were designed to make claims handling more efficient and uniform.
In summary, the revisions include:
- Carriers are now required to provide employers a copy of the Notice of Employer Rights and Responsibilities whenever a policy is written or renewed. This should help educate employers about how to better handle a reported injury.
- Employers are required to accept any notice of a claim from an injured worker and to report that claim to their carrier within one business day. Thus, employers should not “deny” claims and never report them to their carriers.
- When forms are used, the forms on the Bureau’s website are required. They may not be changed in any manner.
- The rules now contain an all-encompassing penalty, $50-$5,000, which may be assessed for a violation of any Bureau rule that doesn’t have its own penalty provision.
- The requirement for employers to display the Posting Notice is included within the rules. The Notice has been revised to make it a little more noticeable and should help injured employees know to whom they should report their claims. Carriers are required to send a copy of the Notice to employers when a policy is written or renewed.
- Medical panels must be provided within three business days from the date that employers receive notice of an injury, not five days as the old rules required.
- Physicians listed must be willing and able to treat in a timely manner.
- If emergent care is required, a panel should be provided after the worker has received emergency treatment and is stabilized.
- Employers may direct injured employees to onsite caregivers, but this doesn’t alleviate the requirement for a panel. The onsite doctor may be listed on the panel but cannot replace the panel. Onsite care may also be used to determine the type of physicians needed on the panel.
- Walk-in clinics may be listed on panels, but they must be accompanied by the name of the supervising physician. Three walk-in clinics within the same provider chain may be listed, but three separate physicians must also be named.
- If a medical practice is named rather than an individual physician, and multiple physicians at that practice accept workers’ compensation patients, the employee is allowed the final selection as to which of those physicians to see.
- Nurse practitioners and physicians assistants may see and treat workers’ compensation patients, but they cannot be listed on panels, give causation determinations, determine dates of MMI or provide impairment ratings.
Also remember that the Bureau will be closed tomorrow for Independence Day. Have a happy and safe holiday.