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I was injured at work on Monday. On Tuesday morning I reported it to my employer. I didn’t get a claim number until later afternoon on Tuesday. I got the claim number and called the only orthoapedic doctor on the list. They were very rude and took my info only to tell me they needed to wait 24 hrs to get an auth #. Yesterday I got a message from them 5 min before the insurance comp lady went home and had to talk to her today. I just talked to her and the doctors office and they aren’t giving me an appt until next Wed. That will be a week and a half since the accident. Is this legal? Is there anything I can do?

3 Thoughts on NJ Workers Comp Question?
  1. Reply
    June 11, 2013 at 7:20 am

    you might be able to get paid time off of work if you are hurt really bad & don’t feel like you can do your normal jobs @ work (stuff that requires: bending, lifting, squating, pulling, pushing, sitting for long hours; anything that will put more stress on you body)
    on the form you fill out for your doctor it should ask if you’ve had to take time off of work because of your injury. Talk to your employer.

    i would ask your employer/employees if they have any recommendations for a new doctor’s office, since the one you spoke with on the phone wasn’t very professional with you & seems to be pretty busy. Maybe you can find another docotor’s office to get a check-up @ before next wednesday.

  2. Reply
    June 11, 2013 at 8:08 am

    OK, so today is THURSDAY and you haven’t seen a doctor yet? TIme to call another doc on the list.

    You don’t get lost wages until a DOCTOR tells you that you can’t work. So the guy above me is not giving you good advice.

    You need to be seen, ideally, the same day that you get injured. The longer you wait, the more likelihood of having problems trying to get the claim paid.

    If you’ve already seen a regular doc, and this is just the orthopedist referral, you’re fine. If you haven’t seen anyone yet, go back to the list, or call your adjuster and ask permission to go to someone out of network, as no one in network can see you for another week. (which is absurd, and not true).

    There’s no law stating that a particular doctor MUST see you same day. But you DO have to stick to doctors on the list. If NO ONE on the list can see you, talk to your workers comp coordinator and have them expand the list – they should be able to do that in a couple hours.

  3. Reply
    June 11, 2013 at 9:04 am

    I work for a major work comp carrier and have been doing this awhile. Unless you were injured in a serious manner you don’t need to just go to the ER. I would go to a minor med. That being said, I would make sure that it is one covered by the work comp carrier. You are lucky to have a claim number so soon. When I was in billing some employers would never even give the employees their claim #’s. One day for an auth# for a NJ claim is standard. They have up to three days to reply for an authorization request. Unless you are in pain, or you think that there is something really wrong with you…it’s sad to say…but I would hold off on going to the doc. If that doc finds that there’s nothing wrong with you….there might be some payments that you will have to make yourself. It would help to know who you work for. I know that is personal, but I could help you out if you work for a company i know something about or an insurance company I have worked with. I talk to people in your situation every single day. They are frustrated and fed up and you know…it’s the government’s fault for giving power to the almighty insurance company.
    They have us by the balls and more!
    Pray Hillary gets elected…..we might soon see FREE healthcare everywhere. No more work comp… nothing. I have a spinal disease so I’m drowning in medical bills. They charged me 40 dollars today just to pick up a written prescription. I refused to pay it and now I’m sitting here typing to keep my mind off of it! Good luck sweety. You can email me if you want help. I know it sucks, but that adjuster is your best advocate. Call them almost every day. If you don’t, they will forget you. If you leave two voicemails and no response….go above their head and speak to a supervisor. Stand up for what you are owed! 🙂

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