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Summary

This video outlines the process following the completion of the Health Carousel workers' compensation incident report. Once the report is submitted, a workers' compensation claims adjuster is assigned within twenty-four to forty-eight hours. This adjuster will contact you soon after. If you have work restrictions due to your injury, it's crucial to inform your assignment manager, IES, and the Health Carousel benefits department to assess possible accommodations. A statement from a treating physician certifying your ability to return to work is necessary before resuming duties. The adjuster authorizes any required treatment, including specialist referrals, and benefit eligibility depends on state-specific regulations. Medical bills should be sent to the workers' compensation billing department. Importantly, the video clarifies that regular medical insurance cannot be used for work-related incidents and addresses the use of other insurance types. If you have questions or concerns, please contact the Health Carousel benefits department.

Transcript

Hello. This video will review what to expect after completing the Health Carousel workers' compensation incident report.

Once the incident report is completed, a first report of injury will be filed with our workers' compensation insurance provider. It takes approximately twenty four to forty eight hours from the date the first report of injury is submitted for a workers' compensation claims adjuster to be assigned.

A workers' compensation claims adjuster, also known as a case manager or claims manager, is someone who helps facilitate and coordinate an injured employee's workers' compensation claim.

You should expect your workers' compensation adjuster to reach out to you shortly after your claim has been filed.

If you have work restrictions, you will want to notify your assignment manager, IES, and Health Carousel benefits department to determine if the restrictions can be accommodated.

If the facility is unable to accommodate your restrictions, you should not continue to work.

Prior to returning to work, you must provide Health Carousel with a statement from a treating physician or qualified healthcare professional certifying your ability to return to work, including the date as well as any working restrictions.

After initial treatment, all following treatment must be done by the same provider unless the adjuster approves changing providers.

It's important to note that only your adjuster can authorize treatment. Referrals to see a specialist must go through your adjuster. Referrals can consist of but are not limited to an orthopedic surgeon or a physical therapist.

Benefits eligibility will be made through our workers' compensation insurance company. Benefits received will depend on which state the injury or exposure occurred.

Please note each state has different workers' compensation regulations and waiting periods.

A waiting period is a number of days you would need to be out due to your injury or exposure prior to receiving workers' compensation wages. Please note just because you lost time, you may not be eligible for workers' compensation wages.

Once your claim has been examined and approved, you should expect to receive benefits shortly after.

All workers' compensation medical bills need to be sent directly to our workers' compensation billing department.

Once notified of your treatment, the adjuster will reach out to the facility to have the bills converted to the workers' compensation format.

This can take thirty to sixty days.

If you receive any bills, please forward them to your adjuster and Health Carousel benefits department.

Some important items to take away.

If you're enrolled in Health Carousel's accident and hospital indemnity insurance, you can use them in conjunction with a workers' compensation claim.

Medical insurance will deny any claims related to a workers' compensation incident.

You must use your workers' compensation insurance.

You cannot use PTO and receive workers' compensation wages.

And lastly, you cannot use workers' compensation and short term disability for the same incident.

Please reach out to Health Carousel benefits department with any questions or concerns you may have.

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