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Deciding whether to file a claim for a patient

greencheckmark If you think a condition is not work-related:

  • You must file the claim anyway.
  • You can indicate that the condition is not work-related on the accident report (see Determining Work-Relatedness section in the Attending Doctor's Handbook, page 7).
  • You can also inform the patient that the inappropriate filing of a claim may delay coverage by other insurers.

greencheckmark If the injury is minor:

  • File a claim whenever you treat an injured worker.  
  • Provisions of state law apply regardless of the severity of the injury. See below for laws and rules.

greencheckmark If you think a condition is work-related, but your patient does not want to file a claim:

  • You are required to inform the injured worker of their rights.
  • If the worker objects after hearing their rights, it is not your responsibility to file a report.
  • L&I cannot pay you for the visit unless a claim is filed.

greencheckmark If your patient is afraid of retaliation for filing a claim:

 

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