Deciding whether to file a claim for a patient
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.
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.
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, you must still file the Report of Accident.
- L&I cannot pay you for the visit unless a claim is filed.
If your patient is afraid of retaliation for filing a claim:
- Let the patient know that they are protected against such discrimination.
- See the Attending Doctor's Handbook, page 22, for what to do if your patient has been discriminated against for filing a claim.
Laws and rules governing the responsibilities of an attending provider when seeing a new patient for a potential work injury:
