Who Controls Healthcare Provider Choices in Kansas?
Jan. 5, 2022
In fiscal year 2020, which ended on September 30, 2020, the Kansas Division of Workers Compensation received reports of 45,281 total occupational injuries and illnesses. Traumatic injuries were the largest category at 43,615 reported cases, representing 96.4 percent of all claims. Repetitive trauma came in second at 1,017, or 2.2 percent, followed by occupational disease at 607, or 1.3 percent. Of the total cases, 41 resulted in fatalities.
The Kansas Division of Workers Compensation annual report notes that these figures represent a decrease of 1,806, or 3.8 percent, cases from the year before. Since the pandemic increased the number of employees working from home accompanied by the number of employees being furloughed, the decrease represents only a one-time blip.
The Kansas Workers Compensation Act (KWCA) was developed in 2011, which made filing and qualifying for claims much more difficult. We at Slape & Howard fight to get justice restored to the worker's compensation system, which now tends to favor employers and insurance providers.
In addition to the KWCA, your employer gets to choose which physician you can use for your treatment. You are limited to $500 if you visit a physician of your choice. Unless your employer agrees with the physician or physician group you choose, you will be stuck with a medical provider named by your employer – or paying out of pocket for a physician of your choice.
If you are injured at work or fallen ill, worker's compensation covers your medical expenses and provides reimbursement if you miss time from work. If you are injured on the job, fallen ill, and in the state of Kansas, contact the worker's compensation attorneys at Slape & Howard. We can help fight for your rights to get the compensation you deserve.
Choosing Your Physician
Though your employer has the final say on which physician or medical group you can use for your treatment under worker’s compensation, the door is wide open for you to negotiate with your employer to get the doctor of your choice approved.
If you suffered an injury at work and you hurry off to your personal physician to get evaluated, it is permitted but only to the amount of $500 in reimbursement. If you wish to continue your treatment with a specific doctor, or specialist, your employer has to agree.
However, you have the right to apply to the State Director of Workers Compensation for a change of physicians. Of course, this may turn out to be a lengthy process, and meanwhile, you can be assigned a physician you may not feel comfortable with.
Once an employee receives medical care for a workplace injury or illness, the employer can order a physical examination as verification. As treatment continues, the employer can mandate ongoing exams, up to twice monthly, or more if approved by the Division of Workers Compensation.
If the employee refuses any of these exams, they may be subject to forfeiting any available benefits.
Fraud and Abuse
The Division of Workers Compensation and the Kansas Insurance Department have units dedicated to investigating fraud and abuse relating to the KWCA. These acts could involve employees, employers, or insurers, as well as medical providers caring for those on worker’s compensation.
If you suspect fraud or abuse in your worker’s compensation claim and benefits, you can contact the Division of Workers Compensation. If you suspect abuse by an insurance provider, you can contact the Kansas Insurance Department.
But keep in mind that being disgruntled over a benefit claim response that you feel was unjust does not rise to the level of fraud and abuse. In these situations, there is an appeals process in place that you must use. Slape & Howard is happy to help you with any appeals, reports of abuse, or fraud.
How a Workers Compensation Attorneys Can Help You
The new system under the KWCA can be hard to navigate. There are even time limits in which to file a claim. If you cannot submit a medical evaluation within 20 days of your accident, your claim can be denied. Our firm, Slape & Howard, can help you with the claims process and other deadlines imposed under the KWCA.
Contact us at Slape & Howard for all your worker's compensation questions and issues. Our firm proudly serves clients in Wichita, Kansas, and throughout the state. We can help you file, appeal when necessary, and fight every step of the way for the benefits and compensation you deserve.