Alabama Workers Compensation - Part 1
I. Workers Compensation Definition
Workers compensation is a strict liability statute which means the injured individual does not have to prove the company did something wrong in order to recover. An injured individual must only prove they injured themselves on the job. As a result, compensation is less, but you have an "easier" time proving your case.
II. File a Written Report (First Report of Injury).
When an injury occurs on the job, you should file a written report with the designated individual at the company. In most cases, the injured individual never files a written report, and it's not absolutely necessary, but it's a good idea. Instead, the person orally reports the injury to the supervisor, and they are instructed to seek medical attention with the "company" doctor (usually, the company doctor is not actually employed by the company but is, instead, frequently used by the company).
III. What Companies Must have Insurance?
Workers compensation insurance is required for companies with more than four employees, and the insurance companies base premiums on the number of injuries during the year. Consequently, many employers want to reduce claims and, in turn, reduce costs. This focus on money and claims creates the "us versus them" attitude amongst many employees. If, instead of focusing on the money and claims issue, the employers of this State would try to focus more on safety and attempt to eliminate the "us versus them" attitude, the employers would probably be able to reduce claims. Unfortunately, many employers in Alabama continue to focus on the bottom line.
IV. The Workers Compensation Process
A. "Company" Doctor
When an injury occurs, the employee is supposed to report the injury to the employer in writing although, as previously mentioned, this rule is often ignored. Obviously, if the injury is severe enough, emergency treatment will be provided and a written report would be impossible. Once the employee reports the injury, the employer may authorize treatment with the "company" doctor, usually a general practitioner, or the employer may turn the case over to its insurance carrier for the referral of a doctor. The doctor is really NOT a "Company" doctor. The company doesn't employ the doctor typically (in rare cases it may), and the doctor is not controlled by the company. However, some doctors market themselves to insurance companies in order to receive more workers compensation referrals, and these same doctors may consistently say the employee is faking or that the employee can return to work when the employee is really not able to.
At this point, the doctor controls the treatment and the employee's work. Depending on the type of injury, the doctor will instruct the employee and inform the employer or its insurance carrier when the employee may return to work as well as the restrictions which are placed upon the employee's activities.
Many disputes arise between the employer (employer's insurance carrier) and the employee at this point of the treatment. If the doctor tells the employee that he/she may return to work (full duty or light duty) and the employee feels differently, the employee begins to think the doctor is working for the company so that the company can minimize its expense in the process. Many clients come to me at this point wondering how they can go back to work when they still suffer from significant pain and are taking prescription narcotics. The employee's only solution is to request a "panel of four physicians" as provided by the workers compensation act.
B.Panel of Four Physicians
If the employee requests a panel of four physicians, the company or its insurance carrier must authorize four physicians who do not practice within the same group and allow the employee to choose one of the four doctors for further treatment. In a case where the employee has been seeing the "company doctor", the panel of four will allow the employee to see a specialist and have more significant diagnostic tests performed in order to determine the problem. However, if the employee does not request the panel of four physicians properly, the employee gets stuck with a physician who is not appropriate for the situation or who the employee does not like. While Alabama law provides for the panel of four physicians, it does not state how many times a panel of four can be requested, and most companies take the position that it can only be requested once. Therefore, the panel of four physicians must be requested right the first time.