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Home Forums Medical Management Do I need a Dr.s referral for ergo consult for a Ca. Work Comp Emp on Temp Disability?

This topic contains 5 replies, has 4 voices, and was last updated by  tonbra32 7 years, 6 months ago.

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  • #36547

    WFOTR
    Participant

     I have a referral for an employee at a private company in California.  The employee has had temporary disability and the employer is asking for a workstation evaluation and modification as needed.  My question is, do I need the employee’s doctor to provide a referral.  If so, do I, as a  provider of that service ( I am an Occupational Therapist with my own consulting service), need to have some type of authorization from the company’s Work Comp provider to then provide the service.  Does my business need a Workers Comp provider number?  Any info would be helpful…Thanks..Jim.

    #39653

    [private user]
    Participant

    My understanding (and previous experience as an independent consultant here in CA) is that the answer is dependent on who will be paying the bill.  If you want to bill the WC carrier, then you’ll need their authorization and you’ll bill through the WC/medical system, and payment will come from the WC carrier.  If the referral is directly from the employer, and the employer is willing to pay you directly, you will not need any sort of authorization from the WC carrier because you’ll be working outside the WC system and payment will come from the employer.

    Joanette Lima, PT, CPE

    Ergonomist, Disneyland Resort

    Anaheim, CA

    #39654

    WFOTR
    Participant

     Thanks Joanette, most helpful!

    #39907

    aprw287
    Participant

    Good morning – this is interesting to read about the need for an MD referral. Considering that General Practitiioners/Family Docs have no training or education in the area of ergonomics or occupational related injury; and have no idea about the workplace why would a Referral or Request be invited by the employer.  They invite further interference from an outside party who really has no business in doing so.

    What we do in our practice across Canada is we advise the employer to not worry about who the payer is.  The employee is their hire and their responsibility.  Setting up a healthy workstation using ergonomic principles is part of their due diligence.  Thirdly asking the employee to provide "proof" of the need for an assessment sends a clear message "I do not believe your judgement in needing a simple ergonomic assessment"

    If the employee requests an ergonomic assessment then so be it. It should mean that a trusted and committed employee needs some assistance with their health and ergonomics.  So send in the professional who is a certified, qualified ergonomist and get the job done right the first time.

    This works for each of our clients across the country.  (and no not all employees are going to abuse the system which some supervisors tend to assume).  Afterall if the qualified ergonomist finds there are no hazards or risks present then the expenditure on equipment, seating, tools is not justified and further funds will not be required.

    Keep it simple, use the science and avoid the use of MD notes at all costs.  JE Sleeth OPC Inc Canada

    #39909

    [private user]
    Participant

    There is no "need" for a referral.  An employee can request and evaluation, and the employer will deal with it in whatever way is customary for them.  The employer is not exactly "inviting" a referral.  If the employee is in the WC system, and the MD recommends an ergonomic evaluation, it is what it is.  The employer has no control over the fact that the MD may make a referral for an ergo eval.  Understanding that the MD probably has no training/education in ergonomics, the referral for an ergo evaluation is actually a good thing.  I have watched this practice evolve over the past couple of decades, and I’m happy to see MD’s making those referrals much more frequently.

    I agree that ideally, the employer would accept responsibility for bringing in the ergonomist and making any necessary changes for the injured worker, but what often happens here is that the employer sees the WC system as a way to shift the cost – if it is a work injury, and the MD makes a referral for an ergo eval, the WC carrier will pay for the ergonomist/consultant and the equipment that the ergonomist recommends.  Again, many times, employers see this as a good thing and a benefit of their WC coverage.  Philosophically, I would again agree that the employer should accept responsibility and take care of things, but often times, as I said, the employer will take advantage of having the WC carrier pay for the evaluation and the equipment.  It’s easy to see why this may happen – I’m not saying I agree with the practice, but it’s easy to see why an employer may choose to shift the cost to the ins. co.

    In a WC case, we cannot ignore a MD recommendation.  It is then up to the employer how to deal with it, and it is out of our control as an ergonomist/consultant, except for making a recommendation to the employer regarding the issue.

    Keep in mind that this is just a WC or accommodation issue, and is not an issue with any prevention work we do.  An MD referral in a medical case is not out of line.

    Joanette Lima, PT, CPE

    Ergonomist, Disneyland Resort, Anaheim CA

    #40273

    tonbra32
    Participant

    I may have to get an ergoonmic evaluation/ consult for a case where I work- how much do these evaluations typically cost?

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