The Sun Clinic of TCM
 
Acupuncture Medical Massage Chi-Gong Herbs Others
      
A workers' compensation claim is not a lawsuit against your employer, but is a request for insurance benefits. Workers' compensation insurance protects you if you are injured on the job. It will pay for needed medical treatment and time lost from work. It may provide retraining and compensate you if you have a permanent disability. This insurance is provided by your employer.
In the News
News Highlight
News Links
Disease & Injury
Diseases Treated
Auto Injuries
Work Injuries
Insurance
Health Insurance
Auto Insurance
Workers' Comp.
Visit Us
Location and Hours
Contact Us
Feedbacks
Others
Coupon
TCM Basics
Acupuncture Schools
e-mail:   services@suntcm.com
phone:   (925) 600-1488
fax:   (925) 600-1488
Make an appointement NOW.
 

Both California and Federal law guarantee certain benefits to employees who are injured on the job.

"Workers' compensation" is a system of laws to provide injured workers with specific benefits and a system where disputes can be resolved. Some patients, who are injured on their job, are afraid of using the workers' compensation mostly becuse they are not famiar with it.

 
 
What are eligible to wokers' compensation?
  Workers' compensation is a "no fault system." In most cases you are covered, no matter who or what caused the injury. Any injury or illness that is caused (or worsened) by your job is covered by workers compensation insurance. This includes specific injuries (falls, cuts, etc.) as well as illnesses or other problems related to cumulative trauma (carpal tunnels, etc.). Some injuries from voluntary, off-duty, recreational, social or athletic activities (for example, a company bowling team) may not be covered. There are generally two categories of work injuries, namely acute and chronic:
1. Acute injuries
 

Work injuries may be due to a myriad of causes including slipping and falling, lifting heavy loads, twisting arms and legs, chemical burns, falling objects, and flying projectiles. Acute injuries as in injuries suffered in auto accidents, if treated early and properly, can heal quickly and with a marked reduction of chronic problems.

 

The reasoning is rather simple. Tense muscle causes pain and an immobile position actually requires the muscle to stay contracted to maintain that position. And after a long period, the muscle learns to stay tense all the time, and that makes it much more likely to hurt. If the process is repeated for months or years, problems will eventually develop.

2. Chronic injuries
 

If one sustains repeated trauma, the cumulative injury may eventually reach a threshold where severe and disabling symptoms suddenly develop. Following are two examples:

  • A secretary who types several hours a day may have enough cumulative trauma to the finger joints to develop arthritis. A forklift operator that needs to use an arm to push a lever for several hours in a shift can experience chronic pain in his elbow.
  • A computer operator who sits in a chair in the wrong position without taking frequent breaks may put enough strain on the back muscles to cause chronic back aches.


 
What should do when injured on job?
1. Your own auto insurance
 

Most auto insurance policies cover medical expenses for acupuncture and acupressure treatments incurred as a result of automobile related injuries with varying dollar limits. A person who does not own his individual policy may also be covered by a policy of a member of the same household. For instance, a teenager hit by a car while crossing the street (an auto related injury) may be covered by the insurance policy of his older brother with whom he lives.

Unlike some health insurance companies, automobile insurance cannot discriminate against Acupuncture care (including medical massage care) and they cannot require you to see a certain physician for treatment. In other words, you can choose to receive care from any doctor.

A list of auto insurance in we dealed with so far is as follows:

21st Century
All State
CSAA / AAA
Farmers
GEICO Direct ct
Liberty Mutual
Mercury
Prudential
State Farm
USAA
2. Third-Party Insurance and Medical Lien (Doctor's Lien)
 

When one is injured in an accident caused by another party who as at fault, he may be entitled to compensation by the other party under the law.

 
However, if the injured does not have his own insurance or adequate coverage, he may have difficulty coming up with the finances to defray the medical costs for his treatments because it may take quite some time before he can obtain compensation for the responsible party under the law. Certain health professionals may be willing to accept an IOU from the patient providing the patient agrees to secure the IOU with future proceeds from the compensation he receives from the at fault party. This is known as a "medical lien" which is similar to a car loan using the car as a collateral or getting a loan for mortgaging one's house. At our clinic, we accept this type of lien in order to get your injuries treated as soon as possible. Please call us at (925)600-1488 to find out how to get the medical lien and further information related.
3. Your health insurance
 

Health insurance usually covers the treatment expenses if the auto insurance policies do not cover it. However, it is generally a good idea to check with your own health insurance company to see what services are covered before treatment. If you belong to a HMO health plan, it is quite possible that you will be covered only if you see your primary care doctor or another specialist only if you are referred by your own family doctor.

4. Worker's compensation
 
If you are injured in an automobile related accident while you are doing your duties as an employee, you may be entitled to coverage by worker's compensation insurance as well. For instance, a messenger side-swiped by a bus while delivering a package should be covered by worker's compensation insurance.
© 2004, The Sun Clinic of TCM
  Acupuncture Acupressure Chi-Gong Herbs Others