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Workers’ Compensation

If your injury or illness is work-related, your care may be covered under Workers’ Compensation.

Our team of medical professionals are here to provide care for your injury or illness, and help you get you back to your work and your life.  Our administrative specialists understand the Workers’ Compensation claims process and can help you navigate through it.

Our Goals

  • Accurately diagnose your injury, and provide you with treatment options as soon as possible following an incident.
  • Work with you every step of the way through your treatment plan to maximize your chances of a strong recovery.
  • Work through administrative obstacles that could delay or hinder treatment.
  • Keep you informed and up to date with clear and easy-to-understand communication along the way.

Our Orthopaedic and Neurosurgical Services:

  • Timely evaluation of injury by surgeon or non-operative provider
  • On-site fluoroscopic guided pain management injections
  • On-site digital x-ray performed by radiology techs with extensive experience in the positioning and technique required to obtain definitive musculoskeletal images
  • On-site application of splints and braces
  • On-site pharmacy
  • Pain management procedures (ex. EMG, Acupuncture, Chiropractic)
  • In-office procedures
  • Access to multiple Ambulatory Surgery Centers (ASC) for orthopaedic and spine surgeries

To schedule an appointment with a NOSS provider, contact us at 203-755-6677 (NOSS) or 1-800-463-8764, or use our online form to request an appointment.

Our Team

Our team of Orthopaedic and Nuerosurgical Specialists work hand in hand with Worker’s Compensation Specialists to provide you with excellent care.

Frequently Asked Questions

What information is needed to schedule a new appointment for evaluation and treatment?

Workers’ Compensation authorization to treat. Copy of a recent MRI, if available. Spine/Cervical patients who have not had an MRI, the first appointment may be with our Physician Assistants who can provide an order to be completed prior to the appointment with the doctor.

May a patient self-schedule a new patient appointment under workers’ compensation?

Yes, if there is an authorization to treat.

How do I schedule an IME or Second Opinion?

Some of our physicians require a review of the records before accepting an IME or 2nd opinion. We will contact you to schedule and make payment arrangements when the physician accepts the appointment.

What is fellowship-training?

An additional year of sub-specialty training following Orthopedic residency. Fellowship training provides a high level of skill in a specialty area. Every physician is not equally skilled in all aspects of surgery. Complex repair of different body parts on one patient may require different surgeons within the same practice for best results.

What are the benefits of referring directly to a specialist for musculoskeletal injuries?

As musculoskeletal (MSK) specialists, we frequently receive referrals as many as 30 days after an injury. Prior to that time, inadequate or inappropriate imaging has often been ordered in addition to therapy that is not being supervised by a physician. Often, our evaluation reveals a need for surgical repair that could have been performed much earlier. At this point, surgery may be more complex, and recovery may be longer because of delay in treatment.

Many employers believe that referring directly to a specialist may result in a rush to potentially unnecessary surgery. Practices like ours offer comprehensive services precisely to prevent that outcome. We have non-operative providers who are well-equipped to evaluate injury and offer conservative care like therapy when appropriate. If conservative treatment fails, transition to a surgeon can occur seamlessly with no delay in care to impede the outcome.

Our practice is eager to collaborate with employers to offer MSK urgent care services customized for their needs.

Who is involved in my treatment?

Physicians may receive inquiries from and have obligations to as many as 6 parties for one work comp episode of care: patient, employer, adjuster, nurse case manager, carrier’s attorney and patient’s attorney.

Often, the communication among these parties is not well-coordinated; thereby increasing the administrative complexity of providing workers’ compensation care.

What if my Injury is complex?

Injured workers require some of the most complex repair and surgical skill of all patients we treat. Re-injury is prevalent in some industries, and repair is always more difficult the second or third time.  Treating with our physicians who are Board Certified and Fellowship Trained in their specialties provides increase expertise.

What paperwork is involved?

Each service rendered for a work comp patient must be approved by an adjuster in advance. Health insurance plans usually require prior authorization for higher cost services, not all services. There are inherent delays in providing care through Workers’ Compensation.

What about work status forms and dictation?

This information must be submitted to multiple parties for each visit. Patients, employers, nurse case managers and adjusters may all want copies of these documents. For other types of patients, a work note is only provided to the patient directly.

How is my bill processed?

Dictation must be submitted with each work comp bill requesting payment in addition to providing it to the adjuster. The adjusters and bill review teams are often siloed and do not share information. Health insurance plans generally require dictation upon request only.

Additionally, the physician is rarely pro-actively notified when a claim is settled or deemed to be non-compensable. We discover it when we receive a claim denial often weeks after a settlement or dismissal. Meanwhile, a claim for the same service will be denied by private insurance until written proof of denial by the comp carrier is provided.

Are there any questionnaires?

Varied forms and other questionnaires are routinely requested by adjusters, nurse case managers and/or attorneys. Health insurance plans rarely require questionnaires as a supplement to dictation.

What about payment?

Because the Workers Compensation Commission sets the maximum allowable payment rates for physicians and facilities, we are not able to negotiate rates directly with the purchaser that exceed those limits. 

Precisely because these complexities exist exclusively in workers’ compensation, our practice has a team of representatives to coordinate treatment with the appropriate stakeholders.

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