If you are an employee who has been injured at the workplace, the first step is to inform your employer. Ask them for the name and phone number of your workers' compensation carrier. Provide OrthoWest the contact information and we will verify that an appointment has been authorized.

The following example demonstrates common procedures for non-emergency situations:

• The injured party informs their supervisor that a work injury occurred.
• The supervisor informs the human resources department.
• The human resource representative will file a report and submit it to their workers' compensation carrier and/or the Nebraska Workers' Compensation Court.
• The workers' compensation carrier authorizes the medical facility to see the patient.

There are specific state laws that mandate how workers' compensation claims are handled. Filing a workers' compensation claim incorrectly can lead to years of claim corrections, paperwork, and legal proceedings.

In most cases, it is not appropriate to bill workers' compensation claims directly to an employer or to a commercial insurance company. According to the mandates of the Nebraska Workers' Compensation Court, an employer may be billed directly if they are exempt or self-insured. However, even if an employer is exempt or self-insured, the injury must be reported. Rule 29 of the Rules of Procedure, published by the Nebraska Workers' Compensation Court, states:

"In every case of reportable injury arising out of and in the course of employment, whether resulting from accident or from diagnosed occupational disease, the employer or its insurer or risk management pool shall file a report thereof with the compensation court, specifically stating the nature and extent of the injury. Such first report of alleged occupational injury or illness shall be filed within 10 days after the employer or insurer or risk management pool has been given notice or has knowledge of such injury."

Commercial insurance companies (your health insurance) will not pay for employment related injuries. Knowingly submitting a claim incorrectly is fraudulent.

OrthoWest, by policy, does not submit fraudulent claims; therefore, if you choose not to report a work injury to your employer, requesting us to bill your private insurance is not an option. You do have the option to pay for the visit, if you choose to waive workers' compensation coverage and private insurance is not liable.