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| workers' compensation guide |
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Medical Benefits
Under workers’ compensation law the county, through, our workers' compensation management partner, OptaComp, pays all authorized doctor, hospital, surgical, prescription and related costs for treatment of a work-related injury. If you receive a bill from a clinician please forward it to OptaComp. If for any reason you pay out of pocket for authorized treatment, you should submit the receipt to your adjuster for reimbursement.
The county, through OptaComp, provides its employees with dedicated nurse case managers to coordinate all medical and related services, and work with the treating clinicians to facilitate the Stay-at-Work/Return-to-Work program. All medical care that you receive must be provided through the an authorized clinician, with the exception of emergency care and certain independent medical exams. You should work closely with your nurse case manager to ensure appropriate medical treatment is being provided.
If your clinician prescribes medications for your injury you may go to any pharmacy to fill the prescription. If your injury requires that you be on medications for a significant length of time, the county offers mail-order prescription service. Using the mail-order service is both convenient for you and saves money for the county. Your adjuster or nurse case manager will offer this service to you when appropriate.
If you are dissatisfied with your clinician or treatment plan you are encouraged to discuss your concerns with the nurse case manager. If necessary, you may ask for a one-time change of clinican through your nurse case manager. Following your one-time change if you are still not satisfied with your medical care you may request an independent medical examination. This clinician will render an opinion about your treatment but will not be authorized to treat you.
The nurse case manager at OptaComp must pre-certify all surgeries and hospital admissions. To ensure the appropriateness of treatment your nurse case manager may arrange a second opinion and/or independent medical examination. If you do not comply with these examinations your benefits may be suspended.
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