Q. If I am injured on the job, is it mandatory that I seek medical treatment from a provider in the network?
A. Yes, under Public Act #93-228, in order to be eligible for any State of Connecticut Workers’ Compensation benefits, it is mandatory that you obtain medical treatment from a provider within the network.
Q.How do I find a medical provider within the network?
A.You can access a list of medical providers by visiting the Human Resources website, or by calling Prime Health Services at 1-866-348-3887.
Q. What do I do if I need emergency treatment?
A. Emergencies are considered to be injuries which, if not treated immediately, would seriously jeopardize or impair an employee’s health. If emergency treatment is needed and the employee is unable to receive medical treatment from a network provider, they may receive the necessary emergency treatment for this injury outside of the managed care network without penalty. If additional treatment is required, a network physician must provide it.
Q. What do I do if I am injured out of state and there are no network providers?
A. When a work related injury occurs out of state and immediate medical attention is required, an employee may receive medical treatment from a local, non-network doctor or facility without penalty.
Q. If I am injured on the job and receive medical care from a network provider, will I be responsible for any of the medical charges?
A. No, the State of Connecticut will pay for all medical costs relating to your compensable work-related injury claim.
Q. What will happen if my claim is contested and I still need care?
A. The State will pay for charges of all medical care prior to your claim being contested. After you receive a contestment notice, all medical bills must be submitted to your health insurance carrier for payment. If your claim is later approved, the State will reimburse your health insurance carrier.
Q. I have been placed out of work due to my work-related injury. What do I need to do?
A. If a medical doctor has restricted you from work for a certain period of time, it is the injured employee’s responsibility to immediately notify their supervisor and the Workers’ Compensation Administrator at (860) 486-0398. A written work status report placing the employee out of work is also required and can be sent directly to the Department of Human Resources or faxed to (860) 486-0406. Once an employee has been placed out of work, there are additional forms that will need to be completed. These forms will be sent certified mail to the employee upon notification of lost time.
Q. Am I eligible for mileage reimbursement?
A. Yes, all workers’ compensation claimants who use their private motor vehicles to travel to medical appointments necessitated by their work-related injuries can be reimbursed for the mileage incurred. The rate coincides with the federal mileage reimbursement rate. The form to file for mileage reimbursement can be found on the Human Resources website and should be mailed directly to the Third Party Administrator upon completion.
Q. I no longer want to treat with my current doctor and would like to switch to another doctor in the network. Is this possible?
A. Injured employees receiving workers’ compensation benefits may not switch doctors without prior approval from the Third Party Administrator or the Workers’ Compensation Commission.
Q. Who is eligible for workers’ compensation benefits?
A. All State employees are eligible for benefits provided under the State’s workers’ compensation insurance. This includes faculty, staff, student labor, work study, special payroll, and graduate assistants provided that the injury occurred while performing a function related to their employment with the University. The decision to accept or deny a claim is made solely by the Third Party Administrator.
Q. I have been provided with a prescription for my work-related injury. Where can I have it filled? A. Injured employees requiring prescribed medications must have their prescriptions filled at a network pharmacy. You can access a list of medical providers by going to the Human Resources website, or by calling Express Scripts at 1-877-672-3340.
Q. How do I report an alleged case of workers’ compensation fraud?
A. If you suspect that workers’ compensation fraud is being committed, you can anonymously call 1-800-927-0456 at any time. This number is available 24 hours a day, 7 days a week.
Q. What happens to my deductions when I am out on workers’ compensation?
A. Payroll deductions for health insurance and other items cannot be deducted from your workers’ compensation check from the Third Party Administrator. If you have elected to supplement with your accrued time, your payment from the University may contain enough money to take some (or all) of your deductions. If you have not elected to supplement your payment with your accrued time, or if the amount of your supplement does not cover all of your deductions, it is the employee’s responsibility to make payment arrangements with the respective payee. Please contact Suzanne Rogoz at (860) 486-0398 or firstname.lastname@example.org should you have any questions regarding your deductions.
Q. I have been released for light duty work. What do I do?
A. If a medical doctor has released you for light duty work, it is the injured employee’s responsibility to immediately notify their supervisor of their restrictions, and to see if they can be accommodated. The employee should also notify the Workers’ Compensation Administrator at (860) 486-0398 and provide an updated work status report releasing them for light duty work.