You may be wondering what rights you as a worker have regarding an occupational injury. Truthfully, the process you will need to follow to obtain medical treatment is somewhat determined by whether or not you are part of a union.
If you are part of a union, it is very likely you belong to one of two systems: A traditional workers’ compensation program, or a collectively bargained workers’ compensation program, also known as a Carve Out.
What is a Carve Out?
Carve Outs operate as a different option to traditional workers’ compensation programs in that they avoid some of the administrative and costly bulk associated with these more traditional programs. A Carve Out is not an “opt out”. With a Carve Out, you still will receive benefits required by workers compensation laws. Carve Outs are ratified laws within your state, and the extent to which a Carve Out changes your workplace injury claims varies state by state.
One of the very first examples of a successful Carve Out program happened here in Minnesota. One of the reasons that these Carve Out programs formed was due to the rising cost of insurance premiums, which put stress on both employers and on the employee. As of January 1, 1990, Massachusetts became the very first state to ratify a law authorizing Carve Out agreements.
The benefit of a carve out lies primarily with you, as the employee. Traditional workers’ compensation programs often delay you filing a claim for monetary compensation, oftentimes ending with you without your rightfully paid out funds. Carve Outs are designed to expedite your claim. Whereas traditional workers’ compensation programs may take over a year for you to get your benefits, Carve Outs often see conflict resolutions in as little as 18-24 weeks.
Construction industry professionals benefit from Carve Outs in particular. The reason that the Carve Out stature happened in the first place was due to frustration of construction workers at their inability to obtain benefits easily and quickly for work related injuries. In addition, the employer struggled in these cases as there was little way for construction workers to return to work quickly after an injury. Carve Outs provided the flexibility needed to get workers like you back on the job.
Am I Limited in Doctor Selection?
One limitation caused by being a part of a Carve Out agreement is that you are significantly more restricted in which doctors you can see. Though you have a right to get an independent medical exam (IME), you are often limited to one opinion per medical issue. In addition, if you don’t submit an IME, you may see your benefits cut off.
These IMEs are also from a panel of medical-care providers who are considered experts in the issue you’re experiencing. About 70% of the time there is immediate acceptance of the conclusion from the IME. A doctor must see you, the claimant, on the same day as the accident.
What’s the Catch?
Of course, Carve Outs are not a one size fits all solution. It could be argued that the first Carve Out plan Minnesota saw struggled because of over regulation. Another fear is that physicians may choose not to work with Carve Out employees because their care needs to be expedited. If a physician does not work within the agreements of the Carve Out would be dropped from the Carve Out plan.
There are many critiques of the Carve Out program, usually stemming from the lack of good physicians taking part in the program. If there aren’t enough physicians, then it is harder to get your treatment and get your claim in a timely fashion. Of course, these delays then make your claim go up in cost. Another worry is that your employer may cherry-pick a handful of doctors, and those doctors would be the only ones allowed to treat an injured person.
Finally, worries exist that your Carve Out agreement may limit your rights to legal representation. While not the case here in Minnesota, California Carve Outs exclude lawyers from a good portion of the workers’ compensation process.
What Do I Do If I’m Injured?
If you are part of a Carve Out plan, one major goal is to get you healthy enough to return to work as quickly as possible. You should be expecting prompt medical care with a Carve Out, and in most cases, a prompt return to work.
Your first step would be consulting a lawyer, especially here in Minnesota where you have more rights to lawyer presence. At Sundquist Law Firm, we are able to assist you in obtaining your just compensation for your work-related injuries, regardless if you belong to a Carve Out or a traditional workers’ compensation program. Take action now and get the compensation you deserve.