What steps should be taken in the event of a work-related injury?
- When a work-related injury occurs, send your injured worker to a BWC certified medical provider for medical treatment. In a medical emergency, the injured worker may seek treatment from a BWC enrolled, non-certified provider and the cost of the initial treatment will be covered once the claim is allowed by the BWC. Spooner Medical Administrators, Inc. (SMAI) maintains a provider referral line that you can call at 440-899-2400 or 800-542-9479 for information regarding BWC certified providers.
- The employee should present the MCO ID card to the doctor or hospital they visit upon arrival. The doctor will copy the card for his/her records.
- You should then contact SMAI to notify us of the injury. We will require demographic information about the injured worker and information regarding how the injury occurred. If you prefer to fax the information from the injury report, that would be entirely acceptable.
- The doctor or hospital is required to inform SMAI of the injured worker's visit and the intended treatment they wish to implement. The physician is required to obtain approval for all treatment beyond the initial visit.
- SMAI will contact the employee to ensure they are comfortable with the physician and treatment they have received thus far. The injured worker is required to obtain medical treatment from a BWC certified physician unless it is an emergency.
- SMAI will also contact you with information regarding the status of the injured worker and the expected date of return to work. In the event that the employee is unable to perform his/her job due to a work-related injury, SMAI will be the link between the employee and the doctor in assessing the circumstances and planning an appropriate rehabilitation program, a transitional or modified work program or vocational retraining.
- SMAI will file the claim with the BWC and the BWC will contact you regarding acceptance or rejection of the claim. Please understand that approval for workers' compensation claims is still determined by the Bureau of Workers' Compensation. SMAI does not decide what is compensable.