On-Site Clinics: How They Help Workplaces, Corruption, and What to do if Your Claim is Being Wrongfully Denied

Some companies are so large that it benefits them to have a medical clinic on-site, in order to handle first-aid, routine check-ups, and workers’ comp injuries in-one.

Job sites like large offices and construction sites have chosen to use on-site clinics due to a range of benefits for both employer and employee.

Benefits for the Employer

An employer may consider setting up an on-site clinic when the volume of employees makes it so that the cost of paying one or more full-time physicians is more cost-effective than the cost of providing healthcare insurance for the entire company.

Other benefits for the employer include:

  • Immediate treatment for injuries
  • In-house drug screenings
  • Improving general health of employees who have instant access to a doctor
  • Increased employee morale due to the above
  • Reduced cost of workers’ comp claims
  • Reduced risk of fraud
  • Improved communication between doctor and employer regarding functional limitations
  • Increased transparency between stakeholders in workers’ comp claims

In an ideal workplace, this system works great for everybody. There are instances where the system has been abused, however.

Potential for corruption

In a previous article, we discussed the history of workers’ compensation as seen through the lens of the AMA Guidelines. The article examines how workers’ comp was established in an attempt to reimburse an injured worker proportional to the injury they suffered on the job. As a result, an injured worker in California cannot sue their employer for a workers’ comp injury except under certain conditions.

Some companies allegedly have put pressure onto the physicians manning the on-site clinics in order to suppress potential workers’ compensation claims. For example, a worker has entered the on-site clinic after having been electrocuted, and are suffering debilitating effects, only to have the physician classify the injury as static shock, not warranting a workers’ comp claim.

When a work injury claim is inappropriately denied a workers’ comp claim by the on-site doctor, some workers have returned to with ongoing symptoms from the injuries, while other systems have to shoulder expensive bills themselves through another doctor who will treat them.

What to do if an employer is denying an injury for evaluation

In order to receive workers’ compensation if your on-site doctor is denying your claim, here are some options:

By law, an injured worker is entitled to compensation for work-related injuries or illness. *note that not every injury or illness is entitled workers’ compensation. See here for a list of first-aid vs. recordable injuries.

  • Contact the local state agency for objective information and recommendations on your concerns. In California this office is known as the Disability Evaluation Unit link: https://www.dir.ca.gov/asp/DEUzipsearch.html
  • If the injured worker decides to become represented and hire a workers’ comp attorney in your area, they will answer any questions and help you with getting your workers’ comp issue resolved
  • The attorney may advise you to report the doctor to the medical director of your state’s workers’ comp system (the California Department of Workers’ Compensation contact information can be found here)

Conclusion

On-site clinics at a workplace or job-site can be a boon for both employers and employees. Having a doctor nearby could remove a lot of complications involved with workers’ comp and healthcare in general.

It is illegal for a company to pressure on-site doctors to suppress workers’ comp claims, or to leave injured workers to deal with their injuries. Workers must then work with injuries, or leave the job altogether, and/or pay for treatment out of pocket.

If an employer or an employee has concerns over an injury, the employee should be sent to the insurance medical provider network (MPN) for proper evaluation and care.

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