On the Job Injuries

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Who do you bill when your patient is injured in an MVA while on the job?

I recently had a client call after being injured in an MVA while on the job. Because he did not want to get his employer involved by making a workers’ compensation claim, he wanted his providers to bill PIP through his auto insurance. I told him that it would not be a smart move for a vast number of reasons.

  • First, if he did not make a workers’ compensation claim he would lose all of his rights for future medical treatment.
  • Second, PIP will not pay for medical treatment that happened on the job.
  • Third, he was putting his medical providers at risk of not getting paid.
  • Fourth, he might get stuck paying the medical bills out of his own pocket.

Here’s the bottom line. If your patient is injured in an MVA while on the job, the entire case should be handled through the patient’s worker’s compensation insurance.

PIP insurance and health insurance are not available to cover any injury that happens on the job. The worker’s compensation carrier is the only insurance company that should be billed. Moreover, keep in mind that under the Oregon Administrative Rules, there could be financial penalties for submitting a bill more that 60 days past the date of service.

Unfortunately, a number of problems arise when the proper insurance company is not billed. Everyone is at risk for a less than ideal outcome. If your patient insists on not billing the worker compensation carrier, have them talk to an attorney who can explain the problems that will arise.

What is always most important is your patient having a full and speedy recovery, and billing the proper insurance company is one way to make sure that happens.

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