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 | Why is treatment taking so long? And why hasn't the doctor released my employee to return to work? |
 | Some injuries are more serious than others and healing will take more time. Factors that may prolong treatment are the injured worker's age and other medical conditions. The doctor will not release the employee to return to work until it is medically safe. Zenith nurses and claims staff work with the doctor to obtain appropriate restrictions. We also work with you to identify a suitable job for your recovering employee. |
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 | Why are you delaying treatment? |
 | Zenith nurses and claims staff want your employee to receive proper treatment. Sometimes we delay treatment, particularly surgery or special procedures, if we have questions about it. We may consult with an outside specialist. Zenith has doctors, called "peer reviewers," who review an injured worker's medical condition and proposed treatment and give us their opinion. They may even call the doctor who is requesting the treatment to discuss it in more detail. This way, we can be sure the worker receives the right treatment or procedure and avoids unnecessary treatments or procedures. |
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 | Why are you denying treatment? |
 | According to law, treatment must be reasonable, necessary and used to cure or relieve the effects of the current industrial injury. If the proposed treatment does not meet any one of these criteria, it may be denied. |
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 | When can my injured worker return to work? |
 | Your injured worker can return to work as soon as it's medically safe. The primary treating physician determines this, but you play a major role in the decision. If you can provide a lighter job or modify your worker's normal job to meet the physician's stated restrictions, then your employee will come back to work much sooner. |
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 | Why can't my injured worker get a medical appointment sooner? |
 | Zenith wants your injured worker to see really good doctors. Unfortunately, top-notch doctors are usually very busy. That can cause a long wait for an appointment, especially with a specialist. |
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 | Why can't we deny this claim? |
 | Labor Code statutes or pertinent case law must support all claim denials. If the claim does not meet the stated criteria, it cannot be denied. |
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 | The injured worker is working full duty. Why is he or she still receiving treatment and why is the claim still open? |
 | Sometimes continued treatment, such as physical therapy, allows the employee to manage pain incurred from return to work. This often occurs soon after the employee returns to work. If continuing a brief course of treatment helps the employee remain at work, it is worthwhile. |
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 | What occupational medicine clinic should I send my injured workers to? |
 | Zenith can help you select a clinic that will meet the needs of you and your employees. You can call a Zenith nurse in the office nearest you at any time for a referral. Or you can assess available clinics with the Zenith claims representative who manages your cases. Or you can call our Employer Hotline at 800-440-5020 (this is also the number to call right away to report new injuries). Our customer service representatives will be happy to look up clinics in your area. |
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 | Is my employee expected to recover completely? |
 | Some injuries never completely go away. We want your employees to return to a condition as close as possible to their state of health prior to the injury. Unfortunately, injured workers may experience some ongoing or occasional pain. |
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 | Can I expect my premium to go up? |
 | Premium rates are governed by several factors. If you have questions about your rate or possible increases, contact your agent. |
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