NOTICE OF INJURY, NOTICE TO EMPLOYE
A.C.A. §
11-9-701.
Notice of injury or death.
(a)
(1) Unless an injury either renders the
employee physically or menially unable 10 do so. or is made known to the
employer immediately after it occurs, the employee shall report the injury to
the employer on a form prescribed or approved by the Workers' Compensation
Commission and to a person or at a place specified by the employer, and the
employer shall not be responsible for disability, medical, or other benefits
prior to receipt of the employee's report of injury.
(2) All reporting procedures specified by the
employer must be reasonable and shall afford each employee reasonable notice of
the reporting requirements.
(3) The
foregoing shall not apply when an employee requires emergency medical treatment
outside the employers normal business hours; however, in that event, the
employee shall cause a report of the injury to be made to the employer on the
employer's next regular business day.
(b)
(1)
Failure to give the notice shall not bar any claim:
(A) If the employer had knowledge of the
injury or death:
(B) If the
employee had no knowledge that the condition or disease arose out of and in the
course of the employment or
(C) If
the commission excuses the failure on the grounds that for some satisfactory
reason the notice could not be given
(2) Objection to failure to give notice must
be made at or before the first hearing on the claim.
CHOICE\CHANGE OF PHYSICIAN
A.C. A, §
11-9-508.
Medical services and supplies.
(e)
... the injured employee shall have direct access to any optometric or
ophthalmologic medical service provider Who agree under the rules, terms, and
conditions regarding services performed by the managed care entity initially
chosen by the employer for the; treatment and management of eye injuries or
conditions.
A.C.A. §
11-9-514.
Change of physician.
EXCEPT FOR EMERGENCY TREATMENT. if your employer or
its insurance company has contracted with a certified Managed Care Organization
(MCO) or is certified as an Internal Managed Care System (IMCS) you must follow
these rules:
1. Your employer has the
right to select your initial primary care physician. The employer may select
the initial primary care physician from among those associated with certified
managed care entities.
2. You may
request a change of physician. You should initially request a change of
physician from the insurance carrier, employer, or self-insured employer.
Within five business days of your initial request for a change of physician,
the insurance carrier, employer, or self-insured employer should notify you of
its decision to grant or deny the change of physician.
3. You may petition the Commission one (1)
time only for a change of physician who must also either be associated with
£ certified MCO or IMCS or who is your regular treating physician. (Your
"Regular Treating Physician'' is one who maintains your medical records and
with whom you have a history of regular treatment before the onset of your
compensable injury.) The health care provider to whom you change must agree to
refer you to a certified managed care entity for any specialized treatment,
including physical therapy, and to comply with all the rules, terms, and
conditions regarding services performed by the managed care entity initially
chosen by your employer.
4.
Treatment or services by any physician other than ones selected according to
the foregoing, except emergency treatment, shall be a the employee's expense.
If the employer or insurance carrier is NOT in an MCO or IMCS
arrangement, change-of-physician laws are different. Except for emergency
treatment, after you receive this Notice, any unauthorized medical expense
incurred shall not be the responsibility of your employer unless you have
followed these rules:
1. If
your employer chooses the Initial Treating Physician, you have the right to
ask. onetime only, the WCC to approve a change. If the WCC approves a change,
the WCC shall determine the second physician and not be bound by
recommendations of you. the employer, or the insurance company.
2. However, if the desired change is to a
chiropractic physician, optometrist or podiatrist, you may make the change
after giving written advance notification to your employer or the employer's
insurance company.
3. If you
selected the first physician, the WCC will not approve a change unless there is
a compelling reason or circumstance justifying the change.
A.C.A. §
11-9-106(a)(1).
Penalties for misrepresentation. Any person or entity who willfully and
knowingly makes any material false statement or representation for the purpose
of obtaining any benefit or payment or for the purpose of defeating or
wrongfully increasing or wrongfully decreasing any claim for benefit or payment
or obtaining or avoiding workers' compensation coverage or avoiding payment of
the proper insurance premium, or who aids and abets for either of said
purposes, under this chapter shall be guilty of a Class D felony.
