Workers compensation FAQs

We understand that suffering an injury at work can be a stressful experience. We’ve compiled a list of frequently asked questions that you may have about the process.

General information

Claims checks/payments

Medical provider visits

  • Can I receive medical treatment from my personal or primary care medical provider?

    Treatment guidelines vary by state. In some states, employers can arrange to have injured workers receive treatment from physicians who specialize in work-related injuries. Before making an appointment, please contact your claims handler or nurse case manager to discuss whether you are able to receive treatment from your personal or primary care medical provider.

  • How do I find a medical provider?

    We can help you find a provider that is located close to you. To quickly find a local medical provider, use our online provider locator.

  • What information should I bring to my medical appointment?

    Please bring the following to your appointment:

    • A list of your current medications
    • Medical records related to your current injury, if available
    • Work status report, if available

    You should also provide your medical provider’s office with your claim number and the mailing address for your medical bills. Your claims handler can provide this information to you.

  • Should I notify my claims handler if I change my medical provider?

    Yes. Please contact your claims handler or nurse case manager before changing your treating provider, as guidelines vary by state. You should also notify your claims handler or nurse case manager if your treating provider refers you to another provider or specialist.

  • Should I call my claims handler or employer when I have a medical provider visit?

    Yes. Maintaining open and regular contact with your claims handler is an important part of the claims process. You should provide your claims handler with a status update after each provider visit. Your claims handler can help answer questions about your claim and will also work with you, your provider, and your employer to facilitate your recovery.

Disability management and return-to-work planning

  • How will my claims handler assist me during the claims process?

    Your claims handler will promptly evaluate your workers compensation claim, explain your benefits, and arrange for medical treatment payments and any lost wage payments for which you are eligible. Your claims handler will also answer your payment questions and update your employer on your work and medical status.

  • What are my responsibilities if I am unable to work?

    If you are unable to work, be sure to:

    • Communicate with your claims handler: Provide necessary information, including any required forms, to your claims handler so we can promptly process your claim. Let your claims handler know of any medical updates or changes to your work status.
    • Follow your treatment and return-to-work plans: Attend your medical appointments and follow any work restrictions set by your doctor—doing so will help you avoid re-injury and facilitate your recovery. If you are unable to work, actively participate in return-to-work planning.
    • Update your employer: Keep your employer updated on your recovery and work status. If you are unable to work, your employer may be able to provide an alternative work assignment until you can return to your regular job.
  • What should I expect from my employer if I am away from work?

    After promptly reporting your injury to Helmsman Management Services, your employer may contact you regularly while you are away from work, share information about your job’s physical demands with your doctor, and discuss possible temporary, short-term, or alternate job assignments with you and your claims handler if needed.

  • What is my doctor's role in my recovery and return to work?

    After evaluating your injury and providing appropriate medical treatment, your doctor should give you a plan for treatment and expected recovery. If you are unable to work, your doctor also helps develop a plan so that you can return to work. If necessary, he or she may recommend referrals to other medical professionals, such as physical therapists, etc. Your doctor will also monitor your recovery, address your physical capabilities, and share this information with your claims handler and employer. Your doctoru2019s evaluation may help identify temporary, alternative job assignments.

  • I have a nurse case manager. What is his/her role during my recovery?

    Helmsman Management Services may assign a registered nurse to your case to help answer your questions, ensure that you are getting the right treatment, and facilitate your safe return to work. Your nurse case manager may also review your jobu2019s physical demands and your work abilities with your employer, your doctor, and you. The nurse will also assist you and your claims handler by answering medical questions and updating your employer on your return-to-work and medical status as needed.

  • Should I tell my doctor about my job functions?

    Yes. Explain your job functions in detail with your provider. When possible, your claims handler or nurse case manager will provide information about your job-related duties to your provider in advance of your appointment.

  • Should I speak to my medical provider about work restrictions and how I can return to work under those restrictions?

    Yes. You should have ongoing discussions with your provider about your physical capabilities as they relate to your job. In some cases, your provider may identify work restrictions that could allow you to return to work in a modified job. Share any information you receive from your provider with your claims handler and your employer. Your claims handler will work with your employer to determine whether modified duty or alternative work opportunities are available.

  • What is modified duty or light duty?

    Modified and light duties are transitional duties that enable you to work with restriction while continuing to recover from your work-related injury. Your provider may allow you to return to work with restrictions. Your claims handler or nurse case manager will work with your provider to determine whether you are able to return to work in a temporary modified or light duty job.

Pharmacy benefits/durable medical equipment

  • If my physician prescribes medication for my work-related injury, how do I get my medication?
  • Do I need to fill my prescription at a specific pharmacy?

    Yes. If your doctor prescribes medication for your workers compensation-related injury or illness and you fill the prescription at a participating pharmacy, the cost of your prescription is covered as part of your workers compensation benefit. Our pharmacy program, which is administered by our pharmacy benefits manager, Optum, is accepted at most major pharmacy chains, nearly 70,000 pharmacy locations. To find a participating pharmacy, please use Optum’s online pharmacy locator.

  • Can I sign up for home delivery of my prescription? What are the benefits of enrolling?

    Yes. Optum offers a home delivery pharmacy program. If you qualify for home delivery, you may be contacted by Optum or your claims handler to discuss enrollment in the program. If you’d like to enroll in the home delivery program, please:

    • Contact your claims handler
    • Call Optum 888-328-0050

    Benefits of the home delivery program include:

    • Direct access to pharmacists: Registered pharmacists are available to answer your questions about medications as well as the home delivery process.
    • Dedicated home delivery client specialists: Client services specialists are available to answer your questions about state-specific home delivery.
    • A 90-day supply of your medication: You can order a long-term supply of your medication if prescribed by your doctor. This means fewer refill requests and trips to the pharmacy.
    • No out-of-pocket expense: Similar to Optum’s retail pharmacy program, the cost of any medications prescribed for your workers compensation-related injury or illness are covered as part of your workers compensation benefit.
  • What should I do if the pharmacy cannot fill my prescription?

    Please contact your claims handler or call Optum 888-328-0050. They will be able to assist the pharmacy in processing your prescription or help determine why the prescription cannot be processed.

  • What should I do if I lose my pharmacy card?

    To request a new pharmacy card, contact Optum 888-328-0050 and have your Helmsman Management Services claim number available.

  • What should I do if I am prescribed durable medical equipment (crutches, a brace, or a wheelchair) or other ancillary services (home health care, translation, or transportation)?

    Contact your claims handler if your medical provider prescribes durable medical equipment or other ancillary services for your workers compensation-related injury or illness.

Medical bills

This website is intended to be informational. Descriptions are provided only as a summary outline of the products and services available and are not intended to be comprehensive and do not constitute an offer to sell or a solicitation. The products and services described may not be available in all states or jurisdictions. See your policy, service contract, or program documentation for actual terms, conditions, and exclusions. Any inquiries regarding the subject matter set forth herein should be directed through licensed insurance professionals.