Workers’ Compensation Insurance and Dental Injuries
Employees can utilize their workers’ compensation insurance for dental work on injuries from incidents, such as “car accidents, workplace violence, construction or manufacturing accidents, slips and falls, or falling objects” (McLain 2011). Their injuries can range from temporomandibular joint dysfunction (TMJ), tooth loss, to chipped teeth (“Will My Workers’ Compensation Cover Dental Visits?” 2017; “Workplace dental injuries” 2017). Their insurance could even help pay for cosmetic treatments if they restore the ability of talking, eating, and “[supporting] the facial structure (“Workplace dental injuries” 2017). Dentists can benefit from being in a workers’ compensation network, which have their own claims and regulations, but they must still create treatment plans that do not compromise the patient’s oral health.
In a workers’ compensation network, dentists can seek assistance from a variety of sources to process their claims and be aware of any rules they must follow. Dentists not only attract patients with this insurance, but also may retain them in the long run (Gorman 2016; McLain 2011). Though, they should find out whether the patient’s injury came from work (Gorman 2016). They could utilize services to help them with the claims (Gorman 2016). For instance, the insurance network should assist the practice with any forms and processes (McLain 2011). Dentists should also employ staff members that can deal with these claims, including those related to more complex cases that would take long periods of time and require other specialists (McLain 2011). In instances where the insurance company denies the claim, the patient “can get a second dental evaluation…” (“Workplace dental injuries” 2017). In addition to these claims, dentists must follow their state’s rules for workers’ compensation coverage (Gorman 2016). Particularly, if they are treating a patient from another state, then “the prevailing guidelines will be those in which the patient lives and works” (Gorman 2016).
When dentists treat patients utilizing their workers’ compensation coverage, they should still address other concerning conditions in the patients’ mouth, regardless of whether they do not have coverage for treating those conditions. When patients visit the dentist for problems derived from work, the dentist could discover other problems that he or she may have to address first “before the accident-related teeth are fixed” (Berger 2017). These problems may not be covered by workers’ compensation insurance, but “doing work out of order can be considered negligence, malpractice, and unethical” (Berger 2017; McLain 2011). These problems could harm the patient’s oral health in the long run, possibly killing him or her (Berger 2017; McLain 2011; “Workplace dental injuries” 2017). Dental practices experienced with workers’ compensation insurance can create “treatment plans that are solely related to the work injury” (Berger 2017).
Dentists need to hire staff members and utilize other sources for processing workers’ compensation claims. While they should ensure that the patient receives coverage, they need to perform treatments for any other problems not be covered by the insurance. They must prevent any long-term problems that could stem from conditions that were present before the injury from work.