On occasion, the Department of Labor and Industries (L&I) asks work injury claimants to fill a “Treating Provider List”. Usually, L&I sends a brief cover letter explaining why they it. Most commonly, it’s because L&I doesn’t know if they should cover a condition under your L&I claim.
Treating Provider List
Filling out the Treating Provider List can be stressful. And there are good reasons for the stress. Work injury claimants often worry that L&I will use past medical history to deny coverage. Also, they worry about the amount of information that L&I requests in the Treating Provider List. Furthermore, many are concerned about what will happen if they forget something. And then, some workers are unsure if they even must complete the form.
Will L&I use the Treating Provider List and the medical history to deny coverage? Maybe. Under the Industrial Insurance Act, L&I must cover conditions caused by the industrial injury or occupational disease. On top, it covers conditions aggravated by the workplace injury or illness. Therefore, just because you have prior treatment for a condition doesn’t mean L&I won’t cover it. In fact, sometimes prior treatment records is exactly what L&I needs to determine condition coverage.
Information L&I needs in the Treating Provider List
Does L&I really need all the information it asks for in the Treating Provider List? Probably. It can seem daunting when L&I asks for all that information. I mean, they ask for names, addresses, phone numbers, conditions treatments, and dates. And that’s for all treating providers. However, the truth is that this kind of detail is the best way to obtain the records.
First, medical records are very lengthy (especially since electronic records became mandatory). General and non-specific record request often lead to production of irrelevant and unnecessary records. Sorting through a ton of irrelevant records only increases L&I’s time to make a decision. Second, medical providers tend to change facilities. Yet, the records usually remain at the treatment facility. And third, many providers have the similar sounding names. It’s worth filling the forms right, even if it seems overwhelming. If you provide L&I an accurate and complete Treating Provider List, it’s the best way to get L&I the record it needs. It’s the quickest and most efficient way to help L&I reach a decision in your L&I claim.
Forgetting details in the Treating Provider List
What if I can’t remember or forget to include a treating provider? It happens. None of us are perfect. Most people don’t keep a journal of every medical provider they see. Not to mention remembering a provider name you saw at the ER or urgent care years ago. That’s ok. Do the best you can. Try to remember all the details or try to find them. If you can’t, do your best to include as much detail as you can.
Must injured workers complete the list form?
Am I obligated to fill out the Treating Provider List? Probably. Work injury claimants have an obligation to cooperate with claim administration. This is true for L&I claims and self-insured employer claims. Personally, I’m not aware of specific rules about completing the list. But, in my opinion, it’s best for work injury claimants to almost always cooperate and fill the form.
I feel this way for several reasons. For one, not filling the form can suggest that you’re hiding something. Secondly, it can delay L&I in making coverage decisions. And third, you must share this information with your doctors and your workers’ compensation attorney. This information can’t catch them by surprise later. After all, if the issue escalates to litigation, you’ll have to provide it during discovery. Hence, it makes all the sense in the world to cooperate and fill the form. Do it as accurately and completely as possible when L&I asks for it.
Summary and notes
In conclusion, it can be scary and frustrating when L&I asks to complete a Treating Provider List. However, the general best practice is to return the form as quickly as possible. Don’t cut corners. Fill the form as completely and accurately as you can. The records in the provider list will be available in your workers’ compensation claim file. You can access it later. Similarly, your medical providers can access it as well. Furthermore, the same goes for vocational providers and your L&I attorney. They can all review the file and address things as appropriate.
Withholding information in the Treating Provider List rarely (if ever) benefits you. However, if you feel there are reasons to withhold information, then it’s best to speak with a workers’ compensation attorney. In such cases, you’ll have to handle the situation carefully.