As a construction worker, tradesman, nurse, first responder or any other job that involves physical activity, your work may come with a risk of workplace-related injuries. Many employers work with companies like Genex to help manage workers’ compensation claims. They are known as third-party administrators. But what does this mean for you and your workers’ compensation benefits in Pennsylvania? In this article, we’ll explore what a third party administrator does and how it can impact your workers’ compensation.
Genex is a third-party administrator that manages workers’ compensation claims for employers. There are many companies like Genex including CorVel, Crawford and Company, ESIS, Gallagher Bassett Services, and Sedgwick Claims Management Services. Essentially, employers outsource their claims management to these companies, who then handle the entire process from start to finish. Their role is to assist both the employer and supposedly the injured worker in navigating the complicated process of workers’ comp. This includes everything from submitting claims to paying benefits and managing medical treatment. Companies like Genex also provide analytics and reporting to help employers identify potential safety risks and trends in workplace injuries.
If your employer works with Genex or a company like them, it means that this third-party (meaning not your employer-) company will be responsible for handling your workers’ compensation claim if you are injured on the job. This could mean that you’ll have to communicate with that company and their representatives rather than your employer directly. They will provide you with medical care and make all necessary payments for your benefits.
While having to go through a third-party administrator may not seem ideal, there are some potential benefits to it. By having these companies handle claims, employers can focus on their day-to-day operations rather than worrying about managing workers’ comp claims. Additionally, they provide a more streamlined approach to claims management, potentially leading to quicker resolution and payment of benefits. Companies like Genex are in the business of overseeing workers compensation claims so they are both knowledgeable and proficient.
On the flip side, there are also a few conceivable problems to working with a third-party administrator. One of the main concerns is that companies like Genex may prioritize cost savings over your well-being as an injured worker. They are a for-profit business that is financially rewarded to close claims as quickly as possible and minimize the overall cost of claims for the employer and insurance company. This can lead to reduced benefits or delayed medical treatment. Or worse, attempts to stop or reduce payments and benefits. Additionally, representatives from these companies may not be as familiar with your work environment, which could impact their ability to make informed decisions.
It’s important to keep in mind that the priorities of third-party administrators like Genex may not perfectly align with your best interests when you are injured at work. As such, it’s imperative to keep yourself informed about the claims process, ensure that you receive appropriate medical care, and communicate with all parties involved in a clear and timely manner. It is also why proper legal representation is often essential.
Yes, you should still receive the same benefits that you would get if your employer was managing your worker's compensation claim. In fact, having a third-party administrator can sometimes speed up the process and get you the care that you need more quickly. The benefits that you receive will most likely be determined by your employer's worker's compensation policy and Pennsylvania law.
Yes, you should have the right to choose your own doctor when using a company like Genex in accordance with PA workers compensation law. However, it's important to keep in mind that your employer may require you to see a doctor that is approved by their worker's compensation policy for the first 90 days. For more on this, please read What to Know About Employer’s Identified or Panel Doctors in Pennsylvania Workers’ Compensation Claims.
If you have a dispute with a third-party administrator, it's important to know that you have the right to negotiate your claim through the Pennsylvania’s workers’ compensation legal system. They will review the dispute and decide how to resolve the issue. Legal representation in situations like this highly recommended. Research shows that legal counsel benefits injured workers immensely.
If your employer works with a third-party administrator like Genex for example, it’s important to understand what that means for your workers’ compensation benefits. While the process may be different than if you were dealing directly with your employer, there are potential benefits to having a dedicated administrator managing your claim. However, it’s also important to stay informed and advocate for your rights as an injured worker to ensure that you receive the care and benefits you are entitled to. If you have any concerns or questions about your workers’ compensation claim, you’ll find our legal guidance helpful.
Mitch Dugan and his highly skilled and experienced workers’ compensation lawyers at Dugan & Associates will work vigorously to pursue fair and just compensation for loss of earnings, medical expenses, and damages. Consultations are free. If there is not a recovery of compensation, there is also no fee. Contact us today online or by telephone at 412-353-3572.
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