Injured Worker FAQ

The following FAQs are offered as a resource for injured workers under Kentucky Workers’ Compensation managed care plans.

Q

How do I get an appointment with a Gatekeeper?

A:

Report your injury to a supervisor before seeking medical treatment. Your employer will then help you make your initial appointment with a Gatekeeper. If you have an “incident” but do not require medical attention, it is still your responsibility to report that to your supervisor so that if care is required at a later time, your employer will have a record of your injury. To select an in-network Gatekeeper, access your applicable Provider Network Directory.

Q:

What if I feel I need treatment from a specialist?

A:

You must obtain a referral from a Gatekeeper before seeing a specialist.

Q:

What if I am not satisfied with my treating provider? Can I change providers?

A:

If you are dissatisfied with your treating provider, you may change one time during the life of your claim. Call toll-free (800) KY-COMP-1 / (800) 592-6671 or in the Louisville area (502) 495-5040, and we will assist in your selection of another provider from the approved listing.

Q:

What if I’m hurt at work and don’t seek treatment, but later I feel I need treatment?

A:

If it is something that can wait until the next business day, report to your supervisor first thing in the morning and s/he will notify the carrier of your injury. If you feel you need immediate care, do not hesitate to go to the emergency room or an urgent treatment center. Then report it to your employer the next working day.

Q:

What if an emergency room provider tells me to follow-up with my family physician?

A:

Emergency room providers may be unaware that your employer participates in a certified managed care plan, and you may be instructed to follow-up with a family physician. However, emergency room providers are not authorized to refer outside of the approved network. The best thing to do is call toll-free (800) KY-COMP-1 / (800) 592-6671 or in the Louisville area (502) 495-5040, and we will assist in your selection of a provider from the approved network directory.

If you need further assistance or clarification on any of these answers, call the OMCA Client Services Department at (800) KY-COMP-1 / (800) 592-6671 or in the Louisville area (502) 495-5040.