As it happens, I used to be a workers’ comp claims adjuster in Maryland. Some things might depend on which state the injury occurred in. I can tell you that under Maryland law, you can go to any doctor you choose for a work-related injury and the employer’s workers’ comp carrier has to cover it (provided the carrier accepts the claim as compensible; it sounds like a pretty cut-and-dried accidental injury on workplace premises, so unless there’s further information I’m unaware of, it sounds compensible). That includes the hospital. Your HMO should not be involved at all, but you can certainly go to one of your HMO doctors if you prefer. Just don’t pay any co-pays or anything like that – nothing should come out of your pocket for a work injury. All bills should go to the comp carrier, so just give them that information. If they insist on getting your health insurance info and/or a co-pay, stand your ground, as they are not allowed to do that. The WC carrier will not reimburse you for co-pays to the doctor, and if the bills and office notes go to your health insurance instead of the WC carrier, it will royally screw things up and cause major delays. Also be aware that WC pays medical bills per a fee schedule set by the Workers’ Compensation Commission. In other words, the amount the medical provider bills is not what they’re ultimately going to be paid. Most providers who deal with WC know this. It is against the law for them to bill the patient for any balance not covered by WC; they just have to write it off. Remember, nothing comes out of your pocket (with the possible exception of co-pays for your prescriptions, but you can get reimbursed for that and the carrier might have a pharmacy program wherein they are billed directly, and you pay nothing). Also under Maryland comp, you can go straight to a specialist without getting a referral from your PCP, so any rules your HMO has regarding that do not apply.
If you’re losing time from work, your compensation rate is two thirds of your weekly wage as averaged from the 13 weeks prior to the injury. But that’s tax-free, so it pretty much evens out. However, in Maryland the first three days are not covered; WC begins paying on the fourth day. Unless you’re out 14 days or more, in which case the first three days will be paid. In Virginia, and I believe in DC, the waiting period is seven days. (These are all calendar days, BTW).
Mileage to and from medical appointments is reimbursable, so submit a statement to the carrier with the date, the starting address, and the destination address of each trip. Mileage to the pharmacy to pick up meds is not covered.
Find out the name and address of the WC carrier, your claim number, and the name, phone number and fax number of your adjuster. Make sure all disability notes are submitted in a timely fashion, or there will be delays in issuing your disability pay. Also be aware that any medical procedure more significant than an office visit – such as physical therapy, surgery, etc., – must be pre-authorized by the carrier, and they will need a written prescription/order from the doctor. You can go to any physical therapist of your choosing.
That’s pretty much the basics, I think. Like I said, that’s how things work in Maryland. I’m less familiar with DC and Virginia WC laws, but I imagine they’re pretty comparable. I’ll be happy to answer any more questions that I’m able to.