The basics

What medical providers need to know about workers’ compensation

When you treat patients for on-the-job injuries, you might hear from their employers or workers’ compensation claim representatives. Employers and insurers want to:

  • Ensure the employer is receiving prompt, appropriate treatment
  • Confirm whether the injury was work-related
  • Learn of any work restrictions through a Work Ability/Return-to-Work form
  • Bring the employee back to work as soon as possible to facilitate healing

Bills & procedures

Where to send medical bills and records

Send by mail:
SFM Companies
PO Box 9416
Minneapolis, MN 55440
Email us >

Send electronically:
SFM also accepts electronic bills and attachments through e-billing agent Jopari Solutions. Sign up at jopari.com or call (866) 269-0554. SFM’s e-billing Payer ID is J1553.


Requests for procedures

Fax any requests for procedures with supporting documentation to SFM at (800) 944-1169.

Return to work

Early return-to-work benefits employees

Early return-to-work has been shown to help employees maintain their psychological wellbeing because it’s conducive to keeping them active and engaged, according to a Job Accommodation Network report .

Research shows that workers who are injured on the job, particularly those with soft-tissue injuries, recover faster and more successfully when they return to work as soon as safely possible.

~ Don Graham, MD, British Columbia Medical Journal website


How you can help employers bring your patients back to work as soon as they are medically able:

  • Identify the injured workers’ physical restrictions and list them in a clear, concise and specific manner, using functional terms. For example, “Can lift up to 20 pounds” or “can stand for a maximum of 30 minutes an hour.”
  • Always complete a Work Ability/Return-to-Work form or similar form at each visit, even if the patient doesn’t ask for it. Sometimes, injured workers don’t realize their employers have light-duty work available. Ensure the form includes a date for return to work and describes what the injured workers can do. Provide a copy to the patient and keep one in the medical record.
  • Explain to the worker the benefits of healing at work and staying active.

Your role

The provider’s role when treating work injuries

Injured workers’ doctors play an important role in the claims process and, more importantly, their recovery. When treating an injured employee, you need to do the following three things.

Determine the cause of injury

It’s important to determine the mechanism of injury. For example, you might note “The employee was lifting a 50-pound box at work and felt pain in his lower back.” Also note any pre-existing conditions that might be related to the injury or delay healing.

Determine maximum medical improvement (MMI) and permanent disability

A patient reaches maximum medical improvement when no further significant or lasting improvement from the injury is reasonably anticipated, regardless of subjective complaints. You may be asked to determine when the injured worker has reached maximum medical improvement and whether he or she has any permanent disability from the work injury.

Communicate with the claims representative

Promptly fax any requests for procedures with supporting documentation to the insurer. The SFM fax number is (800) 944-1169.

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