How to get a workers' comp prescription filled

How it generally works, step by step

Step one is reporting the injury to your employer. That starts the claim process. Your employer or the insurer will usually assign a claim number; get it if one has been assigned.

Step two is seeing a doctor. If they prescribe medication, they'll send the prescription to a pharmacy — usually electronically. Tell the doctor's office the injury happened at work so it's recorded that way.

Step three is the pharmacy. Tell the pharmacy it's a workers' comp prescription and give them the claim details. The pharmacy uses that information to work out billing. Step four: you pick up the medication, or it's delivered to your door if your prescription went to a delivery pharmacy. Rules differ by state and by claim, and your adjuster can tell you about anything specific to yours.

Timing matters for one reason in particular: the first prescription after an injury is often written before the claim is fully set up. If that happens, the pharmacy may need to confirm details before filling it. Knowing that in advance helps you plan, and tells you who to call.

• Report the injury to your employer
• Get your claim number if one has been assigned
• Tell the doctor's office the injury happened at work
• Tell the pharmacy it's workers' comp and give claim details
• Pick up the medication or have it delivered

Questions to ask

Each step has someone who can help. Asking early saves trouble later.

• Employer: Has my injury been reported, and is there a claim number?
• Employer or insurer: Who is my adjuster?
• Doctor: Where will you send my prescription?
• Doctor: Can it go to a pharmacy that delivers?
• Pharmacist: What claim details do you need?
• Adjuster: Does my claim have pharmacy requirements?

What to have ready

Bring or have handy the details the pharmacy is likely to ask for. If you don't have a claim number yet, tell the pharmacy; they can explain your options.

Keep everything in one place, such as a note on your phone, so you're not searching for it each time.

It also helps to know whether your employer uses a particular clinic or pharmacy for work injuries. Some do, and your employer or adjuster can tell you. Rules differ by state and by claim, so don't assume a friend's experience will match yours.

• Claim number
• Date of injury
• Employer name
• Adjuster's name and phone number
• Insurer or claims administrator name
• Photo ID

About the Prescriptions.plus Home Delivery Program

Prescriptions.plus is an educational site, not a pharmacy. Through the Prescriptions.plus Home Delivery Program, doctors can send prescriptions to our licensed partner pharmacy, and medication is delivered to the patient's door.

If getting to a pharmacy is hard after your injury, ask your doctor whether your prescription can be sent to our partner pharmacy. A $5 dispensing fee applies, and a delivery fee applies. Eligibility depends on the prescription, the doctor and the claim.

Some medications, such as Schedule II controlled substances, may not be available by mail — your partner pharmacy will advise. The prescribing doctor decides refills.

If something goes wrong

If something is denied or delayed, ask the pharmacy and your adjuster what's missing. Often it's a claim number, an approval or a detail from the doctor's office.

If the pharmacy asks you to pay out of pocket and you're unsure, ask your adjuster before you decide. If you have a workers' comp attorney, keep them informed of problems.

If your injury gets worse or you have a reaction to a medication, contact your doctor. Medical emergency? Call 911.