Workers’ Comp Doctor

Why Do I Need a Workers’ Comp Doctor?

Your doctor will play an important role in your workers’ compensation claim. When filing the initial claim, your doctor’s report will be the legal basis for justifying your eligibility for workers’ compensation benefits. If you do not have a medical examination to establish the nature and extent of your injury, your claim will be denied.

Be sure that your doctor prepares an official report using the forms required by your state’s workers’ compensation review board. The insurance carrier of your employer will require the specific form for your state to accompany your workers’ compensation claim. If the doctor does not report that you are unable to work, the insurer will not be required to begin making your disability payments. Most doctors have the correct form, however, you may ask the insurer for the specific forms they require so that you can give them to your doctor. Most workers’ compensation boards have websites where you can download the forms.

If your doctor and the insurance company’s doctor disagree on the nature and extent of your injury, the workers’ compensation review board may choose a third physician to conduct another examination. It is important that your doctor provides a fair and honest evaluation of your condition. If your claim is disputed and requires a hearing, the strength of your doctor’s report will be tested in court. Therefore, it is important that you do not attempt to influence your doctor’s decision. All workers’ compensation review boards take fraud very seriously. If they have a sense that your medical condition is being exaggerated, they will deny your claim.

Your doctor’s objective and unbiased examination of your condition is essential to the success of your claim. Click here for an evaluation of your claim by a legal professional.

Am I Required to See a Workers’ Comp Doctor?

To be awarded a workers’ compensation benefit, your claim must have medical evidence of your injury. Therefore, you must see a doctor. The doctor’s medical report will provide the legal basis for your injury claim.

Depending on your state, you may be able to choose the doctor that treats your injury. The types of medical professionals from which you may receive treatments include medical doctors, surgeons, dentists, optometrists, osteopaths, and chiropractors. You have the right to change your doctor only once. You must alert the insurance company when you do so. Subsequent changes of your treating doctor require written approval from the insurance company. If your treating doctor refers you to a specialist, this is not considered a change of doctors.

Regardless of whether you carry health insurance, alert your doctor that you are being treated for a workplace injury. Supply your medical providers with the name and contact information for your employer and their insurance carrier. The medical expenses that you incur as a result of your injury; including doctors’ fees, prescriptions, medical supplies, physical therapy and other treatments, will be paid by the insurance company. In addition, the insurer will cover any related travel expenses including gas, food, and lodging.

Do I Have to See My Company’s Doctor?

You have the right to choose the doctor that treats your work related injury. If your employer requests that you see a doctor of their choosing, this request should be made through their insurer. If you receive such a request you are required to participate in this examination. The insurer may request that their doctor examine you as often as every 60 days.

Similar to the regulations governing the patient’s choice of doctor, the insurer may only change its examining doctor once. If the insurer’s doctor refers you to a specialist this is not considered a change of physician. The insurer will pay the costs of the examination. If you do not participate in the examination your benefits may be terminated until you visit their doctor.

If you have concerns regarding your employer’s request for a medical examination, click here for a free evaluation of your case and find out more about your legal options and responsibilities.

Who Determines if I Can Work Again?

The decision of when you are able to return to work is a medical one. The insurance company cannot tell you to return to work, nor can your employer. If you have had a consistent report from your doctor throughout the duration of your treatment, your medical report will reflect the appropriate actions that should be taken with regard to your return to employment. Your primary physician should be the one that makes the medical determination of when you have achieved a complete medical recovery and are able to return to work in a part-time or full-time capacity.

If the doctor chosen by the insurer disputes your treating doctor’s medical opinion, there is a process of litigation to protect you from bad faith determinations on the part of the insurance company. Should your case reach this point, it is highly recommended that you secure professional legal representation.

See if you qualify for legal representation to make sure your claim is properly filed and you get the care you deserve.

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