Many of my clients have one goal after a work injury - to get better. And to get better, they need quality medical treatment from a doctor who takes the time to listen to their concerns, understand their injuries and limitations, and develop a comprehensive treatment plan that includes not just proposed medical care but also work restrictions.
Unfortunately the workers compensation claims process can make it difficult to receive the medical care you need and deserve. But there is a way to increase the likelihood of receiving all reasonable and necessary medical treatment so that you can recover as much of your pre-injury capabilities as possible: talking to your workers compensation doctor about your injury.
This article provides guidance on how to talk to the workers compensation doctor in your case so that you receive all the medical treatment, temporary total disability payments, and permanent partial disability benefits you’re entitled to.
The Workers Compensation Doctor’s Role in Your Case
The authorized treating physician has a lot of power in your Virginia workers compensation case. Here are some of the ways that the workers’ compensation doctor can affect your case:
- The workers compensation doctor determines what specialists you need to see for your work injury;
- The doctor’s opinion regarding causation helps determine whether your injury is compensable under the Workers’ Compensation Act.
- The doctor’s opinion regarding your work status determines whether you’re entitled to temporary total disability benefits, temporary partial disability benefits, or no wage loss benefits at all.
- The doctor’s opinion on whether you’re capable of performing a light duty job offered by the employer or its insurer determines whether you have to go back to work.
- The doctor’s opinion on your level of permanent impairment determines the amount of permanent partial disability benefits you’re entitled to. The doctor’s opinion on causation determines whether the employer. Insurer are responsible for recommended medical treatment including surgery.
- The doctor’s opinion on the type of medical care you may need in the future helps determine the settlement value of your case.
As you can see, your treating physician has a big role in your workers’ comp claim. This is why it’s so important that you choose the right workers compensation doctor and talk to him or her about your work injury and limitations. You will rely on your workers compensation doctor to get the medical treatment and workers compensation benefits you need.
What Should I Discuss with the Workers’ Compensation Doctor?
When you first meet the workers compensation doctor, he or she will take a history of your injury using patient forms that you complete in the waiting area and what you tell him or her in the examination room. You should tell the workers compensation doctor and those who work for the doctor all the facts about your workplace accident and injuries. Do not leave out any injuries or body parts that you think may have been hurt in the work accident. Sometimes injuries do not become apparent until days, weeks, or even months after the accident.
After you have established care with your workers compensation doctor, it’s important that you tell the doctor about any changes in your condition. Common changes include:
- Changes in pain levels - Side effects from medication - Having pain in a different part of your body (For example, a back injury may cause pain that goes into your legs and a neck injury may cause pain that goes into your arms) - Having new symptoms (For example, maybe you had pain to start but now you’re experiencing numbness and tingling) - New limitations that you’re experiencing at work or at home - Problems that you are having performing light duty work
We recommend keeping a log or diary of your pain and symptoms - what makes it worse, what makes it better, how often you have flare-ups - and sharing this information with your workers compensation doctor at appointments. Ask the doctor to make your log or diary part of your medical records so that you can enter it into evidence at your workers compensation hearing if necessary.
How Do I Talk to the Workers Compensation Doctor?
Honesty
You should always be honest with your workers compensation doctor. This is important for many reasons.
First, your doctor needs to know the truth so that he or she can provide the correct medical treatment. If the wrong medical care is prescribed because of inaccurate information from you, the treatment may cause more harm than good.
Second, the employer and insurer, as well as the Workers’ Compensation Commission, will see your doctor’s office visit notes and reports. If you provide inaccurate or conflicting information then the other parties to your claim will find out and your credibility will be destroyed. Credibility is important in Virginia workers compensation. Without it, you will have difficulty receiving benefits.
Openness About Your Concerns and the Workers Comp Litigation
There are some doctors who seem to believe that injured workers are exaggerating to try to get more money from the insurance company. Fortunately these doctors are in the minority.
It’s important that you tell the workers compensation doctor that you want to get better. Tell him or her about any medical treatment denials or problems that you are having getting transportation, wage loss benefits, or medical care approved by the insurance company.
You should also tell your workers comp doctor about any concerns you have with returning to work. You do not want to re-injure yourself by returning to a light duty job that is inappropriate because it exceeds what you can do comfortably and safely. If your employer or the insurance carrier offer a light duty position, get a written job description and talk about the specific demands of the job with your doctor.
By Showing Up to Medical Appointments with Your Workers Compensation Doctor
When you fail to show up to an appointment with your workers compensation doctor or are so late that the doctor can’t examine you, then your medical record may state that you were a “no show.” The record may or may not state the reason you missed the appointment.
Too many “no shows” in the medical record hurts your case. It calls into question your credibility. The insurance company and the Commission may question the severity of your injuries if you miss medical appointments.
Treat your workers compensation doctor appointments as a priority. Keep all your appointments. If you have to miss one, call in advance and reschedule it. Then let your attorney and the insurance adjuster know that it has been rescheduled. This may keep the insurance company from filing an application to suspend your benefits based on refusing medical treatment.
What Do I Do if the Insurance Company is Interfering with My Medical Treatment and My Workers Compensation Doctor? Many workers compensation insurance companies. Insurance adjusters try to control the injured worker’s medical treatment. Insurance companies do this by trying to speak with your workers compensation doctor and telling the doctor:
- What medical treatment they will approve and what medical treatment they will fight - Whether they think you’re capable of light duty work - What specialists and facilities they want the workers compensation doctor to refer you to - How many physical therapy visits they’ll approve
In several cases I have had a client forward me an email or text message from their workers compensation doctor where the doctor says that he or she “has to do what the insurance company says.” But this is not true. Neither you nor your workers compensation doctor should be pushed around by the insurance company.
In Virginia the authorized treating physician is in charge of medical care. The employer and its insurance carrier are not permitted to manage your medical treatment. The insurance company’s job is simple - to pay for treatment rendered by or at the direction of your workers compensation doctor
But this doesn’t stop some insurance companies from trying. And when the insurance company pushes you or your doctor around, it hurts your case.
You want a good workers compensation doctor who will be firm with the insurance company. By talking with your workers comp doctor about all aspects of your case and hiring a workers comp attorney who can deal with the insurance adjuster and build evidence with the help of your treating physician, you give yourself a better chance of a full financial and physical recovery.
Get Help Talking to the Workers Compensation Doctor
Sometimes it is easy to get the medical treatment you need for your work injury. Other times it is difficult because the insurance company tries to persuade your workers compensation doctor to release you back to work before you’re ready or to try conservative treatment instead of an operation or procedure that may help you recover faster.
You can fight for that medical treatment on your own. You may be able to win.
Or you can hire someone to help you take on the insurance company. After reading this article on how to talk with doctors in your workers compensation case, we recommend scheduling a free consultation with an experienced workers compensation attorney like Corey Pollard.
I am more than happy to schedule a free strategy session with you and your loved ones. Call, text, or email us today to get started.
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