How To Deal With Your Workers’ Compensation Doctor In VA
If you are pursuing a workers’ compensation claim after being injured on the job, you will likely be treated by a physician that treats workers’ compensation injuries, legally called the authorized treating physician.
This doctor has an extremely important role in your case. Not only will he or she provide the medical treatment you need, their opinion will also have great weight with the Virginia Workers’ Compensation Commission. Your authorized treating physician’s opinion will be a primary factor for the Commission to decide on your medical benefits, lost wages benefits, return to work, and overall settlement value of your case.
Given these, we can never stress enough how vital it is to have a good doctor-patient relationship with your workers’ comp physician. Here are some tips to help you.
How You Choose Your Authorized Treating Physician
Under Virginia law, your employer and their insurer must present you with a panel of three physicians to treat you for your injuries. You can then choose from this panel which doctor you will treat with.
Many workers’ comp claimants ask if they can choose their own doctor outside of this pre-approved panel. The short answer is no.
For one, the workers’ comp insurance company will refuse to pay for your medical care if you go with your own doctor. An exception to this would be if the workers’ compensation insurance company has flat out denied your claim.
Another disadvantage with using a non-approved doctor is that your employer and their insurer won’t give importance to the doctor’s opinion. This especially affects your lost wages check, your date of returning to work, and the amount of work you are given upon return. You might have to request a hearing to get your employer to abide by the doctor’s disability recommendation.
On the other hand, choosing from your employer’s pre-approved panel of doctors may also put you at a disadvantage. We’ve seen many employers pick doctors who are likely to say that employees are able to work again even without adequate diagnostic testing. To avoid your injury being undermined like this, you’ll want to have a lawyer on your side to guide you in picking the best physician for your workers’ comp claim.
What Happens During Workers’ Comp Doctor’s Appointments?
During your first meeting, your workers’ compensation doctor will take a history of your injury. Aside from talking to you personally, the doctor will give you patient forms to fill out or sometimes have someone, like a nurse, talk to you as well. Provide them with information as completely and honestly as you can. Include these details:
- Injuries you have sustained, including ones that seem negligible like bruising
- Other body parts that may have been affected – for example, if you injured your shoulder, your arm and neck may be affected as well even though they don’t show symptoms yet
- Symptoms that may not be immediately apparent, such as fatigue, bowel problems, breathing difficulties, and sleeping problems
- Facts about your work – the tasks you do, the devices or equipment you use, your hours of duty, safety measures in the workplace.
In your subsequent meetings and examinations with the doctor, remember to tell him or her about any changes in your body. These might include new symptoms, changes in pain levels, new physical limitations at work or at home, and side effects of medication.
It’s best that you keep a daily diary or a log of your experiences so you remember what to tell your doctor and also so that you have additional evidence supporting your injury claim.
Finally, before you leave the doctor’s office, ask for a disability slip. This important piece of paper indicates that you have physical restrictions preventing you from working just yet. You’ll need this so that your employer and their insurer are obliged to pay you your weekly benefits.
Changing Your Workers’ Comp Doctor
Can you change your chosen workers’ comp physician? The answer is yes, but only in certain circumstances.
One is if your current doctor directly refers you to a specific specialist, in which case this specialist can then handle your case as your new authorized treating physician.
Without a direct referral, a change in physician would need the approval of your employer and their insurer. They have the right to present you with a new panel of physicians from which you can pick your new authorized doctor.
If your employer or the insurance company does not approve the change at or does not provide you with an appropriate panel, you can petition the Workers’ Compensation Commission to approve the change. The Commission will require you to show valid grounds to change your physician, such as:
- Your condition requires a specialist
- Your original doctor is not giving you adequate treatment
- Your health is not improving under the original doctor’s treatment
- Your original doctor is not cooperating with the Commission
- Your original doctor has no treatment plan for any potential long-term disability.
The Commission may require you to prove these circumstances in a hearing. It is wise to have a reliable workers’ comp attorney to help you build evidence to convince the Commission.
Does Your Employer Or Their Insurer Have Authority Over Your Doctor?
No. Under the law, your employer and the insurance company should not interfere with your treatments nor influence your physician’s opinion.
Unfortunately, this remains an ideal. In reality, many companies today try to control their injured worker’s medical care and return to work. For example, an insurance adjuster might tell the authorized physician that the insurance company will approve only some types of medical treatment or certain facilities to use. Or the employer may assure the doctor that there is light-duty work that the injured worker will now be able to do.
Remember that your authorized workers’ comp physician is in charge of your treatment, and that he or she is not obliged to do what your employer or their insurer says.
If you believe that you or your doctor is being pushed around, contact a workers’ compensation lawyer as soon as possible. At Slominski Law, we’ve seen many cases where injured workers are not given enough chance to recover physically and financially. They were led to agree to stop treatments or to return to work too soon, and this hurts their settlement claims. We’ve seen how companies do this, and we want to help you avoid the same situation.
Dos And Don’ts Of Dealing With Your Workers’ Comp Doctor
- Do be honest. Even though you want to be complete in the information you provide your doctor, don’t exaggerate the details or lie about your history. Insurance companies commonly try to dig through your work and medical records, and if they find evidence that you have falsified some information, it can greatly damage your claim.
- Do be open about the incident and your injuries. There is no doctor-patient privilege in workers’ comp, meaning that your discussions and examinations will be available for review by other parties such as the insurer. Despite this, don’t be afraid to tell your doctor the details around your injuries. If you are still reluctant, protect yourself with a trusted workers’ comp lawyer.
- Do discuss your work restrictions. Explain to your doctor what kind of work you do and how your injury now restricts you from performing. The doctor has to understand these limitations so that he or she can determine your level of disability and when it would be appropriate for you to work again.
- Do keep records. Apart from your daily log of your symptoms and experiences, also keep your medical bills, travel receipts, previous wage checks, and other documents relevant to your compensation claim.
- Don’t miss or be late to appointments. Every meeting with your authorized treating physician is vital not only for your health but also for your claim. Missing an appointment can be taken as proof that your condition is not as serious as you are claiming. If you can’t make it to an appointment, inform your doctor in advance and have it rescheduled.
- Don’t forget to ask for a disability slip. As discussed above, your disability slip is crucial for you to get paid your weekly benefits.
- Don’t hesitate to call a lawyer. While it’s possible for you to pursue a workers’ comp claim by yourself, there are plenty of ways that an insurance company or even your employer can deny you your fair benefits. Over and over again, it has been shown that having an attorney is crucial in protecting your rights as an injured worker, in avoiding mistakes that can cost you your claim, and in fighting for your rightful compensation.
Contact Slominski Law
Slominski Law is a firm that many Virginians have come to trust. We are a local firm dedicated to helping real people instead of companies and insurers. We can work closely with you to help you succeed in your workers’ compensation claim. Talk to us about any concerns regarding your injury or your doctor. Call us today at (434) 384-9400 or reach us through our online contact form at Slominskilaw.com.