The Role of a Doctor in a Workers’ Compensation Claim
Different states have different rules that govern a worker’s ability to choose their own doctor. If you have some right to choose, you should consider this decision carefully. You will want to find a doctor who has a record of experience in treating your specific condition and with whom you feel comfortable. The doctor should be familiar with the workers’ compensation process and ready to provide records or testify on your behalf. They should be accessible and available for consultations or general questions.
Sometimes an employee does not have the right to choose a doctor. Instead, they must see a doctor chosen by the employer or insurer. Many injured workers understandably worry that this situation places them at a disadvantage. The doctor may feel that they have a greater responsibility to the employer or insurer than to the employee, since they want to protect their relationship with the entity sending referrals to them. Not all doctors in this situation favor the insurer’s interests, but some do. They might try to cut costs, minimize the extent of an employee’s disability, or prematurely declare that they have recovered. Often, you can avoid this situation by changing to a doctor of your choice after a certain time has passed.
How Your Doctor Will Affect Your Claim
The treating doctor will be the principal authority on your medical condition. They will be responsible for making the initial diagnosis, monitoring your progress, and prescribing any medications and therapy that may be needed. The doctor may provide referrals to specialists, based on their analysis of your condition and the symptoms that you report. They will determine the course of treatment that is reasonable and necessary in your situation. The documentation that they create will be used as evidence in your claim, and they can provide testimony for you at a deposition or a hearing.
A Doctor’s Role
1Diagnosing, monitoring, and treating the condition
2Providing referrals to specialists
3Determining an appropriate course of treatment
4Providing evidence for the claim
5Evaluating work restrictions
6Determining a return-to-work date
7Evaluating maximum medical improvement
8Providing an opinion on permanent disability
In addition to treating your condition, the doctor will evaluate any restrictions on your ability to work. This will affect the amount of any temporary disability benefits that you receive. The doctor will determine when you can return to work and whether restrictions on your job duties will continue to apply. These decisions can affect your ability to fully recover from a condition and your ability to support yourself while you recover.
Sometimes an employee will not fully recover from an injury or illness, leaving them with a permanent disability. The doctor will decide when they have reached maximum medical improvement, which means that their condition will not improve with time or further treatment. Their opinion on any remaining limitations can shape the amount of any permanent disability benefits that you receive. Permanent and partial disability benefits can be awarded if you can still work in a reduced capacity, while permanent and total disability benefits can be awarded if you are no longer able to hold a job. A doctor’s opinion on a permanent disability also can determine the type of vocational rehabilitation or retraining that an injured employee receives through workers’ compensation.