Workers Compensation:

Treatment by Doctors

If a worker is injured on the job, they may be required to see a physician provided by the insurance company. Unfortunately, because many insurance carriers seek to minimize benefits, the doctors in connection with the company may not be entirely truthful with the employee’s diagnosis. For instance, a doctor provided by the insurance company may tell the worker that they can return to work before the injury has healed simply so benefits cease.

The following are tips to help workers who must see a doctor from their employer’s insurance carrier:

Don’t cancel your appointment. If you fail to show up at your scheduled appointment, you may be obligated to pay the doctor’s fee. In some cases, neglecting to keep the doctor’s appointment can suspend the payment of your medical bills.

Know what to expect at the appointment. While the doctor may be honest, remember that this physician was chosen because he or she is conservative in their diagnoses and generally biased against injured workers who file a workers’ compensation claim. The physician has most likely been told to find that you were not injured or not entitled to benefits. Some doctors even earn a significant amount of money performing exams for workers’ compensation insurance companies.

Don’t take it personally. Remember to enter the appointment with a good attitude. Being defensive with the doctor can only hurt your claim.

Be honest with the doctor. Make sure you are truthful, polite and cooperative during your examination. If you lie about your injury, most doctors can tell immediately. Provide straightforward answers, maintain eye contact and try not to be nervous.

Don’t elaborate. Keep in mind that the physician was provided by the insurance carrier to help its case. Be sure to answer the question truthfully or completely, but don’t unnecessarily elaborate on your condition.

Be consistent. The doctor will be taking note of both your actions and your responses during the exam, so make sure you behave consistently. For instance, you complain to your doctor that your left ankle hurts when you put pressure on it. However, when you are leaving the appointment, you hop down onto your left foot from the examination bed. This action is inconsistent with your initial complaint.

Here are some additional things to avoid during your doctor’s appointment:

  • Do not discuss the settlement of your workers’ compensation case
  • Do not take any psychological tests
  • Do not undergo x-rays or other diagnostic tests
  • Do not see any other doctor without consulting a workers’ compensation attorney

Unfortunately, many doctors provided by insurance companies will conclude that the employee was not injured in the work accident and needs no further treatment. In many states, the employee can see a physician of their choice after 30 days. If you prefer to see your personal care physician rather than the insurance company doctor, speak with a workers’ compensation attorney who can advise you how to go about doing so.