When you are injured your employer or your employer’s workers’ compensation insurance company typically provides you with a list of pre-approved doctors, hospitals, or medical providers.
New York requires you to be provided with at least two options in each medical specialty and at least two hospitals to choose from.
The answer is complicated.
The First Thirty Days
Most workers’ compensation companies use Preferred Provider Networks, so you must almost always begin the process with these pre-approved medical providers.
You may not trust them, fearing they have some incentive to prioritize the employer’s needs over your own, but you must wait at least thirty days before requesting a change back to your medical provider. The New York Workers’ Compensation Board must approve the request.
Usually, it’s a good idea to seek help from a workers’ compensation attorney before making the shift.
If you don’t go through these steps, the workers’ compensation insurance company may deny your claim, which means you’ll have to pay for medical treatment yourself and may miss out on lost wage benefits.
Dealing with an Employer-Improved Doctor
As workers’ compensation attorneys, we recommend documenting everything the doctor says or does during your appointment. Don’t be shy about raising any concerns you might have about your treatment.
You need to be able to show the Workers’ Compensation Board that your employer-appointed doctor is not listening to you, so they will allow you to seek a second opinion.
During Treatment
No matter which doctor is treating you, it is absolutely imperative that you follow all doctor’s instructions. You should assume you’re under surveillance.
Failure to follow even the simplest of doctor’s instructions could lead to accusations of insurance fraud or the termination of your workers’ compensation claim. Your employer is likely to take advantage of any chance to claim your injury isn’t as bad as you say it is.
In addition, you should not skip any Independent Medical Examinations (IMEs) that the insurance company may order. Workers’ compensation insurance tends to order IMEs whenever you try to use your own doctor.
Take detailed notes and ask for copies of any records generated from your visit. Take someone with you to serve as a witness.
If the IME doctor disagrees with your doctor about necessary treatments, it may be time to involve a workers’ compensation attorney.
Get Help Today
Workers’ compensation insurance is complicated. If your employer or insurance company starts making life difficult for you, securing representation as soon as possible is best.
Contact our office to get help today.
See also:
Does New York Workers’ Compensation Cover Ambulance Costs?