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Can You See Your Own Doctor On Workers’ Comp?

Suffering an injury at work can be a very stressful and problematic situation. Most injured workers not only have to put up with the injuries and the recovery process, but they also worry about the financial burden that medical bills may cause.

However, if you suffer a workplace injury, you have the right to file a workers’ comp claim to pay for your medical treatment, lost wages, and physical therapy if necessary.

Many people question whether they can consult their primary care physician under workers’ comp, particularly if they have a pre-existing medical condition managed by their doctor over time.

Every state has different rules and regulations when it comes to switching doctors or medical providers while on workers’ comp.

In New York, for example, it is possible to see your medical practitioner only if the chair of the NY Workers’ Compensation Board approves it. Generally, after filing a workers’ comp claim, your employer or your employer’s insurance company will provide you with a list of doctors, hospitals, or medical providers approved by them.

The state of New York requires all employers or their insurance carriers to provide injured workers with at least two options in each medical specialty and two hospitals to visit for the injured worker to choose from. Even if you prefer to see your own doctor, you’ll need to initiate treatment with one of the medical providers pre-approved by the insurance company.

If you still want to continue to seek medical treatment with your own doctor, you can do it 30 days after starting the treatment with the medical provider assigned by the insurance company. Your doctor must first be approved by the chair of the New York Workers’ Compensation Board.

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What happens if I don’t see an approved doctor when my state requires it?

If you choose to visit a doctor not approved by your employer or their insurance company, they may not cover the costs. may dispute your workers’ compensation claim.

If, in the end, your case is denied because you visited another doctor, you will have the financial responsibility to pay for your medical treatment. Depending on the severity of your injuries, your medical bills could be enormous. For that reason, if you want to choose your own doctor for treatment, you should speak to an experienced compensation attorney.

Since every state has different laws and procedures, speaking to someone who has experience in the field is the best decision you can make.

Should I see a doctor or talk to a lawyer first after getting hurt at work? 

Immediately after an accident, you should go to the emergency room to receive medical care as soon as possible. Some workplace injuries can be life-threatening, therefore, going to the ER is crucial.

Once you are in the emergency room, you or someone who is with you need to notify the doctor in charge that you suffered a work-related injury. This is a very important step because this will open your workers’ comp claim.

Additionally, when you specify that the injury you suffered was at work, the doctors in the emergency room will have to include that information in the medical report. By doing so, your workers’ compensation benefits will cover your emergency room visit.

After your visit to the ER, you will most likely need medical treatment to fully recover from your injury or illness. If your doctor is not on the list of pre-approved medical providers, you should contact a lawyer first.

A workers’ compensation lawyer will explain how to use a doctor outside the insurance company’s network of medical providers.

Nevertheless, before making any decisions, you should consult with your medical physician. Not all doctors or clinics accept workers’ compensation patients. Medical providers that treat injured workers must adhere to certain limits and criteria.

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How to best deal with doctors who treat you for your injury?

If you are receiving treatment from a doctor affiliated with your employer’s insurance company’s network of approved medical providers, remember that they have a business relationship with the insurance carrier.

That means, they will offer the medical care you require while also attempting to limit expenses in order to keep the commercial partnership. For that reason, you need to carefully document everything that the doctor tells you in every appointment.

You also have to express any concerns that you may have about the treatment that is being provided. Make sure that the doctors also include in your medical records everything that you tell them or any symptoms that you feel.

In case you feel that your medical treatment is not working and you want to see another doctor, you will have evidence that you have been reporting every concern to the treating doctor and you require a second opinion. 

Do I have to see the business’s doctor for medical treatment?

In most cases, you must receive medical treatment from the company doctor or the doctor provided by their insurance company, at least for the initial treatment.

After a certain period of time, you may be able to see a different doctor if your state’s workers’ comp commission approves it. This does not only apply to the primary care provider, this can also be the case if you request alternative care such as chiropractic care or acupuncture.

Just make sure to seek legal counseling with a workers’ compensation attorney before making any decisions that may compromise your claim. 

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Will an injury sustained at work be covered by my insurance?

You should not use your own health insurance to pay for your medical treatment if you suffered a workplace injury. It is your employer’s responsibility to pay for your medical treatment, lost wages, and other out-of-pocket expenses caused by the injury you suffered while working.

Furthermore, using your own health insurance may cause you to pay very high deductible fees that you should not be paying. Some health insurance carriers may pay for your medical treatment, but they will ask you to sign a document where you agree to pay them back if you receive a settlement. 

What not to do while on workers’ comp:

If you are on workers’ comp avoid doing the following:

  • Missing medical appointments with the doctor who is treating you.
  • Not following every indication given by your medical provider. 
  • Missing physical therapy sessions.
  • Consulting doctors who haven’t been sanctioned by your state’s workers’ comp commission can jeopardize your case.

Engaging in any of the actions listed above could compromise your workers’ compensation case.

The insurance company could deny your claim, alleging that your injuries were not as severe as you stated or that you have fully recovered. 

What else do I need to know in order to protect my workers’ comp claim?

Since every state has a different set of rules and regulations it is important to seek legal advice from a workers’ compensation lawyer that has vast knowledge about your state’s laws. 

Greenberg & Stein P.C. We can assist you if you were injured at work in New York City. We are a respected law company with some of the state’s best attorneys. Our legal team has provided representation for numerous individuals who have sustained injuries at work.

We can assist you in fighting for your right to fair compensation. Do not hesitate to contact our law firm. Call our law offices at 212-681-2535 to schedule a free case consultation with a member of our legal team. 

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