Understanding the Significance of Workers’ Comp Doctors in Your Case

Healthcare costs for job-related injuries and illnesses are covered by your workers’ compensation insurance coverage provided by your employer. Your compensation depends on the treating physician’s medical findings and opinions.

This blog discusses the importance of workers’ comp doctors for injured or ill workers, how to choose your treating physician, and the factors to consider.

Importance of the Treating Physician in Workers’ Compensation Case

The treating physician plays a vital role in workers’ comp cases as their decisions in the steps mentioned below impact your recovery and the workers’ comp benefits you receive.

  • Diagnosis and Treatment
    The workers’ comp doctor’s diagnosis of the injury or illness and the treatment plan determines the type of benefits that you will get. The treatment, which may include surgery, therapy, or specialized treatment, can be decided only by the workers’ comp doctor.
  • Referrals to Specialists
    You may require a consultation with a specialist for more extensive or severe injury or illness. For this, you need a referral from your workers’ comp doctor. For this, they must be convinced that your condition needs specialist consultation.
  • Determining Your Time-Off-From-Work Period
    Your workers’ comp doctor decides your recovery period and back-to-work date. Based on that, you receive partial wage benefits.
  • Evaluating Your Disability Level
    Their evaluations of your physical condition at the end of treatment determine the type and amount of financial compensation that you may receive.
  • Maintaining Relevant Documents
    For workers’ comp cases, insurance providers rely on the medical documents your workers’ comp doctor maintains and provides as evidence.

Who Chooses My Treating Doctor?

The state where you reside determines who chooses workers comp doctors. In some states, you may select your primary care physician as your workers’ comp doctor. However, in other states, you may have to choose your workers comp doctor from an approved list or a network of physicians your employer provides.

Changing from Your Company Doctor

Your employer or insurance provider may appoint a company doctor you must consult for work-related injuries and illnesses. While in most cases, the appointed workers’ comp doctors offer quality medical care, there are instances when the company doctor works in favor of the employees and offers treatment plans that cost less to the employer’s insurers.

Suppose your recovery and compensation are compromised due to the company doctor’s biased practices. In that case, nearly all state laws allow you to change your doctor once, provided you adhere to the stipulated guidelines on changing your workers’ comp doctor.

How to Choose a Treating Doctor for Your Workers’ Compensation Case?

If your state laws permit you to choose your workers’ comp doctor, to get maximum benefits, you must ensure that the physician is:

  • Trained and experienced in your injury type or illness
  • Well-versed in the process of handling workers’ comp claims
  • Amenable to be paid according to the workers’ comp medical fee schedule
  • Easily available
  • Located nearby

Ensure Your Financial Well-Being with CDF-Artisan Insurance

Choosing the right treating physician is crucial for workers’ compensation cases. They impact diagnosis, treatment, referrals, time off work, and disability evaluations. Consider specialization, familiarity, accessibility, and proximity. Seek legal guidance for state-specific regulations. Contact us today at Artisan Insurance Solutions, you can also call us at (909) 275-7557 for expert coverage that benefits both employers and workers.

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