Going through the workers’ compensation claims process can almost be more painful than the original injury. New York has its own set of laws that govern how these claims will be handled and what is required of the injured worker in order to receive compensation. One such requirement is that the injured worker’s claim must be evaluated and diagnosed by a workers’ compensation doctor who has been hired by the insurance company.
If you have been injured on the job, you will need some assistance filing your workers’ compensation claim – and you need an advocate there to protect your rights. You will be required to be medically evaluated and treated by the physician approved by your employer’s insurance carrier. While you can be treated by your own doctor, as well, your claim will still be dependent on the diagnosis and evaluation of the doctor chosen from the insurance company’s’ approved list. Your own physician may not be one of those approved physicians.
The Doctor’s Competence
Doctors each have their own reasons for working for an insurance company; for most of them, the goal is to receive a paycheck. Some doctors will work for insurance companies after retiring from private practice, while others will use insurance companies to supplement their income from their private practice. Usually doctors who are certified in areas like surgery, orthopedics and other specialties are not found working for insurance companies; instead, doctors employed by insurance companies are typically general practice physicians.
In most cases, doctors who work for an insurance company will continue to depend on the referrals they receive; therefore, you may wonder if these doctors will do much to protect your interests instead of their own. Some of the doctors who work for workers’ compensation companies are “fringe” doctors. They rarely read up on the latest treatments or conditions, while some even use such “old school” methods that today’s physicians would be able to easily debunk any diagnosis that they conclude.
Most workers’ compensation injury claims involve things like torn cartilage, soft tissue damage, herniated discs, stretched muscles and tendons. Back injuries are very common in workers’ compensation claims, but are extremely difficult to diagnose. In order to determine if a patient is truly injured, a competent physician would need to order an MRI, CT scan, or other expensive diagnostic tests.
Most of the physicians working for workers’ compensation insurance know that the company does not want to spend money on testing. These tests not only cost the companies, but are complicated and time-consuming. Doctors employed by insurance companies may tell the patient that they are working for them; in reality, they are working to keep the costs down for the insurer that is paying them.
Doctors working for insurance companies may forgo actual testing and recommend starting treatment. But, this treatment often includes high doses of pain medication, which can lead to further complications, unhealed injuries or even medication addiction problems.
Using Independent Medical Examinations
Sometimes the insurance company will require the injured worker to have an Independent Medical Examination (IME). These are typically ordered because:
- The insurer doesn’t agree with a personal physician’s diagnosis;
- The claim is moving too slowly and the insurer wants to complete it; or
- More evidence is needed to resolve any issues that have been found in the claim itself.
The doctors hired to conduct the IME still work for the insurance company; therefore, it can be in their best interest to diagnose in accordance with the insurer rather than your own physician. For this reason, it is critical that you hire your own attorney, in addition to using the physician of your choice.
Contact Schwartzapfel® Lawyers P.C. Today
By consulting an attorney, you can protect your interests and ensure that the doctor hired to examine and/or treat you is not doing so only with his or her own pockets in mind. If you have been injured on the job, contact the expert attorneys at Schwartzapfel® Lawyers P.C. today for a free consultation. Call us at 1-877-737-4806 or fill out our online contact form with your workers’ compensation questions.