Talking to the Workers Compensation Doctor

If you have suffered an injury at work, you probably want to get the medical treatment you need to recover.  A good doctor will provide you with that treatment.  But workers’ compensation is complicated.  To make sure you get the medical treatment you need, you must talk to the workers’ compensation doctor about your injury.

Many people do not understand the power that the workers’ compensation doctor has in a Georgia claim.  It is a lot of power, and I discuss this power in more detail below.

Unfortunately, your employer and their workers’ compensation insurance company almost certainly understand the power the workers’ compensation doctor has.  You can bet that your employer, their workers’ compensation insurance company, and/or their attorney probably already have spoken with your workers’ compensation doctor.  They may have discussed the following things:

• What medical treatment they will approve;
• Whether you can go back to light duty work; and
• To which specialist they want the doctor to refer you.

“Authorized treating physician” is the legal term used for your main Georgia workers’ compensation doctor.  The discussions the workers’ compensation insurance company has with your authorized treating physician often prevent you from getting the benefits or medical treatment you need.

How does my workers’ compensation doctor affect my case?

Georgia’s workers’ compensation law gives your authorized treating physician a lot of power.  Your authorized treating physician can affect almost all your workers’ compensation benefits.

Here are a few ways your workers’ compensation doctor can affect your case:

• The doctor’s opinion regarding your ability to work determines whether you continue to receive temporary total disability benefits;
• The doctor determines what specialists you will see about your injury;
• The doctor can approve or disapprove light duty jobs; and
• The doctor’s release to light duty work can reduce the amount of your weekly benefits.

As you an see, your authorized treating physician affects all areas of your workers’ compensation case.  This makes it very important to select a good doctor and to make sure that doctor understands your injury.  You can do this by communicating truthfully with your doctor.

You want to get good medical treatment.  Good medical treatment helps you recover from your injury.  You will rely on your doctor for this.

What do I need to discuss with the doctor?

Your workers’ compensation doctor needs to understand the facts about your injury.  Doctors take a history of your injury when you treat with them.  They gather this information through documents that you fill out before seeing them.  They also gather information when anyone in their office talks to you.

This history helps the doctor make a diagnosis.  For example, suppose you tell the doctor that you slipped and fell at work and your arm.  The doctor may suspect you fractured your arm and order x-rays.  Providing a proper history to the doctor can help you get the proper treatment.

Providing a proper history can also help your case.  Insurance companies and their attorneys like to comb through your medical records to find potential inaccurate information.  They often try to blame you for these inaccuracies and ask the judge not to believe your testimony if your case goes to court.

How can I make sure my medical records are accurate?

Talking to the workers’ compensation doctor helps you make sure that your medical records are accurate.  It probably goes without saying, but you need to always tell your doctor the truth.

You will want to keep the doctor updated on any changes with your condition as well.  Some of these changes could include:

• Your pain increasing or decreasing;
• Having pain in a different area of your body;
• Having a different type of pain;
• Changing circumstances (a new injury, new duties at work, etc.);

How should I talk to the doctor?

First, you need to be honest.  You never want your truthfulness to come into question in a workers’ compensation case.  Insurance companies love to claim that you are lying.

Second, you need to talk to the doctor about what is important to you.  Unfortunately, some doctors believe that many injured workers are just looking to get money from an insurance company.  The doctor needs to understand that you want to get better.  You need to let the doctor know this.

But, you do not want to cause yourself additional injury.  Your injury could make it harmful for you to return to certain jobs.  Many of my workers’ compensation clients go back to work when their employers provide them with a suitable job.  However, you will want your doctor to address any concerns you have about job suitability.

Do not get pushed around by the insurance company

Many workers’ compensation insurance companies try to control your medical treatment.  The insurance company is a business.  Like most businesses, they try to make a profit.  Since workers’ compensation cases costs them money, they will probably try to pay as little as they have to on your case.

The insurance company may try to tell you what doctors you can see.  The adjuster may tell your doctor that they will only approve a certain number of physical therapy visits.  The nurse case manager may tell the doctor that the doctor has to refer to a certain orthopedic surgeon or neurologist.  They may tell the doctor that he has to send you back to work.

When the insurance company pushes around you or your doctor, it hurts your case.  You want a good doctor.  You want that doctor to make the decisions, not the insurance company.

When you talk to your doctor, you improve your chances of getting the treatment you need.  You may also find out if the insurance company has pressured the doctor.  Knowing that will help you decide how you need to respond.

What should I do if the insurance company is interfering with my medical treatment?

You deserve to get the medical treatment you need for your injury.  Georgia’s workers’ compensation law entitles you to that treatment.  Unfortunately, you will often have to fight with the insurance company to get it.

You can fight for that treatment.  I have discussed some of the tactics insurance companies use to delay and deny treatment before.  You may be able to overcome them.

Often, it helps to have someone on your side in that fight.  After you educate yourself on how to talk with doctors and deal with the tactics insurance companies use to deny your medical treatment, I would recommend that you find out how a workers’ compensation attorney could help you.