The Role Of The Doctor In Your Work Injury

The doctor plays a critical role in a workers' compensation insurance claim. When an employee is injured on the job, the first step is for them to seek medical attention. The doctor will assess the extent of the injury, provide treatment, and document the details of the injury.

The Role of the Doctor 

The doctor's documentation is essential in the workers' compensation insurance claim process. The insurance company will use the doctor's report to determine the severity of the injury, the employee's ability to work, and the appropriate amount of compensation to be paid. The doctor's report will also be used by the employer to make decisions about the employee's return to work. It is important to note that the doctor who treats the employee must be authorized by the workers' compensation insurance carrier or state agency. In some cases, the employee may have to see a different doctor if the initial treatment was not authorized.

What Disagreements Arise

In some cases, your workers' comp doctor will not agree with the workers' compensation insurer and vice versa. If the doctor and the workers' compensation insurer do not agree on treatment issues, there are several steps that can be taken to resolve the issue. Here are some options:

Independent Medical Examination (IME): The insurer may request an (IME) by a different doctor to get a second opinion on the injury and treatment plan. The employee may also request an IME if they disagree with the treating doctor's recommendations.

Medical Treatment Guidelines: Many states have established medical treatment guidelines that outline the recommended treatment for various types of injuries. These guidelines can help to resolve disagreements about appropriate treatment.

Mediation: If the dispute cannot be resolved through an IME or by using medical treatment guidelines, mediation may be an option. Mediation involves a neutral third party who will help facilitate a discussion between the doctor and insurer to find a solution.

Workers' Compensation Hearing: If all other options fail, the employee may request a hearing with the workers' compensation board to resolve the dispute. The board will hear arguments from both sides and make a decision based on the evidence presented.

Some workers will need to advocate for their own best interests by having legal representation. Speak to a workers' compensation lawyer about the IME, medical treatment guidelines, mediation, hearings, and more. You have legal rights after a disputed work injury and you are likely entitled to back pay and potentially, a lump sum settlement. Speak to a workers' compensation law firm such as Weaver Law firm today to learn more.