When filing a workers' compensation claim in New York State, selecting the right doctor is crucial. Making the wrong choice can jeopardize your claim or even lead to losing your benefits entirely. In this blog post, I'll explain what makes a good workers' compensation doctor and provide steps to help you find one.
If you get injured at work, your first priority should be to get immediate medical treatment. In an emergency, you don't choose your doctor; you are taken to the nearest hospital and treated by the available medical staff. Rest assured, your employer’s workers' comp insurance will cover all related expenses.
Once you are out of immediate danger and on the road to recovery, New York State law allows you to choose the doctor you work with, provided they are authorized by the New York State Workers Compensation Board—referred to as being “coded.”
If you prefer working with your primary care physician, contact them to check if they are coded by the Board to handle workers' comp cases. It's also important to confirm if they have regular experience with these types of cases, as even a small mistake can result in fewer benefits or losing them altogether.
If you don’t have a preferred doctor, you can use the database of authorized healthcare providers on the Workers’ Compensation Board website. This tool allows you to search for general practitioners as well as specialists—such as cardiologists, orthopedists, or physical therapists—and filter by geographic region to find someone close to you. Note that some doctors listed may no longer handle workers’ comp claims, but don’t let that discourage you. Simply move on to the next one on your list.
A common myth is that doctors who handle workers' compensation cases are not good doctors. This is not true. There are many excellent doctors who are coded to treat injured workers in New York State. I have personally received treatment from workers' compensation doctors and have referred family and friends to them as well.
If you work with a lawyer, they should be able to recommend skilled doctors who are authorized to handle workers' comp claims and will take excellent care of you. And if you are not satisfied with the care you are receiving, you are free to switch doctors at any time. It’s crucial to feel comfortable with your doctor, as this often leads to better recovery outcomes.
So, how do you identify the right doctor for you? Comfort is key. You should feel comfortable working with your doctor, as this generally leads to better recovery outcomes.
Your doctor should understand the connection between certain jobs and types of injuries, which helps in proving that your injury was sustained at work. One of the main ways insurance companies deny claims is by arguing that the injury occurred off the job. Your doctor’s medical report can counter this argument early in the process.
The right doctor also understands the urgency of a work injury claim and will schedule your appointment quickly. They should have regular, ongoing experience with workers’ comp cases and be familiar with the required forms to prove your injury was work-related, maintain benefits over time, and optimize any final award for permanent disability.
If you're out of work, your doctor needs to justify your lost time to the court by submitting regular medical reports. A medical report only supports 90 days of lost time, so you need to see your doctor at least once every three months to maintain ongoing benefits. This involves filing a lot of forms, and doctors who do not regularly handle these cases may not be familiar with them. If your doctor drops the ball here, it can mean the end of your benefits forever.
While New York State gives you flexibility in choosing your doctor, the laws around paying for treatments are more restrictive. Insurance companies often interpret the state’s treatment guidelines conservatively to minimize their expenses. Therefore, it’s important to have both a skilled doctor and a lawyer who can work with you to get the treatment you need.
If you or a loved one have been injured on the job in New York and would like to set up a free consultation, give me a call at 212-406-8989 today. Together, we can ensure you receive the treatment you need and the benefits you deserve.
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Remember, choosing the right doctor is critical for your workers' compensation case. Don’t rush the process—take the time to find a doctor who will support your recovery and help secure your benefits.
