A common theme to many of the questions we’re asked by injured workers involves the treatment and diagnosis provided by a company physician.
The situation is frequently as follows: a worker is injured and reports to his supervisor, who recommends an exam by the company physician. The company physician may be on the worksite full time, or someone the company contracts with who is located off-site in a private medical office.
Many workers comply with their company’s request and will begin treatment with their company’s physician. Often an employee feels that treatment by a company physician is a requirement. They trust that the company recognizes their injury and has their best interests at heart when providing care.
For many injured workers, however, pain and suffering continues or intensifies despite a company physician downgrading their injury or in fact, releasing them back to work without restrictions. Often times, a company physician will refuse to order further tests, such as an MRI, or refuse to send the injured worker to an appropriate specialist, such as an Orthopedic Surgeon or Neurologist.
Just as a Workers’ Compensation insurance adjuster protects the financial interest of the insurance company, not an injured worker, a company physician is paid by the company ‘s insurance carrier to protect the insurance carrier’s interest foremost, and may, or may not provide objective, necessary care in the best interest of the injured worker.
It is often at this point that an injured worker becomes concerned; worried that he or she is not getting needed care, and unaware of the right to seek care through a private physician. Often they are warned, directly or indirectly, that seeking outside care could compromise their weekly benefits. Don’t be fooled.
By law, injured workers are allowed to have their personal physician of choice manage their on-the-job injury, which includes coverage for any referrals to specialists that the managing physician feels are necessary. In fact, an injured worker is allowed two choices of a physician. If at some later time you decide that you’d like to change primary care physicians for your injury, you’re allowed a second (and final) choice. However, be forewarned: If you choose to transfer to a third managing physician down the road, that physician, and any referrals made by that physician, will not be covered. You are only allowed two choices of physicians to manage your injury.
Injured workers are advised to have a primary care physician (someone who also manages your general medical care) as their managing physician who can make appropriate referrals to specialists, rather than select a “specialist” from the onset as their first or second choice, as a specialist may not be the best choice to “manage” all things related to the injury, now or in the future.
For example: If the injury involves a back injury or broken leg, the injured worker should go through their general physician for a referral to an orthopedic specialist if necessary, rather than selecting an orthopedic doctor to manage the “whole” of their care. If the injured worker also needs to consult later with a neurologist, their primary care physician can manage that referral and it will be covered by workers’ compensation.
A primary care physician also acts as the best point of access for communication regarding your injury status and your ongoing medical needs.
The bottom line:
- Whenever possible, always seek initial and follow up treatment for an on-the-job injury through your personal primary care physician as soon as possible.
- While Chiropractors often play an important role as part of an injured worker’s care team, many arbitrators would not give their diagnosis and treatment plans the full weight they would give to a medical doctor. If you wish to seek treatment from a Chiropractor, consider doing so under the management of your primary care physician.
- Having been examined by a company physician following an injury does not take away your right to receive care through your primary physician, and we recommend you do choose your own doctor.
- Note: Choosing to have ongoing care provided only by a company physician could be viewed as your first (out of two) choices of a managing physician, limiting your choices down the road for a personal managing physician, so again, seeking initial and follow up care with your personal physician from the onset is best.
If you feel your care has been compromised or limited by a company physician, or have questions regarding a conflicting diagnosis or return-to-work prognosis, you should obtain a consultation with an experienced Workers’ Compensation attorney to ensure your rights now, and in the future are protected.
For more information regarding your Workers’ Compensation rights, visit our website (www.horwitzlaw.com) where you’ll also find the book, “How To Win a Workers’ Compensation Claim in Illinois”, by Horwitz attorney, Mark Weissburg.
Attorney Mark Weissburg, welcomes your comments on this article.