Are Workers’ Comp Doctors Biased Against Workers?

August 23, 2021

Are Workers’ Comp Doctors Biased Against Workers?

Is the Doctor Chosen by the Workers’ Comp Insurer Biased Against Me? In California, if you do not predesignate a doctor to treat you after a workplace injury, you are required to go to a doctor chosen by your employer’s workers’ compensation insurance company. If you are concerned the doctor may be biased in favor of the insurance company, that is a valid concern. This is why you may want to consider predesignating a doctor you trust to treat you. There are also steps you can take to document an appointment with a doctor you believe was biased against you. It is recommended that you discuss this information with an experienced workers’ compensation lawyer in Bakersfield. Are Workers’ Comp Doctors Fair? While some doctors chosen by workers’ compensation insurance companies are fair, some may not be. Insurance companies are looking to pay out the least possible amount of compensation, so they look for doctors who they think will reach conclusions that help them achieve that goal.

If a doctor reaches conclusions that appear to help workers, insurers may stop working with that doctor. Doctors know this, so it may create an incentive for them to make decisions that favor the insurance company. They may avoid conducting expensive tests like MRIs and CT scans, which can make it more difficult to adequately assess a patient’s health. Act like they are always monitoring you. They may watch start watching you as soon as you exit your vehicle and walk into the office. They are looking for any indication of an injury. Bring a third party with you. Ask a friend or family member to come with you to your appointment so that he or she can take notes and serve as a witness in case some aspect of the examination is later in dispute. Document the appointment. Keep a journal where you note the events that transpired during your examination, the statements made by the doctor and how long the examination took.

Be polite. Do not give the doctor an excuse to make a negative finding about you by being abrupt or rude. Having independent documentation about the examination can help you if you are later in dispute with the insurance company. Can I Change Physicians? If you have not predesignated a physician to treat you, you can still change physicians if you are not satisfied by the diagnosis or review of the workers’ comp doctor. However, this process can take more time and delay compensation. You can request a second opinion and if your request is approved, you will be sent to another doctor within your employer’s network. If you are still not satisfied, you can choose your own doctor once 30 days pass from the date of your injury. However, changing doctors may not work out as planned. Your new doctor may agree with the first or second doctor you saw, which will provide more evidence against you. The second, third or fourth doctor may state that you require less treatment than the first doctor. If you have questions about medical examinations after a work injury and switching doctors, contact Berry, Smith & Bartell to schedule a free consultation. Our legal team has decades of combined experience pursuing benefits for injured workers and a track record of success.

If you have an attorney, the rating can be done by either the DEU or a private rater. You or the claims administrator also has the right to have the report of your primary treating physician (PTP) rated, but this does not happen automatically. You must request a rating of the PTP's report by completing a Request for Summary Rating Determination of Primary Treating Physician's Report and sending it to the DEU with a copy of the PTP's report. The process used to calculate your rating can vary, depending on your date of injury or other factors. The PD rating is used in a formula that determines the benefits you'll receive. You have a right to receive a copy of the QME's report as well as the reports from your PTP. Read the QME's and PTP's reports carefully. Make sure they are complete and do not leave out important information.

Are Workers’ Comp Doctors Biased Against Workers?

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