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Workers' Compensation

How Choosing a Doctor Impacts Your Workers’ Compensation Claim

By March 27, 2023August 7th, 2023No Comments

Medical evidence is vital to a successful workers’ compensation claim. Claimants must see doctors who accept workers’ compensation when injured in a work accident to have their claim successfully processed and healthcare covered. In New York State, doctors must be specifically authorized to treat workers’ compensation claimants. Always confirm that your doctor accepts workers’ compensation insurance before becoming a patient for a work-related injury or occupational disease.

Using Workers’ Compensation Insurance After an Accident

If you are unconscious, need to be transported by an ambulance, or seek treatment in the nearest possible emergency room after your work accident, workers’ compensation insurance can be retroactively applied to your care. Getting medical treatment should be your priority. Your insurance claim can be processed later.

Note that some employers have a Preferred Provider Organization (PPO) and can require you to seek treatment with that PPO within the first 30 days after your injury, even if that means following up with the PPO after receiving emergency care.

Seeing A Doctor Who Accepts Workers’ Compensation Claims

It is important to work with a workers’ compensation doctor’s office that understands the process and will take the steps necessary to get you the treatment you need. Having prescription medications approved and tests, treatments, and surgeries authorized by workers’ compensation insurance can be complex.

Maintaining Workers’ Compensation Insurance Eligibility

If you are out of work and want to collect workers’ compensation benefits, your doctor’s report needs to indicate your degree of injury and disability, and that your disability or occupational disease is caused by your work injury. To remain entitled to benefits, you generally need up to date medical evidence every 90 days. The amount of, and continuation of, your workers’ compensation benefits depend on the strength of your medical evidence.

Handling a Workers’ Compensation Claim Denial

In general, you can receive treatment from any doctor/medical provider who accepts New York State Workers’ Compensation. If your employer denies your claim, in addition to proving that you gave the employer notice of your injury within 30 days, you will need a medical report describing your work accident, diagnosing your condition, and stating that your condition was caused by your work.

Receive Help With Your Workers’ Compensation Insurance Claim

The New York State Workers’ Compensation Board website has information on authorized medical providers and the workers’ compensation lawyers at Lewis & Lewis can assist you in finding a doctor and work to give your claim the best chance of being accepted.

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