New York Workers' Compensation is an intricate area of law that is often subject to a number of misconceptions. This site is intended to help readers seeking clarification on the topic of NY Workers' Comp. Whether you are an injured worker lost amidst the complexities of Workers' Comp, a doctor who is not sure how to properly handle a Workers' Comp patient's file, or simply a curious New Yorker who worries about what would happen if you were ever injured on the job, I hope that the content of this site will deliver the answers you seek, even to questions you didn't know to ask.

It is my pleasure to welcome you into the world of New York Workers' Compensation. I hope you enjoy your visit, spread the word, and come back soon.

Best regards,

Camila P. Medici, Esq.

Tuesday, October 12, 2010

Dealing With Doctors

Because you are injured, you will find yourself in a medical system that may at times make you feel like no one is listening to or cares about you.  For that reason, we are offering you some general advice:

Generally speaking, most people are first treated at an emergency room and then referred to a doctor, which could be your family doctor.  It is important that, if you choose to first see your family doctor, you tell him/her that your accident was work-related, and that you ask for referrals of doctors who understand Workers’ Compensation and are coded by the Workers’ Compensation Board.  Going to a Workers’ Compensation doctor will decrease your chances of problems with the appropriate forms being filled out or relevant information missing.  You can choose what doctor you go to, but you may not be able to choose which radiological facility you can go to.  The insurance company has the right to give you a list of places near you that you may choose from to go for diagnostic testing, such as MRIs, EMGs, or X-rays.    

This includes ALL illnesses and previous accidents or injuries.  Prior accidents and injuries generally do not affect the viability of your claim unless you hide it!!!

Clarify it immediately.  The doctor assumes that he/she is correct.  But you must remember that the doctor sees many patients every day and may not accurately remember your particular case.  Doctors make mistake just like any of us, so it is important that you correct them when you see them being made, otherwise you may end up with contradictions in your medical reports that may delay your claim. 

While your doctor is there to treat you and render his professional opinion, it is your body and your life.  If you feel that he/she is not listening to you and for a few minutes so you can explain the whole picture to him/her.  The overall picture should be important to your doctor.  The doctor should want to know what your concerns are and what problems your injury is creating in your life.  Don’t be afraid to tell your doctor that you don’t understand something.  The extra few minutes of time will make a difference in your recovery.

It is human nature to want people to believe you are hurt and the easiest way to do that is to stress how much it hurts or to use facial grimaces.  We have found that doctors relate better to a patient if they can describe pain and discomfort using a 1 to 10 scale.  For example, “my pain is an 8 on a scale of 1 to 10, 10 being the worst”.  We are not advocating that you hide your feelings.  If it hurts you may not be able to control the facial expressions or stress in your voice.  That is perfectly fine.  However, don’t fake it, because the doctor will know if what you are saying does not co-relate with his objective exam findings.

Your doctor has your attorney at the bottom of the priority pile.  When it comes to your doctor’s call backs and responses, the patient (you) come first, then the Carrier (who pays the medical bills), then us (if the doctor remembers).  Therefore, you should try to be on top of obtaining copies of your own medical records and making sure we have received them too.  We will try to get them directly from your doctor, but if your doctor does not respond to us in a timely fashion it is your case that is in jeopardy, so you should have a personal interest in making sure your doctor is filling out the appropriate forms correctly after each visit, and sending us copies of those records for your file.    

You are free to choose whatever doctor you want to go to, and you can also choose to switch.  However, remember that anything you do may be questioned by the insurance company.  You should make sure you have a good reason to switch your doctor so that you do not create the impression that you are switching because you are doctor shopping for the one who will say you can’t work.  Of course if you feel that your doctor is not nice, or is not listening to you that would be a good reason to switch. 

Both the doctors and the insurance company view missed appointments with suspicion.  Of course there are many things in life that are beyond our control, and sometimes you may not be able to make it due to unforeseen circumstances.  You should always make sure you keep record of the reason for your missed appointment and reschedule it for the nearest possible date.  You should also inform us if you missed an appointment and the next available date would cause you to have a lapse of more than 45 days since your last visit.  If you do not see your doctor every 45 days, the Carrier may legally suspend your benefits, even if only for a one day difference. 

You must keep your attorneys informed of your treatment dates, what doctors you are treating with, any diagnostic exams being requested and any diagnostic exam results you receive, any talk about or request for surgery, any scheduled surgeries, any surgical reports, any specialists you are being referred to, any treatments that are being recommended (for what and by who), and send your attorneys copies of all medical reports you have at hand. 

1 comment:

  1. Your post is really good providing good information.. I liked it and enjoyed reading it. Keep sharing such important posts.
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