I cannot overstress the importance of the role of your workers’ compensation treating physician in your case. Besides the fact he will be one who will be taking care of your physical needs, his opinions will decide the legal consequences of your workers’ compensation claim. Therefore, it’s very important to have a good relationship with your workers’ compensation treating physician even if this physician has been chosen by the insurance company. Since your workers’ compensation treating physician’s opinion is given great weight when an issue arises about what caused a medical problem or if a particular treatment may be reasonable and necessary, his opinion is very important.
Here are some tips when dealing with your doctor:
1. Describe the work accident specifically on the first visit to the doctor. One of the worst mistakes that an injured worker can make is not to describe in detail on his or her first visit to the doctor the facts of the accident. It is difficult to prove that you had an injury by accident if in the first doctor’s visit there are no notes in the history section as to how the injury occurred. Therefore, it is very important to state to the doctor where you were and what occurred. Then in his notes in the history section (which is in all medical notes) it will state “slipped and fell at work” or “lifted a box at work.”
2. There is no doctor/patient privilege. You need to understand that there is no doctor/patient privilege in workers’ compensation. Thus, all your medical records will be read by the insurance adjuster and can also be read by the insurance defense attorney and the Virginia Workers’ Compensation Commission. Therefore, it’s also important not to make statements to the doctor that you would not want other individuals to know. Of course, be truthful with your doctor so he can treat you as effectively as possible but avoid getting into arguments with your physician or rambling about non-work related medical conditions unless you do not mind the insurance company knowing.
3. Talk to your doctor about your work restrictions. If at all possible, try to get the doctor to discuss with you his opinion about your return to work restrictions, your functional capacity, and anything related to your ability to return to work before he gives them to the insurance company. Many times, a nurse case manager may try to unfairly influence the doctor’s opinion with regard to these issues. Thus, if you bring up this issue with your doctor first, you would at least have an opportunity to present your views to the doctor on an equal basis with the nurse case manager.
4. Always mention all body parts that were injured. Every time, especially the first time, you go to the doctor it is important that you reiterate every body part that has been injured as a result of the work accident. If a body part is not mentioned, it will be cause for the insurance company to deny treatment in the future for that injury. Many insurance adjustors will deny medical treatment for a body part not mentioned in the first appointment. I have had to help injured workers get medical treatment for serious injuries to the neck that did not get mentioned until the second doctor visit because the pain in the shoulder was so severe that the neck problem didn’t seem that important. Therefore, if you have one area that hurts really badly and one area that hurts a little bit, you still need to tell the doctor about both.
5. Always get a disability slip from your doctor. Before you leave your doctor’s office, always get a disability slip. The workers’ compensation insurance company is not going to pay you a weekly check unless they have a copy of a disability slip that says you are not able to work or your work restrictions are such that your employer cannot accommodate the restrictions.