If you have a workers’ compensation claim in Virginia, you are most likely seeing a workers’ compensation approved treating doctor. These doctor’s are typically hand-picked by the insurance carrier and have worked within this system before so they know how the insurance companies operate and the things the insurance companies may be looking for. Dealing with your workers’ comp doctor is a large and extremely important part of your claim so don’t make these 5 mistakes that could wreck your claim!
Waiting to seek medical care
Insurance companies and Commissioners believe that if you are not injured badly enough to seek medical attention, you are not injured badly enough to be entitled to workers compensation benefits. You should ALWAYS seek medical care after an injury; even a minor injury can get worse if untreated and, as I have stressed so many times before, DOCUMENTATION is KEY!!
Not being HONEST with your doctor
When you discuss your injures with the doctor, the insurance company (and the Commissioner) will see his or her notes. It is important that you are completely honest with the doctor about your prior medical history, how your injuries happened, your pain levels, symptoms and your personal habits.
- Prior Injuries – Any prior injuries you have will show up in your medical history so you need to be transparent about this. Omitting prior injuries or surgeries from your statements to your doctor or the insurance company can cost you in the end.
- How your injury happened – these needs to be consistent from your first accident report to how you report the injury to the doctor and the insurance company. Consistency is extremely important
- Symptoms and pain levels – You need to have your symptoms and pain levels properly documented by your doctor at each and every appointment. Under reporting things to your doctor in the beginning can be problematic if your recovery takes longer than anticipated – it could even give the impression to the insurance company that you are exaggerating your pain now, when you reported feeling fine at your last 3 appointments. Some folks hide their symptoms from their doctors in an effort to be released back to work; while I know you want to be able to return to work and put this whole mess behind you, this is not the way to do it. Once a doctor releases you to go back to work, they are typically very reluctant to take you back out. (See #
Conflicting and inconsistent information will also destroy your credibility and this can be devastating to your case!
Failing to get all of your injuries and pain levels properly documented.
Saying you are in pain is not the same as having it documented in your medical records. You can say you are in pain all day but the DOCTOR has to be the one to document your pain and relate your pain complaints to the work injury. This is why I tell people to keep a log or diary of their pain – when it is the worst, what makes it better, or what makes it flare-up – that way you can share this information with your doctor at your appointment and be sure these issues are part of the conversations you are having with him or her.
Showing up late or missing a doctor’s appointment.
When you “no show” for an appointment with the doctor or are so late that the doctor can’t see you, typically all that is in the medical record is that the appointment was missed and you did a “no show.” The doctor’s office does not make your reason or excuse for missing the appointment part of the document so when the insurance carrier or the Commissioner sees this in your file, they could easily assume that you didn’t make it to the appointment because it was not a priority for you and this can cost you in a big way by giving the impression that you are not committed to getting better and the insurance carrier may say that you are refusing medical treatment which can cause benefits to be cut off. I always advise injured workers to keep their all of their appointments but if one has to be missed, call in advance and reschedule the appointment or let them know you are running late.
Not following doctor’s instructions on course of treatment or medications.
When the doctor tells to participate in physical therapy or to take a certain medication and you don’t do it, the insurance company, and sometimes the Virginia Workers’ Comp Commission, might assume that you are not taking your recovery seriously or delaying getting better because you are not following the doctor’s treatment plan.
Remember, there is a reason why doctors prescribe a particular type of medication for a particular time period. You should follow your doctor’s recommendation until your doctor tells you something different. If you think a medication is making your muscles ache or your stomach hurt, say so; side effects are not rare, and your doctor can usually switch you to another drug. The same goes for your treatment plan. If a particular treatment is not helping or even making things more painful, you need to report this to the doctor as he or she is the only person who can make changes to this.
Don’t put yourself in the position where you have to admit that you chose not to follow your doctor’s advice. This can be devastating to your claim.