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When Do You Need a Workers’ Comp Doctor in New York?

Offered by Island Musculoskeletal Care MD, PC

When you’re hurt on the job in New York, there are two things you need to do right away. The first is to report your injury to your employer as soon as possible, ideally in writing, so that you have a record of it. This is a key step in the workers’ compensation process.

The second step is to get medical attention as soon as possible. You need to get your injuries checked out to protect your health, and you need a record of the injury to protect your workers’ compensation claim. The sooner you see a doctor who understands the workers’ compensation system, the better.

The advantages of seeing a doctor right away

First, and most importantly, seeing a doctor right away is the safest option for your health. Some work accidents can cause injuries with delayed-onset symptoms, such as internal injuries. In addition, you could inadvertently aggravate an injury you don’t know about, leading to serious and potentially life-threatening complications. The sooner you get checked out by a doctor, the sooner you will get the treatment you need and the sooner you will know about any medical restrictions you need to follow to protect your health.

Second, seeing a doctor right away strengthens your workers’ compensation claim. In New York, workers’ comp pays for the full cost of reasonable and necessary treatment for a work injury. One of the few ways the insurance company can deny your claim is by arguing that a particular injury is not work-related. If you wait to see a doctor, it’s easy for the insurance company to say that something else happened in the intervening time to cause your injuries and deny your claim on that basis. If you see a doctor immediately, you will have a medical record of your injuries that you can use to support your claim.

You may think your injuries aren’t severe, or you can afford to “wait and see” instead of going to the doctor, but that’s a mistake. In the immediate aftermath of a work accident, your adrenaline levels are high, and your “fight-or-flight” response is engaged, which can dull pain and mask other symptoms of an injury. In other words, you are in no position to diagnose yourself. Leave that to a medical professional.

Remember, you are free to choose your doctor

New York law doesn’t allow your employer to decide which doctor you see for a work injury. Generally, you can see any medical provider authorized by the Workers’ Compensation Board to treat work injuries. Authorized providers have been through a training and medical review process to show they know how to treat on-the-job injuries.

There is one exception: if the workers’ compensation insurance company has a preferred provider organization (PPO), then for the first 30 days after the injury, you must see a doctor in the PPO. However, you are free to choose any doctor you like within the PPO and change doctors at any time.

How to choose the doctor you see after a work accident

Many doctors are authorized to treat work injuries – indeed, in certain medical specialties, every provider who can be authorized is required to be authorized – but that doesn’t mean all doctors are equally skilled at treating work injuries and navigating the workers’ compensation system. You need a doctor with the equipment and training to thoroughly diagnose work injuries, document everything to the satisfaction of the workers’ compensation system, and guide you through the treatment process.

Your doctor plays a crucial role throughout the workers’ compensation process. That starts with diagnosing your injuries and recommending initial treatment. If there is a dispute with the insurance company about whether a particular treatment or medication is “reasonable and necessary,” your doctor needs to advocate for the treatment you need. In addition, your doctor needs to clear you to return to work at the appropriate time, determine any work restrictions, and document the extent of your disability for schedule loss of use (SLU) benefits. The sooner you see a doctor who has experience dealing with the workers’ compensation system, the more smoothly this process will go and the better your outcome will likely be.

In short, if you’re hurt on the job in New York, it is in your interest to see an experienced workers’ compensation doctor as soon as possible, ideally on the same day. If you haven’t seen a doctor yet, the next-best time is right now. Make an appointment to see a work injury doctor as soon as possible.

Workers’ Compensation Assistance

Island Musculoskeletal Care (IMC Bone Doc) is a leading orthopedic practice serving the Bronx, Queens, Brooklyn, and Long Island. We accept most major types of insurance, includin...