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Who Will Your NY Worker’s Compensation Doctor Be?

by | Sep 12, 2023 | Firm News

Unlike in some other states, New York gives the worker control over which doctor they see. The only requirement is that the New York Workers’ Compensation Board approve the physician.

In an emergency situation, you can go to any ER and use any ambulance. You don’t need to check whether either of them is registered with the Workers’ Compensation Board. In this case, we’re talking about the physician who will be handling your follow-up care and who will handle referrals to any specialized physicians. 

This is no guarantee that the doctor you’ll see is your regular doctor. Still, it does reduce the chances that the doctor has a special relationship with your employer or the workers’ compensation insurance company. 

You can use the online database to search for a suitable doctor, but you should check with your employer first. Some employers have workers’ compensation insurance companies that use Preferred Provider Organizations (PPOs) to cover employee medical care. 

You only have to use a PPO doctor for 30 days and can change if you don’t feel that the doctor is listening to you or working in your best interests. After 30 days, you can switch doctors. You can choose your doctor at any time if they don’t use a PPO at all. 

You’ll usually have a moment to think it through and make some decisions here. Don’t be afraid to choose carefully. Check the doctor’s reviews. Check their malpractice record with the County Clerk’s office as well. 

Note that choosing your own doctor does not change the fact that the workers’ compensation insurance company may request an IME at any time. An IME, or Independent Medical Examination, exists not to give you care but to analyze your claim. 

They are gathering evidence against you, or are trying to, but there’s not much you can do about that. You must attend the IME with the physician the insurance company chooses. You still have some rights: they must inform you of the IME 8 days in advance, and the examination location must be reasonably convenient. 

You must also receive your copy of the IME report within ten days, and they must mail all copies simultaneously. You also have the right to bring a witness to the exam or to have it taped. 

Ask your doctor to keep good records, as your doctor will gather the evidence that helps you. 

Even when you choose your doctor, you might struggle to get the treatment you need. State treatment guidelines bind Doctors, and the insurance company wants them to use the cheapest possible treatment, which might not be the treatment that actually supports your health. 

As workers’ compensation lawyers, we are experienced advocates who can help you get the care you need and deserve, even when the insurance company balks. We can push back when the insurer tries to claim a treatment is “not medically necessary” and can show how using the treatment you need would fall within state guidelines.

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See also:

What Happens When a Work-Related Injury Exacerbates a Pre-Existing Condition in New York? 

Steps to Take After Getting Injured on the Job in New York

Workers’ Compensation Insurers May Trade Quality for Cost Savings