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How do I Choose the Best Workers' Compensation Doctor?

Keith Koons
Keith Koons

There are many factors to consider when seeking a workers' compensation doctor and, unfortunately, most of them are completely up to the insurance company or the employer. When a work-related injury occurs, it is standard for a worker to receive immediate treatment at a local hospital. Once he is released, a workers' compensation doctor will be assigned by the insurance company to determine the extent of the injuries. This diagnosis will also determine the length that the employee is out of work, what therapies will be available and, eventually, a settlement amount. An employee should normally seek an unbiased doctor to review the findings as well in order to protect his personal interests.

A workers' compensation doctor is paid directly by an insurance company. This professional knows that his responsibility is to minimize losses by the employer in terms of time and money, which is why his findings are often not in the patient's best interests. It is not that this doctor does not want to help the patient make a full recovery; he simply often wants to maximize the referrals from each insurance company. For this reason alone, patients should find their own doctor for a second opinion.

A worker's compensation doctor is paid directly by an insurance company.
A worker's compensation doctor is paid directly by an insurance company.

The reason that finding a different workers' compensation doctor is so important is because of long-term care and an eventual settlement. Insurance companies use a percentage-based formula to calculate permanent damages, and these results are completely open to interpretation. A knee injury, for example, could be seen by one worker's compensation doctor as a 10% loss in mobility while another would estimate it at 55%. This single finding could lead to a significant difference in how the case is handled.

Workers' compensation exists to provide financial assistance and medical treatment to employees who are injured on the job.
Workers' compensation exists to provide financial assistance and medical treatment to employees who are injured on the job.

If an attorney is sought in this type of case, he will normally have a workers' compensation doctor that he will recommended to the injured employee. Since this doctor knows that overstating the injuries would result in more revenue from the attorney, he will often claim that the worker has significant problems that require long-term rehabilitation. While this also may seem deceptive, attorneys use these types of physicians to ensure that their clients will receive the maximum possible settlement for their injuries. When it comes time to settle, the two physician estimations are averaged in order to find a fair amount of compensation.

Whenever a worker decides not to contact an attorney, it is much easier to find a workers' compensation doctor that would give a fair diagnosis. This professional is usually not paid through the worker's compensation policy after the first visit, so it is important for the injured person to verify that he is comfortable with the doctor and respects his decisions. It often helps when the patient reveals his intentions up front in these types of situations, because most doctors understand the game that some workers comp cases play to minimize their payouts. The patient will normally receive the most practical care in this situation as well since the doctor's only concern is treating the injury and helping the patient recover.

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    • A worker's compensation doctor is paid directly by an insurance company.
      By: JackF
      A worker's compensation doctor is paid directly by an insurance company.
    • Workers' compensation exists to provide financial assistance and medical treatment to employees who are injured on the job.
      By: wellphoto
      Workers' compensation exists to provide financial assistance and medical treatment to employees who are injured on the job.