The most important part of your Workers' Compensation case is your
medical treatment -- period. Your health is priceless, worth more than
the best settlement. Getting good treatment in the Workers' Compensation
system can be a challenge --treatments get declined, and the insurance company delays at every turn. The key is finding the
right doctor. A good Workers' Compensation doctor is the difference
between watching your injury degrade further and getting the care you
need to recover and get back on your feet.
What makes a good Workers' Compensation doctor? Obviously, your doctor needs to be an expert in their field. However, for Workers' Compensation, expertise isn't enough. A Workers' Compensation doctor needs to be patient enough to deal with endless paperwork, ethical enough to make the right choices for you and not for the insurance company paying their bills, and surrounded by excellent support staff. If that sounds difficult to find, it's because it is. However, it's possible with these five Workers' Compensation industry tricks.
1) Do your research.
Injured workers just like you are posting about their experiences with doctors' offices online. Take advantage of the information that they're sharing. Read about any potential doctors on Yelp, Google, and Facebook before calling to make an appointment. Some time spent reading reviews can save you a lot of grief down the line.
2) Find the right specialist.
Your Primary Treating Physician (PTP) will be able to refer you to specialists for specific issues and procedures, but it's important to choose the right kind of doctor for your PTP first. At Pacific Workers' Compensation, we like pain treatment specialists, physiatrists, and sometimes chiropractors to act as PTPs for our clients because they take a more holistic view of a patient's issues. While a good surgeon or a specialist focusing on the injured body part can be a crucial part of an injured worker's recovery, the PTP should be someone who will look at your symptoms with a broader perspective and think about all possible options for treatment.
3) Avoid Occupational Medicine facilities.
This means US Healthworks, Concentra, Sutter, and (sometimes) Kaiser Occupational. This isn't to say there aren't any good doctors at these kinds of facilities. However, there's a reason your employer's insurance company sends you directly to these facilities. Your Workers' Compensation doctor will have to provide evidence to support your claim if you go to trial or seek a settlement. For facilities with strong relationships with insurance companies, maintaining that relationship means a great deal more than your case or care.
4) Make sure the doctor is in your Medical Provider Network (MPN).
In most cases, an insurance company will not pay for you to see a doctor outside of their MPN. There are exceptions -- if your employer's Workers' Compensation insurance company doesn't have enough providers in your area, they must pay for you to see the doctor you choose, regardless of MPN -- but generally, you are bound by the MPN. This can be confusing, so if you need to, talk to a Workers' Compensation attorney to make sure you don't end up going out-of-network and spending your own money on care that's covered by Workers' Compensation.
5) Enlist the help of a good Workers' Compensation attorney.
Relationships matter. Here at Pacific Workers' Compensation, we have longstanding relationships with good Workers' Compensation doctor's offices around the Bay Area. When you retain a Workers' Compensation attorney -- whether that's Pacific Workers' Compensation, or someone else -- you get to take advantage of your Workers' Compensation attorney's connections and expertise. You no longer have to worry about finding a Workers' Compensation doctor: your Workers' Compensation lawyer will do it for you.