It’s an unfortunate side effect of the Workers’ Compensation claim process that sometimes the most simple errors can throw a huge wrench into the entire process, derailing the whole thing. One such error is consulting the wrong doctor for your workers’ compensation claim.
When injured on the job, in most cases, your employer will provide you with the names of physicians associated with their Preferred Provider Organization (PPO). By law, your employer must provide you with at least two choices in each medical specialty and two hospitals you can visit. Your initial treatment must be undertaken by one of those doctors. If not, you risk losing your right to compensation.
What happens I’m not happy with the doctor my employer provides?
You can change doctors. Under New York Workers’ Compensation law, 30 days after the initial treatment, an injured worker may select any authorized doctor or health care provider to continue your treatments. For these purposes, “authorized” means that the doctor is registered with the New York State Workers’ Compensation Board and can file a Form C-4 claim for you. If you do not work with an authorized health care provider, you may be personally responsible for all your medical expenses. Therefore, before scheduling an appointment for a workers’ comp injury, you must confirm that the health provider is properly coded for Workers’ Compensation claims and can file a Form C-4.
In addition, be sure to find a doctor that you trust. Try to find one that doesn’t rush you in and out of appointments and who takes the time to listen to your concerns. It’s a good idea also to find a doctor that isn’t just authorized to handle Workers’ Compensation cases, but who has ample experience doing so.
Where do I find New York workers’ compensation doctors?
If your regular physician is not authorized to treat you for workers’ compensation injuries, ask him or her to recommend a doctor who can. Also ask friends and family members, local hospitals, or your local county medical society for recommendations. You can also consult the Workers’ Compensation Board “Health Provider Search” site. There, you can search for an authorized provider by specialty, location, and language spoken.
What if I don’t have the money to pay the doctor?
New York Workers’ Compensation health care providers are not allowed to bill you directly, but must send their bills and reports to your employer’s insurance company and Workers’ Compensation Board.