Workplace injuries occur across all occupations, though some jobs are more dangerous and prone to workplace accidents and injuries. Whether you work in a relatively safe occupation, or one that is prone to worker injury, medical treatment is necessary whenever you suffer a work-related injury or illness.
Your employer likely has a designated company doctor or location for workers to obtain medical treatment for workplace injuries. New Jersey’s workers’ compensation law enables your employer to require you to obtain medical services from its designated medical services providers. To receive workers’ compensation, you must go to a company-approved doctor.
You still can obtain medical treatment from your usual general practitioner, but your workers’ compensation claim will require you to see an employer-designated medical services provider.
When to Obtain Work-Related Medical Treatment?
If you suffer a serious injury while working and need immediate medical care, that always is the top priority. You cannot be punished for seeking medical help.
A medical emergency requires a trip to the emergency room or nearest trauma center as soon as possible. Your employer likely has the local hospital emergency room listed as an acceptable medical services provider, anyway. If it is not, the trip still would be covered by workers’ compensation.
You do need to inform your employer of the injury and its cause as soon as possible. The state only gives workers up to 14 days after a work-related incident to notify their employers of any injuries or illness that they have suffered. You have up to two years to file a workers’ compensation claim.
The sooner you can obtain medical treatment and notify your employer, the stronger your workers’ compensation insurance claim could become. Obtaining medical care right away helps to document the injury and its cause. It also helps to directly tie your injury to the work accident.
Who Pays if You See Your Own Doctor?
Your employer or workers’ compensation insurance underwriter cannot force you to see only the physician of their choosing. They only can refuse to pay for medical services obtained outside of their chosen services providers.
For the purposes of workers’ compensation benefits, you must obtain medical care from an approved provider. That will ensure that your claim remains good and the insurance provider should pay for all medical costs.
But you still can obtain care from your personal physician. The care will be in addition to the work-approved medical services provider. You will be responsible for paying the medical bills from your family doctor.
You could request that your doctor be added to the list of approved physicians for workers’ compensation, but without that addition to the roster of medical services providers, you are liable for the additional medical costs for treatment outside of the approved doctors.
Fortunately, most people have health insurance. If you have a policy, you could use your health insurance to pay for your medical care obtained outside of the work-approved doctors. You would be liable for any deductibles and other costs not covered by your health insurance.
How to Obtain the Services of a Preapproved Doctor?
If your need for medical treatment is not necessarily an emergency, your employer should give you a list of approved medical services providers. The list likely will include the nearest hospital emergency room.
If you do not need immediate medical treatment, you could contact a services provider from the list. You should be able to go in right away and be seen for your work-related injury or illness.
The workers’ compensation insurance policy should cover the costs of all of your medical care done by approved services providers. It also should pay for your time off work if you miss more than three days to a work-related injury or illness.
Why Employers Choose Workers’ Compensation Doctors?
Unfortunately, insurance fraud is a significant concern for employers and underwriters of workers’ compensation insurance. They need doctors and other medical professionals that they can trust to provide honest medical diagnoses and not commit fraud.
The pre-approved list of doctors and other medical services providers helps them to accomplish that. The doctors are supposed to provide workers with honest medical services diagnoses and treatment. The doctors also
The employer can obtain a list of approved doctors from the insurance underwriter. If the employer has a standing relationship with other medical services providers, it might be possible to get them added to the list of approved medical services providers.
What if the Medical Care is Poor?
The approved doctor who treats you does not work for your employer or the workers’ compensation insurer. So the quality of care provided should be within acceptable medical standards of care.
If you have reason to believe the level of medical care is substandard, your own doctor might be able to confirm it. You at least could obtain a second opinion from your doctor.
One or more doctors might affirm that the care is not what it should be for your injury or illness. You might request another doctor from the approved list provided by your employer.
You also could obtain the services of an experienced workers’ compensation lawyer. A good attorney could help to argue the need for a change in medical services providers.
If the standard of care is provably poor and you deserve more, your attorney might be able to get your doctor approved for payment by the workers’ compensation insurer.
Your employer or the workers’ compensation insurer could refuse to address your concerns. A reliable workers’ compensation attorney might help you to press the issue.
Filing a lawsuit normally would be out of the question. That is because accepting workers’ compensation benefits requires you to give up your right to sue your employer.
A substandard level of care and refusal by your employer or insurer to change care providers might earn you the right to sue. At the very least, a medical malpractice claim might be made against the medical services provider.
Cherry Hill Workers’ Compensation Lawyers at Pietras Saracino Smith & Meeks, LLP, Help to Enforce the Rights of Injured Workers
If you were injured at work, contact our experienced Cherry Hill workers’ compensation lawyers at Pietras Saracino Smith & Meeks, LLP, by calling 856-761-3773 or contacting us online to schedule a free consultation at our law office in Cherry Hill, New Jersey. We represent clients in Camden, Cinnaminson, Delran, Maple Shade, Pennsauken, South Jersey, and throughout the state.
