Is the Doctor Chosen by the Workers’ Comp Insurer Biased Against Me?

In California, if you do not predesignate a doctor to treat you after a workplace injury, you are required to go to a doctor chosen by your employer’s workers’ compensation insurance company.

If you are concerned the doctor may be biased in favor of the insurance company, that is a valid concern. This is why you may want to consider predesignating a doctor you trust to treat you.

There are also steps you can take to document an appointment with a doctor you believe was biased against you. It is recommended that you discuss this information with an experienced workers’ compensation lawyer in Bakersfield.

Are Workers’ Comp Doctors Fair?

While some doctors chosen by workers’ compensation insurance companies are fair, some may not be. Insurance companies are looking to pay out the least possible amount of compensation, so they look for doctors who they think will reach conclusions that help them achieve that goal.

If a doctor reaches conclusions that appear to help workers, insurers may stop working with that doctor. Doctors know this, so it may create an incentive for them to make decisions that favor the insurance company. They may avoid conducting expensive tests like MRIs and CT scans, which can make it more difficult to adequately assess a patient’s health.

What to Do in an Appointment with a Doctor Chosen by the Insurer

Since doctors chosen by workers’ compensation insurers could be biased against you, there are some important things you should remember before and during visits with these doctors:

• Act like they are always monitoring you. They may watch start watching you as soon as you exit your vehicle and walk into the office. They are looking for any indication of an injury.
• Bring a third party with you. Ask a friend or family member to come with you to your appointment so that he or she can take notes and serve as a witness in case some aspect of the examination is later in dispute.
• Document the appointment. Keep a journal where you note the events that transpired during your examination, the statements made by the doctor and how long the examination took.
• Be polite. Do not give the doctor an excuse to make a negative finding about you by being abrupt or rude.

Having independent documentation about the examination can help you if you are later in dispute with the insurance company.

Can I Change Physicians?

If you have not predesignated a physician to treat you, you can still change physicians if you are not satisfied by the diagnosis or review of the workers’ comp doctor. However, this process can take more time and delay compensation.

You can request a second opinion and if your request is approved, you will be sent to another doctor within your employer’s network. If you are still not satisfied, you can choose your own doctor once 30 days pass from the date of your injury.

However, changing doctors may not work out as planned. Your new doctor may agree with the first or second doctor you saw, which will provide more evidence against you. The second, third or fourth doctor may state that you require less treatment than the first doctor.

Contact an Experienced Lawyer for Help

If you have questions about medical examinations after a work injury and switching doctors, contact Berry, Smith & Bartell to schedule a free consultation. Our legal team has decades of combined experience pursuing benefits for injured workers and a track record of success.

We work on a contingency fee basis and are paid nothing for our services unless we help you win.