The Workers Compensation system is very dependent upon your doctor providing medical reports describing their treatment and opinions about your injury. In fact, this is probably the single most common cause of problems associated with your case. The law requires your doctor to file reports with the Workers Compensation Board, the insurance company; and to us with very specific information, and within mandated time frames. You can help by reminding your doctor what he or she needs to write and when.
If you are out of work and receiving Workers’ Compensation temporary disability benefits, you MUST see your doctor every 90 days at a minimum and your doctor must state your level of disability in each report they file. If you were previously found to have a permanent partial disability and are receiving lost wage benefits as a result of this you do not need to continue documenting your disability. If you do not have a current medical report documenting your temporary disability the insurance company will try to stop payments to you, and probably succeed.
Every time a doctor files a report on you, it MUST contain the following information:
• Your name and Workers’ Compensation Board case number.
• The date of your accident.
• A diagnosis of your injury.
• A statement saying your treatment is “causally related” to the accident.
• A statement of your level of disability.
If the doctor fails to put this information on his or her report, it is basically worthless to us. Also, the report must be signed by the doctor -– not the nurse or doctor’s assistant.
Many times a doctor will tell you that there is nothing else to be done, and stop seeing you, or refer you to someone else for your long term care (for example, a pain clinic or a physical therapist). Very often, specialists will refuse to provide an opinion on your level of disability. This does not stop the need for ongoing medical reports that include a statement of your level of disability. Generally we tell people to keep seeing their family doctor, or to find a new doctor to make sure the insurance company doesn’t try to stop benefits.
Posted in: Workers Comp