by James L. Creegan Esq.

One of the most frequent issues I encounter when I speak to clients and groups of workers around the State, is obtaining appropriate medical treatment in a workers’ compensation claim.

When you’re hurt on the job, you encounter a whole new world of insurance-related hurdles in obtaining medical treatment. It’s not as easy as heading to your family doctor for a referral. The insurance company controls the medical treatment at all stages. If you’re hurt at work in New Jersey, your employer or its insurance carrier has the absolute right to choose your doctor.

The reality is that the insurance company, through its adjusters and nurse case managers can, and will, contact your doctor and his or her staff – and they’ll do it often. They do this for various reasons, such as to see if you really need to be out of work for the next 4 weeks or whether you need that MRI now as opposed to 3 months from now.

The best advice I can give, is that the doctor can be your biggest ally in a workers’ compensation claim. The insurance company has the absolute right to pick your doctor in New Jersey. However, it cannot disagree with the recommendations of its authorized physicians just to cut costs or end treatment. You will not earn respect if you do not show respect. Here are some tips I give to my clients with regard to how to approach medical care in a workers’ compensation claim:

Be Assertive, Not Aggressive: It’s important to be assertive when meeting with your doctor and his or her office staff. However, there is a difference in not taking no for an answer, and yelling at the doctor or the receptionist. Explain your problems to the doctor, don’t allow your concerns to be glossed over, but remain patient. For instance, if you’re released to work, you have to try to go back and then, if you can’t work, discuss your failed attempt with the doctor. Trust is earned over time, not after one office visit.

Ask Questions, Don’t Question: It’s a great idea to do some research about your injury or condition during treatment. A little knowledge will help you understand the doctor. For example, you should ask, whether it might be time for an MRI, a referral to a specialist, or if there are options other than surgery. It’s not productive to question your doctor’s credentials, judgment or ability to make a decision. Just because information is available on the internet, it doesn’t mean it’s right. Ask questions designed to explore all treatment options and scenarios. Don’t alienate your doctor by questioning his or her judgment.

Go it alone: Sure it’s helpful to bring your significant other, friend or loved one to the doctor’s office. They want to help make sure you communicate your problems to the doctor. It is hard for someone who cares about you to remain patient when they do not feel treatment is progressing. All too often, if you bring someone into the examining room, the situation will turn confrontational and this is never helpful. All kinds of bad things happen when the doctor-patient relationship becomes confrontational. It is best to leave your loved ones in the waiting room.

The pace of treatment in a workers’ compensation claim can be slow and I counsel my clients to be direct with their doctors, but not confrontational – nobody wins if that happens. Delays are common and it’s not easy to navigate through the insurance hurdles.

If you are having issues obtaining medical treatment in a New Jersey workers’ compensation claim, we offer free consultations to see how we can best serve your needs. At Stark and Stark we strive to relieve the stress associated with the workers compensation process in addition to obtaining the financial benefits you deserve.

James L. Creegan is a Shareholder and member of the Workers’ Compensation Group of Stark & Stark.

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