I've written about choosing, and the process for choosing, a doctor for a New Mexico workers' compensation case in the past. I try to avoid repeating what I write about, but the process of choosing a doctor to treat your work injuries is incredibly important and can often determine whether your case is resolved quickly and correctly, OR if it gets stuck in litigation for months and, sometimes, even years.
When a worker is injured or hurt at work, the New Mexico Workers' Compensation Act states that the parties shall choose a workers' compensation doctor according to the following process:
- The employer gets to choose the first doctor. However, the employer can let the injured worker choose the first doctor. If the employer lets the injured worker choose the first workers' compensation doctor, the employer must notify the injured, IN WRITING, that he or she gets to choose the first doctor. The written notice must be given to the injured worker within a "reasonable" time after the work injury. Nobody knows what is a "reasonable" time but the New Mexico Court of Appeals has said in one case that 27 days after the injury was not reasonable.
- 60 days after the first appointment, the party that did NOT choose the first doctor can choose a new doctor. To choose a new doctor, the party that did not make the first choice has to send a Notice of Change of Healthcare Provider to the other party stating who the new doctor is. The other party can object to the change, and then a workers' compensation judge decides if the change was proper. Most of the time, the change is proper. The workers' compensation insurer only has to pay for treatment by this new doctor and his or her referrals.
- After the second doctor is chosen, it is fairly difficult to get a new doctor to treat the injured worker. However, that depends on the facts of the case, and is, therefore, beyond the scope of this post.
The process of choosing doctors in the New Mexico Workers' Compensation Act is important because depending on who chooses first, it can greatly affect an injured worker's medical treatment.
If an employer chooses first, it will often choose a doctor or provider who is sympathetic to the employer and the worker's compensation insurer's interests. This often means that treatment is limited and the injured worker is returned to work before he or she has recovered enough. The sliver lining is that the injured worker can eventually choose a new doctor who will give him treatment that is reasonable and is intended to get the worker back to work as soon as possible but only when the injured worker has sufficiently recovered.
If an injured worker is forced to choose first, this can be positive as long as the worker has enough information and knowledge to choose a doctor who will treat the worker reasonably. The problem with an injured worker choosing first is that the employer can choose a new doctor 60 days after the first appointment and, essentially, short circuit the injured worker's treatment and recovery. Once again, an employer will choose a a doctor or provider who is sympathetic to the employer and the worker's compensation insurer's interests.
The key for injured workers who want to maximize their medical treatment and, therefore, speed up their recovery is planning. To do such planning I recommend that a worker do the following:
- Before you are injured at work, ask your employer what doctor you are supposed to go to if you are hurt on the job. Most employers should be able to to answer this question. If they can't, I suggest that you nicely ask if they can come up with a policy. Generally, the human resources department handles workers' compensation issues for most employer. Finding out what doctor you should see before you're hurt is important because once you're injured on the job things can become chaotic making it a challenge to find out who should treat your work injuries. And, if you need to make the choice, there's often no time to do any research to find a good workers' compensation doctor.
- If, before you are injured at work, and you know you are supposed to choose the first workers' compensation doctor, try to identify a doctor BEFORE you are hurt on the job. See below my tips for choosing a workers' compensation doctor.
- If you are injured at work and it's an emergency, go to the closest emergency room so you can get the treatment you need. Once you're stabilized, you can then work on determining who will treat you for the long term.
- If you are injured at work and it's not an emergency and you don't know who to see, ask your supervisor. If that person doesn't know, go to his or her supervisor or to the human resources department.
- If you are injured at work and it's not an emergency and you do know who to see, go to that doctor or provider as soon as possible so you can start your treatment.
Below are my tips for choosing a workers' compensation doctor:
- Call me or any other lawyer who represents injured workers for recommendations. Because we represent injured workers, we deal with doctors and other providers who treat injured workers as a regular part of their practice and can may recommendations for doctors to treat your work injuries.
- Try to choose a doctor who treats injured workers.
- Try to choose a doctor who accepts workers' compensation insurance. It's not absolutely required, but it can greatly ease getting your treatment paid for.
- Try to choose a doctor who is familiar with the New Mexico workers' compensation system. Billing for treating injured worker is different than billing for treating regular patients. Workers' compensation doctors often have to give depositions, and some doctors do not want to be deposed or be involved in workers' compensation litigation.
- Try to choose a doctor you feel comfortable with and can trust.
There's a lot more I could probably cover in this post. However, I hope I have conveyed how important choosing a doctor can be for your workers' compensation case.
If you have any questions, please contact us. Thanks for reading.