By William R. Cahill, Jr.
Often we protect ourselves in the workplace against disciplinary, wage or seniority related problems by looking at our contract or Collective Bargaining Agreement. However, if you or another employee is hurt on the job, these documents may not fully address the issue.
Part two of this series will guide you past some potential pitfalls in the workers' compensation matrix. (Click here to read part one.)
Doctors, Doctors Everywhere
Assuming your employer has been notified of your work-related injury, where do you go from there? Some companies will suggest you go to a specific healthcare provider with whom they have an established relationship.
Some states only allow the employer to send you to an Independent Medical Examination (IME) twice a year, while other states allow unlimited IMEs. An IME physician will not be your treating physician and generally will have a bias favoring the employer, although there are some physicians who are right down the middle. (More on IME appointments later.)
If you have an injury where an orthopedic evaluation is required, contact a physician, such as your primary care doctor, for a referral.
Stick with the Facts
When you are being examined for a work-related injury, restrict your conversation to where, when, and how the injury occurred. Do not discuss other non-related interests or activities. You would be surprised at what may end up in the physician notes. There may be material that is totally unrelated to your current condition, but that will raise a red flag for the insurer/employer.
For example, it is not relevant that you coach youth hockey and are in a bowling league when your back injury resulted from lifting an object at work. Be a good historian with regard to your injury and how it occurred, especially during that first visit—the history will likely be cut and pasted onto all future office notes for the physician.
State-to-State Differences
If you are treated in New Hampshire and you are covered by the New Hampshire Workers' Compensation Statute, make sure you review the NH Workers' Compensation Medical Form prior to leaving the office. Ensure that if the doctor agrees you are disabled as a result of an injury arising out of and in the course of your employment that he checks off the appropriate box. Also check whether he filled out the appropriate restrictions for your workplace if applicable.
If you are claiming an injury in Massachusetts, or other jurisdictions that do not provide forms, carefully review the office visit notes when they are available. Such notes are usually available within seven days. Confirm that the note mentions the mechanism of injury, that it is work related, and whether or not you can return to work with modification or if the doctor is taking you out of work.
Selecting and Interacting with a Physician
Another consideration when dealing with physicians is whether he or she is the right fit for you. If you find yourself sitting before a physician who appears not to be listening and will not take the time to understand the hazards of your particular job, you may want to consider finding another physician. Find a physician that you connect with and have confidence in. You must be a strong advocate to get the medical attention necessary to resolve your injury.
As for the IME appointments mentioned above, you should arrive promptly, be cooperative, and focus only on your work-related injury. The physician will be reporting directly to the employer/insurer regarding the causation, extent of disability, and reasonableness of treatment. A copy will be sent to you upon your request or, if you have an attorney, they will forward a copy to your lawyer.
Some pitfalls to avoid:
- Do not talk about activities outside the workplace that are unrelated to your industrial accident.
- Do not go for treatment for a past unrelated injury and then ask the physician to examine you regarding a new work related injury. Make separate appointments.
- Be a good historian and stay away from phrases like "I think" or "it could have happened." If you do not know when the injury occurred or when the pain progressed to a point where you sought medical treatment, the physician certainly will not know.
- If the company sends you to a particular physician ask whether it is an IME or if they are simply suggesting you go to that particular doctor. If it is just a suggestion, then find your own physician. (IME appointments generally have to be in writing.)
Do not hesitate to reach out to a Teamster Business Agent or an attorney for advice regarding a workers' compensation claim. Protect yourself and your family by being informed. Knowledge is power.
This article was submitted by William R. Cahill, Jr., of Dumont, Morris, and Burke, PC., 14 Beacon St., Ste 300, Boston, MA. Attorney Cahill was formerly a principal officer of a Teamster Local and has been practicing law in MA and NH since 1996/1997 respectively. He received an Honorable Discharge from the Massachusetts State Police after 26 years of service to the Commonwealth.