Episode 93: Calloway County workers’ compensation attorney Jeff Roberts has handled claims for workplace injuries for over 32 years throughout Kentucky. Today, he’ll return to the issue of “the company doctor” and your right to choose your medical provider.
It’s an unfortunate fact that some employers will try to manipulate information related to your workplace injury. This often occurs when they “recommend” you see a specific doctor for your medical treatment. Sometimes, they’ll go so far as to tell you it’s a requirement. While you think they’re being helpful, that’s not what’s going on. They know certain doctors value the referrals they get from the employer and that may influence how they document the extent and treatment of your injuries. We refer to these physicians as “the company doctor.”
In Kentucky, injured workers have the right to select their own doctors, physical therapists, pharmacies, etc. This is the law. However, what you don’t know CAN hurt you (or at least your claim). You have the right to avoid the company doctor for your workplace injury.
Jeff was actually involved in a case that went all the way to the Kentucky Supreme Court based on the worker’s right to choose a specific pharmacy. The question was whether a pharmacy is considered a medical provider, thus giving the worker the right to choose between pharmacies. Jeff won the case at the Kentucky Supreme Court. In fact, Jeff has had a fairly successful history of taking cases to the Supreme Court and winning. Obviously, each case is fact specific and Jeff cannot guarantee the outcome of any case.
Is It Okay to Go to the Plant Medical Station or Nurses Station?
Yes. Sometimes an injury might need a bandage or other initial treatment, before you seek medical treatment from your family doctor. Jeff has seen claims initially denied because the injured worker didn’t see the plant nurse, first. Once Jeff reminds the employer of Kentucky’s workers’ compensation law specific to medical providers, that argument is usually resolved.
For instance, if a worker sustains an injury on 3rd shift, the plant medical may be closed. If the employee seeks treatment the next day from his/her family doctor, there’s no reason for the company to try to give him/her the run around. Even so, employers and their insurance companies can play all sorts of games in an effort to minimize medical expenses.
Home Cooking Is Good for a Meal Not Your Medical Treatment
Jeff explains why he’s had to deal with these types of situations for 32 years. The insurance companies and employers will always try to downplay or to deny that it’s happening. However, if it weren’t such a common issue, why does it continue to happen all across the state? If you want home cooking, Jeff recommends Rudy’s on the Square. As for your workers’ compensation benefits, avoid home cooking at all costs. Unfortunately, many workers are unaware it’s even happening, until it’s too late.
Why Do Companies Do this to Their Workers?
Companies and their insurance companies know they can dodge significant medical expenses, over time, if they continue to play games. It’s a question of calculating the odds of getting caught.
Think of how many workplace injuries occur in a given year. If an insurance company can reduce even a fraction of the expenses, it’s a significant savings. The moment you get injured, you become an expense to your employer.
Some doctors have a reputation for being much more insurance-friendly in their medical diagnosis and treatments. Jeff describes how one such doctor was known to have the opinion that cumulative trauma does not cause carpal tunnel. For this reason, many companies referred their workers to that doctor for medical treatment, knowing the cause of the injury had a good chance of being blamed on something other than a being work-related.
Jeff points out that the earlier an injury is successfully treated, the better chance that person has of making a full recovery or at least experiencing a better recovery than had they delayed treatment. If a doctor were to minimize the extent of the injury and pushes the employee to return to work earlier than normal, the problem could be worse down the road. In the end, the insurance company might end up paying more medical expenses because they tried to cut corners. Again, they’re often willing to play the odds with your health.
The Importance of Designating Your Doctor for Treatment
In Episode 68, Jeff explained the importance of Form 113, the Designated Physician Form. Jeff recommends that you use this form to assign your family doctor as your treating physician. It’s important that you don’t inadvertently sign a company form giving up this right. Remember, games are being played.
You family doctor, or primary care physician, is going to be able to evaluate your injury and recommend specialists, if needed. Your family doctor isn’t worried about the company’s financial exposure. He/She just wants you to heal and recover as fully as possible.
Does Your Company Have a Managed Care Plan?
Some companies have a managed care plan in place and they can require you to seek treatment from the doctors who are part of this plan. However, they cannot send you to a specific doctor. It’s still your choice. There’s a chance your family doctor may be one of the doctors in this managed care plan.
Jeff stresses that if you are hurt on the job, you may need to go to the plant medical facility, at first. There’s nothing wrong with that. You might need a bandage, split or even some aspirin. However, you can then go see your family doctor or go to an urgent care facility if you need to.
However, if the plant nurse begins talking about sending you to a specific doctor, your red flags should go up. You have the right to tell them that you’d prefer treating with someone else or asking your family doctor for a referral. They can’t force you to go to a specific doctor.
Remember to Report Your Injury
In Episode 23, Jeff explained that you have to report any workplace injury to your employer. It’s a requirement under the law. You have a duty to notify your supervisor or some other manager that you were injured. This allows the employer to potentially correct something that may have caused your injury, so it doesn’t happen to someone else.
Most of the time, if you do report to the nurse’s station at the plant, this would also fulfill your duty to notify your employer. Remember, you have to tell someone higher up the in the company, not a co-worker.
You Can Get Reimbursed for Mileage Related to Medical Treatment
Episode 68 also covered Form 114, which is the reimbursement form you can use to submit mileage and other expenses related to your medical treatment. Many people forget about this, or were never told. This is particularly helpful if you need to see a specialist in a different city or state.
It’s important to remember that you only have 60 days to submit the expenses. If you incur a copay for a prescription or office visit, you can submit the receipts with Form 114. Workers’ comp will cover those expenses. You could also get reimbursed for buying bandages or other items related to your work-injury.
Jeff always recommends keeping a copy of the information you’re submitting and the date you sent it to the insurance carrier.
What if the Specialist Recommends Surgery I Don’t Want?
It’s possible that a doctor may recommend certain procedures that you may not want. For instance, a surgery may result in complications or limitations. In this case, you may want to pursue alternative treatments before a surgery. Your attorney can help you to seek a second opinion to be sure you’re making the best possible decision regarding your treatment.
Some doctors are referred to as “super specialists.” They have a well-deserved reputation for treating certain medical conditions. Jeff explains that judges tend to rely on an opinion or recommendation by these doctors. Because Jeff’s handled workers’ compensation cases for over 32 years, he’s familiar with some of these super specialists. It’s possible the doctor will recommend a certain course of treatment or surgery. This recommendation is often easier to get approved by the insurance company and/or the judge. The recommendation might support what the original doctor prescribed, or it might be a different type of treatment all together.
At the end of the day, you want to recover from your injuries. To do this, you’re probably going to need some help. Having an experienced workers’ compensation attorney protecting your rights, arguing with the insurance company on your behalf and helping you to get the best possible medical treatment is to your benefit. The company doctor may have different motivations. This is why you should avoid the company doctor for your workplace injury.
A delay in getting the proper medical treatment for your work-related injury may cause more pain later in life. Jeff understands this and is ready to use his experience to help you get the treatment you need and deserve.
What Do Other Clients Think About Jeff?
We always encourage listeners to read the Google Reviews Jeff Roberts has received from many of his clients. A 5-Star rating and the comments are earned recognition and demonstrate Jeff’s commitment to his clients. As a solo attorney, he has more Google Reviews than some firms with multiple attorneys. Jeff shares the credit with his staff at the Roberts Law Office. Successfully representing injured clients is a team effort. It’s why Jeff likes to say his firm offers small town service with big city results.
Jeff Roberts Represents Injured Clients Throughout Kentucky
With offices located in Calloway County (Murray) and in Christian County (Hopkinsville), Jeff has a history of representing personal injury clients, workers’ compensation clients and social security disability clients across the state. He’s represented clients from Paducah, Bowling Green, Louisville, Covington, Whitesville and many other Kentucky locations. He’s not just a Western Kentucky injury attorney.
We hope you found this episode insightful and helpful. Thank you for listening!
Is It Time to Speak with an Attorney about Your Workers’ Compensation Claim?
The office phone number is (270) 753-0053 or toll free at 800-844-5108. For more information, visit www.JeffRobertsLaw.com. This podcast is meant to provide information and is not legal advice. Jeff’s principal office is located at 509 Main Street, Murray, Kentucky. Co-host Jim Ray is a non-attorney spokesperson. This is an advertisement.
