It is a prevalent misconception that most employees have an obligation to be treated exclusively by a company doctor after suffering a work injury. Despite employers asserting the necessity of adhering to a “panel provider” during the critical 90-day period post-injury, the reality is that many workers encounter significant hurdles in securing medical practitioners willing to treat them within these confines.
This raises a crucial question: should employees unquestioningly trust a company doctor, or is there a need to critically evaluate the implications of such mandated medical care? Delving into this dilemma will require the help of a proficient Philadelphia work injury attorney, but it will go a long way toward ensuring you make informed decisions that will expedite your recovery.
Why should you have to wonder if your doctor cares about you?
There are many reasons why the trustworthiness of company-endorsed healthcare providers should always prompt a closer examination. Here are several examples that will help you gain some perspective on the matter.
Example 1: Dishonesty in omission
A client with post-concussive syndrome recently reminded us of the dramatic way that employer-designated medical providers treat workers’ compensation patients differently from the way private medical providers treat patients.
At each visit after the first one, the panel neurologist asked her to tell him what areas had improved, which he duly noted in his records. However, he didn’t ask her any other questions pertaining to her symptoms.
For example, she still had photophobia but her headaches were somewhat better. However, all the office note said is that her headaches were better. As a result of his omission, you would think that the other symptoms didn’t exist. While the office note was accurate, it was dishonest because it was incomplete.
Example 2: The 180° turn
Similarly, in employer-designated physical therapy centers, physical therapists push patients to report improvement even when they are not getting significantly better. “Come on, you must be feeling a little bit better,” is a typical declaration injured workers get at physical therapy centers they have been referred to by company doctors.
If their backs are in spasm, which is a serious sign of injury, these facilities often report “tightness” or “tenderness to palpation.” Company doctors know that injured workers only have an obligation to treat with them for 90 days and often report significant improvement during that time, even when there has been little or none.
Furthermore, when patient treatment reaches about the 70th day, many company doctors suddenly begin to describe “pre-existing conditions” as the cause of the patient’s symptoms, knowing that the patient will not be treated by them for longer than 90 days.
Example 3: Blind coverage denial
A former medical director for Aetna Insurance Company admitted under oath that “he never looked at patients’ records when deciding whether to approve or deny care.” The stunning admission came amidst a deposition taken in a lawsuit filed by a college student who suffers from a rare immune disorder and needed Aetna to pre-authorize an expensive infusion.
The medical director, who signed the pre-authorization denial, admitted that he knew next to nothing about the disorder and testified that he never looked at any medical records in his entire career in connection with any review of medical treatment made by Aetna.
The silver lining
There are some very fine medical providers who treat patients at the request of insurance companies or employers. There is no reason, however, why patients should wonder whether the provider’s loyalties are to the insurance company or them.
For this reason, those who have suffered serious work injuries should almost always try to get documentation of their symptoms from a primary care physician – even during the 90-day period during which they are supposed to be treated by the company doctor. Furthermore, when the company’s 90-day treatment period expires, it’s time to get treated by someone you are sure is honest.
Where in Philadelphia can I find an experienced work injury attorney near me?
At Liberty Bell, you can find the finest lineup of workers’ compensation attorneys on either side of Schuylkill River. Our seasoned legal team adopts a client-centric approach, tailoring our strategies to reflect the unique circumstances of your case. We possess a profound understanding of the work comp system and we’re widely recognized in Philadelphia for our integrity and commitment to justice.
Don’t fall into the trap of legal mills whose only goal is to enhance their bottom line. Contact us today and ensure you have a partner who’s willing to fight tooth and nail to ensure the best outcome for your case!
