Getting Workers’ Compensation often means seeking treatment from a doctor your employer chooses, at least for the first 90 days of treatment. This can be stressful if you don’t trust that doctor, especially if they give you reason to believe they’ve committed malpractice by misdiagnosing you.
Your first concern is getting your Workers’ Comp claim approved and the treatment you need carried out. To accomplish this, we can often seek second opinions and outside review to get medical proof of your injury and assess the true impact on your ability to work and support yourself. We can also help you switch doctors. From there, if you received improper treatment because of that misdiagnosis, you might also have a malpractice claim against that doctor.
For a free case review, call the Pennsylvania Workers’ Compensation Lawyers at Cardamone Law today at (267) 651-7945.
What if My Workers’ Comp Doctor Gets My Condition Wrong?
When you initially get treatment for a work injury, you are required to use a doctor from your employer’s approved provider list for the first 90 days of treatment. These are often called “panel doctors,” but they are not necessarily all physicians. The list must include at least six options, though they are not necessarily all general practitioners; e.g., some might be chiropractors, surgeons, or specialists. It will be up to them to diagnose you and recommend the course of treatment, but they can hurt your case if they make mistakes in treating and diagnosing you.
If their initial diagnosis is wrong, we can get outside doctors to review your case and diagnose you instead. From there, we can take this evidence to court and use it to contradict the evidence your employer puts forward from their chosen doctor.
That means that even if your initial treating physician makes a misdiagnosis, our Pennsylvania Workers’ Comp lawyers can often counter what their doctor said with our own medical evidence, potentially helping you get your Workers’ Comp claim accepted.
Can Independent Medical Exams Help Uncover Misdiagnosis?
Employers can request independent medical exams (IMEs) to verify your condition and disability and impairment rating evaluations (IREs) to later determine your disability status. These IME/IRE doctorswill not be your treating physician; this will be a separate doctor the employer or their insurance carrier hires to examine you and determine whether you are really unable to work because of your injury.
This doctor works for your employer, and you should not necessarily trust them to have your best interests in mind or to be “independent” in any meaningful way. Their goal is to obtain information your employer can use to deny your claim, not to properly diagnose your condition or uncover medical mistakes your treating physician made.
Technically, they are still healthcare professionals, and they may uncover things your treating physician missed, potentially uncovering malpractice or misdiagnoses. However, this isn’t their job, and you should not count on it.
Can You Get a Second Opinion on Workers’ Comp Treatment?
You can always go see another doctor if you doubt the accuracy of your treating physician’s diagnosis or care. You can always switch to a different doctor on your employer’s approved list, but you may want outside care. Because you have to use an approved doctor in the first 90 days, outside care might not be covered at first, but it might be necessary to protect yourself from bad medical care and get your Workers’ Comp benefits granted.
Outside opinions can be obtained out of pocket, and the evidence you get from that doctor can help build your case and prove your disability to the court. At the end of the case when we get your benefits granted, the cost of getting this additional medical evidence should be reimbursed. Because of this, our lawyers can often front these costs and pay for outside exams to obtain evidence.
You are also allowed a built-in second opinion if your treating physician recommends surgery. This second opinion can help you decide whether or not surgery is the right course of action, but you cannot necessarily use a surgeon of your choice. You still have to use the approved providers to perform the actual surgery if it happens in the first 90 days of treatment.
Can You Change Doctors if the Workers’ Comp Doctor Misdiagnoses You?
If the doctor treating you commits errors, makes mistakes, misdiagnoses you, or otherwise falls below the standard of care in treating you, you may have a good reason to change doctors.
You can always switch to a different panel doctor on your employer’s list. If the first doctor made you uncomfortable or seemed incompetent, getting the best care might mean switching doctors, and any other doctor on the approved list should still be covered in full.
If you have a legitimate conflict of interest with one doctor (e.g., they’ve committed malpractice against you), you should switch right away. But what if you run out of listed doctors? The odds of you having a legitimate conflict or being mistreated by each doctor on the list, all within the first 90 days of treatment, is quite rare, but we can address this with the court if it were to happen.
After the first 90 days, you can always switch to a doctor of your choice, whether you have a good reason or you simply want to switch. You can also use an off-list doctor if you need a specialist that isn’t listed.
Can You Sue a Workers’ Comp Doctor for Medical Malpractice Based on Misdiagnosis?
Doctors used for IMEs and other independent exams and reviews throughout your case are not actually treating you. Their role is not really as your doctor, and so they are not held to the same standards as a treating physician. For this reason, it would be difficult to bring a medical malpractice claim against them.
However, your treating physician is your doctor, even though the insurance company pays for them. This provider needs to follow all relevant standards of care for your proper care, and they cannot skimp or give you inadequate care.
You can often sue for misdiagnosis from a Workers’ Comp panel doctor, especially if it leads to dangerous treatments you did not need, e.g., chemotherapy for misdiagnosed cancer or unnecessary amputation.
Call Our Workers’ Comp Lawyers in Pennsylvania Today
Contact our Allentown, PA Workers’ Comp lawyers at Cardamone Law at (267) 651-7945 to get started with a free case review.
