Working with work-injury doctors

The treating physician’s job is to diagnose, treat and document. The attorney’s job is to advise the injured worker on their rights and represent them in the claims process. The two roles overlap in one place: the medical record, which often determines what benefits are available.

Attorneys rely on clear, complete documentation of causation, restrictions and work status. Physicians rely on accurate histories and on not being pressured to reach particular conclusions. Keeping those roles distinct protects the patient, the doctor’s credibility and the integrity of the claim.

Send records requests with a proper authorization signed by the patient, a clear description of what you need and a reasonable timeframe. Busy clinics process many requests; specific, well-organized requests are filled faster and with fewer errors than broad ones.

Ask for what the case actually requires. Office notes, work status reports, imaging reports and restriction forms are common needs. Respect the clinic’s fees and procedures for copying, which are often set by state law.

Attorneys sometimes ask treating physicians for narrative reports that explain the diagnosis, how the injury relates to work, and current restrictions. Ask open questions rather than leading ones, provide the relevant history, and accept the doctor’s conclusions even when they are not what the case needs.

Independent medical examinations, sometimes called IMEs or by other names depending on the state, are arranged under state-specific procedures. Rules on who can request them, who pays and how the injured worker may prepare differ widely, so check your state’s rules and explain the process to your client in plain terms.

A physician’s opinion is only valuable if it is genuinely the physician’s. Never suggest treatment, ask a doctor to change a diagnosis, or imply that a referral relationship depends on favourable reports. Courts, insurers and licensing boards all take a dim view of arrangements that compromise medical independence.

Likewise, the decision about where an injured worker treats belongs to the worker within whatever choice their state allows. Attorneys can share educational resources about finding a doctor, but should not pressure a client toward a particular provider.

Referral arrangements between attorneys and medical providers are regulated. Paying for referrals, splitting fees with non-lawyers or giving anything of value in exchange for patient or client introductions may be prohibited or tightly restricted. Any referral arrangement must follow your state bar rules and applicable health care law.

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