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How to Pick Your Primary Workers Comp Doctor

How to Pick Your Primary Workers Comp Doctor

doctor - silly.jpgWhat do you call the person that finishes last in their class at med school?  Doctor!  For that reason and many more, it is imperative that you proactively vet your primary workers comp doctors when it comes to your organization’s rehabilitation of injured employees.  It is easily one of the most crucial elements of your workers comp risk management services program.  The right physician can bring huge value, but the wrong ones can cost you hundreds of thousands of dollars.  Read on to learn about the benefits of picking the right one and what to look for.  BONUS: download our vetting cheat sheet to assist you in the process.


In many states, you have the right to direct care and pick the physician or panel of physicians that treat your injured employees.  States that require a physicians panel are slightly different.  You can read about them here.  If you have any questions about the state/s you operate in and the regulations regarding choosing a physician, use this resource put out by TokioMarine America


Supercharge the savings in your workers comp program by pairing the right Post-Injury Best Practices with the ideal Primary Physician.


Benefits of Picking the Right Primary WC Physician

  • Efficiently gets injured employees back to full duty
  • Identifies fraudulent or over embellished symptoms/injuries early in the process
  • Creates a positive rehabilitative relationship with employees
  • Reduces duplicated or unneeded medical procedures
  • Acts as a monitor to help avoid opioid abuse or addiction issues
  • Provides real-time feedback and anticipated return to work timing to the employer
  • Extends your internal culture of safety and accountability to the rehabilitation process





What to Look for in a Primary Workers Comp Doctor

  • Availability – office hours and location are always key as sending employees to the physician may be needed during first or second shift and long travel can decrease the morale and confidence of the employee
  • Communication
    • Physician should be proactive in their communication and not just wait for you to get examination reports or updates via fax or mail
    • Physician should always be willing to take your call or get on a conference call to discuss specific claims
    • Reports and notes should be thorough and precise (no broad statements or lack of support should be present in their reports/charts)
    • Any changes in the treatment plan for a particular employee should be immediately brought to your attention to help you anticipate staffing needs and readjust your expectation of a return to work
    • Positive working relationship with your claims team or third-party administrator is a huge plus
  • Proactive Treatment
    • The final outcome should always be in focus with an emphasis on the most efficient way to get an employee back to health and back to work
    • Physician should be able to deliver strong feedback to an employee if it is suspected that they are fabricating symptoms or ‘milking’ an injury to stay out of work or on restricted duty for an extended period of time
    • Treatment plans should include consistent follow up with the employee to make certain they are sticking with the plan and to help identify any setback immediately
    • Unnecessary medical procedures prescribed by specialists should be scrutinized – everyone over the age of 35 has some kind of ligament tear in their shoulder, not every shoulder strain requires an MRI…you might end up buying a $100,000 surgery that had nothing to do with the employee’s injury
    • Determining an employee’s ability to return to full duty should be made with their job description and duties in mind (full duty may be possible prior to full recovery and the employee can finish their treatment plan while working)
    • Focus on non-opioid pain treatment to help avoid or reduce the possibility of an opioid addiction due to inadvertent overprescribing or doctor shopping on the part of the employee


Download Our Cheat Sheet to Help You in Your Vetting Process