How to Get a Second Opinion in Your Workers’ Compensation Case

Who Decides What Doctor You See After a Workplace Accident?

Under the New York workers’ compensation law, you can seek treatment from any physician authorized by the New York State Workers’ Compensation Board (WCB). However, if your employer’s workers’ compensation insurance company has a list of doctors in its network that you must see, you are likely stuck with their selection of doctors for the first 30 days after your accident.

Many people express concerns that doctors in an insurance policy’s network will issue an opinion favorable to the insurance company so that they can continue to get business. A good physician will place a priority on patient care and the recovery of workers’ comp patients. But what happens if you believe a doctor’s opinion is incorrect? After your initial doctor’s appointment with an in-network doctor, you have 30 days before you can change doctors.

If the doctor you are seeing does not agree with your assessment of the severity of your symptoms and injuries, you can choose a different doctor after the 30 days has expired. You can choose any doctor authorized by the NY State Workers’ Compensation Board, regardless of whether the doctor is in-network or out-of-network. The good news is that all doctors listed in our physician directory are authorized by the NYS Workers’ Compensation Board.

Can You Get a Second Opinion in your Workers’ Comp Case?

If you are faced with an opposing opinion to your injuries or symptoms, you may consider getting a second opinion. If the first doctor you see clears you for work or thinks that your injuries are not as severe as you believe them to be, this could affect your workers’ comp benefits.

You can choose to seek out a second opinion from a reputable workers’ comp physician to dispute the findings of the first doctor, and potentially maintain or restore your benefits. In many cases, there will be a hearing before the New York State Workers’ Compensation Board to determine whether the second opinion will prevail. However, in some cases, the insurance company will choose to rely on the second opinion, and a hearing will not be necessary.

It is important to note that an insurance company may not pay for expenses incurred in getting a second opinion if they have already terminated your benefits. In this case, it may be beneficial to speak to a workers’ comp attorney to determine your options.

What is an IME?

An Independent Medical Examination (IME) is a medical exam ordered by the insurance company. This is an examination conducted by a physician of the insurance company’s choosing to evaluate your injuries or symptoms. After examining you, an IME doctor will issue a report of his or her own findings to either verify or dispute, either in whole or in part, the original report of your doctor. If the IME physician disagrees or clears you for work, an insurance company may use this as a basis to reduce or terminate workers’ comp benefits.

The IME Doctor Disagreed with My Physician. Do I Need to See Another Doctor?

If the IME physician disagrees with your physician, you may wonder if you need to seek out another opinion. Typically, your first doctor’s findings will be sufficient. You will just need to go through a process for those findings to prevail. You may have to file an appeal with the New York State Workers’ Compensation Board if your benefits are terminated. In many cases, both your original doctor and the IME physician will be questioned under oath to determine whose report is more credible. If you are represented by a workers’ comp attorney, he or she can walk you through the process.

Need a Second Opinion? Don't Wait. Call Today For an Experienced Workers' Comp Doctor

If you are dealing with a workers’ compensation case, you may face several obstacles. Getting medical treatment should not be one of those obstacles. Unfortunately, you may be faced with a situation in which you need a second opinion. If you are seeking a second opinion in your workers’ comp case, you should visit an experienced workers’ compensation physician as soon as possible. 

Doctors listed in our directory have extensive experience treating injured workers, providing quality and compassionate patient care. We will evaluate your injuries and give you a truthful assessment of the treatment you need. To inquire about getting a second opinion, or to make an appointment with an experienced workers’ compensation doctor, call 1-800-897-8440 today.