How doctors make or break a workers compensation claim

Doctor’s Orders – How doctors make or break a Workers’ Compensation Claim

When it comes to workers compensation disputes, it’s the opinions of doctors that will make or break your claim.

General Practitioners

It starts when you first receive your injury. How much detail does your GP record when you see them? How accurate is this recording? Will they write you up a certificate of capacity? The GP you see can make a bigger difference than you might think.

In a recent claim handled by Turner Freeman, a GP certified their patient as ‘fit for some duties’ when in reality, the nature of their psychiatric injury meant that they were not realistically able to work at all. The Workers Compensation Commission was likely to prefer the doctor’s opinion and would have greatly reduced the weekly entitlements of our client – our client was forced to settle for less than what they felt they were entitled to.

In another claim, our client’s GP wrote a report stating that our client was unable to work at a particular employer, but would be likely to recover if they found work elsewhere. This made it difficult to argue that our client was incapacitated for all work and the value of their settlement was reduced accordingly.

When it comes to GPs, make sure you trust that your GP is an experienced professional and is willing to do what is best for you. A GP you have known for a long time and is familiar with your personal history is best, but if you have your doubts about their quality, don’t be afraid to find a doctor that provides better care. There are plenty of quality bulk-billing GPs around. Nobody should settle for inadequate care.

Specialists

There are plenty of things outside your GP’s expertise. This is normal and that’s why with many injuries, you’ll end up having to see a specialist too. Specialists are no different from GPs in that some provide better care than others, so don’t be afraid to find one that’s right for you.

Sometimes we find that our clients have been seeing specialists that may not be the right specialist for their injury. Clients might be seeing a chiropractor to relieve their symptoms when what would really support their claim is the diagnostic opinion of an orthopaedic surgeon. Other clients may be discussing their problems with their GP and not seeing any specialist at all!

When it comes to specialists, make sure you discuss all the possible options for specialists with your GP and don’t settle for just alleviating symptoms – make sure you see a leading specialist who can properly diagnose your condition and give you all the options for treatment.

Independent Medical Examiners

If your workers compensation claim becomes a dispute, you may have to see an independent medical examiner (IME) to provide a medical report. Often you’ll have to see multiple – at least one organised by your insurer and at least one organised by us here at Turner Freeman.

IMEs are supposed to be independent experts in their medical fields who can provide reports on the relationship between your injury and work, whether certain treatments are reasonably necessary or assessments of permanent impairment for lump sum claims. In reality, they vary wildly in fairness and quality.

In one matter, an IME organised by our office has assessed our client as suffering from 25% whole person impairment, entitling our client to a significant lump sum claim. Another IME organised by the insurer has assessed the same client as suffering from no impairment at all! The difference in opinion can be astounding.

Here at Turner Freeman, the advantage we offer is decades of experience dealing with every sort of medical professional. When it comes time to send you to an IME, you can trust that we know which doctors are fair and reasonable and have the experience and professionalism to give you the medical reports that you deserve.

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