Content reviewed by:
Alex Shulman
Yes, in New York, you can change doctors during a workers’ compensation case. However, the new medical provider must be authorized by the Workers’ Compensation Board to ensure continued coverage and benefits.
Workers’ compensation cases rely heavily on proper medical care and documentation. If you are unsure how to switch providers or protect your benefits, working with a New York City workers’ compensation lawyer can help you follow the correct process under New York workers’ compensation law.
When You Can Change Your Treating Doctor in New York
At Shulman & Hill, we regularly guide injured workers through the process of changing doctors. Under New York workers’ compensation law, you are generally allowed to switch your treating doctor, but the provider must be approved by the Workers’ Compensation Board.
There are several common reasons for changing doctors, including dissatisfaction with care, the need for specialized medical treatment, or a retiring doctor. Regardless of the reason, the new treating physician must be listed in the state’s provider database to ensure your workers’ comp claim remains valid.
Common Reasons for Switching Medical Providers
Choosing the right provider can significantly impact your treatment plan and long-term outcome. Injured employees may consider changing doctors for a variety of reasons related to their recovery and medical condition, such as:
- Lack of progress: Medical treatment is not improving your work-related injuries or medical condition.
- Need for specialized care: You require specialized medical care beyond what your current occupational doctor provides.
- Communication concerns: Your treating doctor is not clearly explaining treatment options or work restrictions.
- Availability issues: You are located in an area with limited access to qualified health care providers, sometimes referred to as medical deserts.
Switching practitioners in these situations is allowed, but it must follow the state’s workers’ compensation rules.
Steps to Request a Change of Doctors
At Shulman & Hill, we help ensure the switching of doctors is completed correctly to avoid complications with the insurance company. Changing doctors in a workers’ compensation case involves a formal process consisting of these steps:
- Confirm provider authorization: The new medical provider must be approved by the Workers’ Compensation Board.
- Submit a request if needed: In some cases, a formal request to change doctors or a request for a hearing may be required.
- Transfer medical records: Your medical records must be shared with the new treating physician to maintain continuity of care.
- Continue treatment: Follow the updated treatment plan and attend all scheduled medical examinations.
Following these steps helps prevent disputes with the insurance carrier and ensures your medical expenses remain covered.
The Role of Independent Medical Examinations
During your workers’ compensation case, the insurance company may require an independent medical examination. This evaluation is performed by an examining doctor chosen by the insurance carrier, not your treating physician.
These exams are used to assess your medical condition, work restrictions, and whether you have reached maximum medical improvement. While the results can impact your workers’ compensation benefits, they do not replace the independent medical judgment of your treating doctor.
Why Staying Within Approved Providers Matters
In New York, injured workers must receive medical care from providers approved by the Workers’ Compensation Board. If you choose a doctor outside of this authorized network, you may run into issues such as unpaid medical bills or gaps in your treatment.
There are a few important points to keep in mind:
- Authorized providers only: Your treating physician must be listed with the Workers’ Compensation Board to ensure your care is covered.
- Proper documentation: All required forms will need to be completed fully and accurately.
- Ongoing compliance: Your treatment plan and supporting medical evidence should follow New York’s workers’ compensation guidelines.
Not following these requirements can create problems with your workers’ comp claim and may slow down or interrupt the medical treatment you need.
How Changing Doctors Can Affect Your Benefits
Switching doctors can impact your workers’ compensation benefits if not handled properly. Insurance companies often review changes closely, especially if there are differences in medical opinions or impairment rating assessments.
At Shulman & Hill, we help clients avoid common issues, including:
- Conflicting medical evidence: Differences between providers regarding your medical condition.
- Delays in benefits: Gaps in documentation that affect your workers’ compensation benefits.
- Disputes with the insurance company: Questions about the necessity of treatment or diagnostic tests.
With proper legal guidance, these risks can be minimized while ensuring you receive appropriate medical care.
Legal Guidance for Changing Doctors in a Workers’ Compensation Case
Having the right legal advocate can make a significant difference when changing doctors. At Shulman & Hill, we assist injured employees throughout the process, ensuring compliance with workers’ compensation law and protecting their rights.
Our team helps coordinate medical care, gather medical evidence, and communicate with the insurance carrier. We also assist if disputes arise, including filing a request for a hearing before the Workers’ Compensation Board.
Get Help With Your Workers’ Compensation Case Today
If you are considering changing doctors during a workers’ compensation case, it is important to follow the correct legal process. At Shulman & Hill, we bring over 200 years of combined experience helping injured workers secure the medical care and benefits they deserve.
We have recovered more than $1 billion for our clients and understand how to handle complex workers’ compensation claims involving insurance companies and medical providers. Contact us today for a confidential consultation and let us help you protect your rights and your recovery.
