Q&A: What Is The Business Owners Role In Scheduling Workers’ Compensation Doctors’ Appointments?

When employees get injured on the job, small business owners should be aware of their rights and responsibilities while also respecting injured workers’ rights.

If an injury occurs, business owners should immediately report the claim to their workers’ compensation insurance carrier. Owners must also ensure an injured worker receives proper medical attention. Depending on the severity of the injury, this can range from emergency treatment to an appointment with a physician.

Here are some of the most commonly asked questions related to workers’ compensation doctor appointments and what you should know:

Q: Are employers allowed to attend workers’ compensation doctor appointments?

A: No. Due to privacy issues and injured worker rights, employers may not be present at workers’ compensation doctor’s appointments, workers’ compensation physical therapy appointments or in the examining room with an injured worker.

Employers are allowed to transport the injured worker to a medical facility. While employers are not entitled to private information, they are entitled to a limited amount of information about the workers’ compensation claim. Specifically, employers are entitled to information that may have an impact on their insurance premiums. Most states interpret this to mean information regarding potential work restrictions, diagnosis and, in some cases, the scope of treatment.

Q: When employees are scheduling workers’ compensation doctor appointments, what should an owner or employer do?

A: An employer can offer to take the employee to their medical appointment at the most appropriate facility.

Q: When an employee has a workers’ compensation injury, are they allowed to choose their own doctor?

A: The employee’s option to choose their own doctor depends on the state where the claim is filed. Some states require employers to select the medical provider, to keep the medical care in-network. Other states require the employer simply provide the injured worker with a variety of in-network choices for the employee to choose from. There are states that do not allow employers to direct treatment at all. In these instances, the treatment plan and choice of medical provider is the sole responsibility of the injured worker.

Q: Does an insurance company representative need to be present for the appointment?

A: An insurance company representative is not required nor permitted to be present for the appointment. However, insurance companies may contact physicians before and after an appointment to obtain information about the injury or illness.

Q: How do small business owners know what their state law dictates for doctor appointment protocol?

A: Each state has relevant information listed on their government website and you may also consult your local insurance agent for case-by-case information.

EMPLOYERS® is committed to helping small businesses operate safer, more efficient work places. Contact EMPLOYERS® today to learn more about our cost-effective workers’ compensation insurance.