Workers' Comp Medical Issues FAQs

Q: Can I refuse further treatment if I think it's causing more harm or isn't helping my condition?

  • A: You can choose to refuse treatment, but discuss your concerns with your doctor before taking action. The insurance company could stop paying benefits and claim you're not cooperating with plans for your recovery.

Q: Is my employer required to follow restrictions on my work, as ordered by my doctor?

  • Generally, yes, your employer must honor these restrictions, whether ordered by your treating physician or based on an independent medical exam (IME). These doctors can disagree on the scope of restrictions, and those issues are a source of workers' comp litigation.

Q: Am I free to choose my doctor, and if not, how is the doctor selected?

  • A: Depending on your state's laws, you may have a choice, or you may have use the doctor selected by the workers' comp insurer or your employer. Some states allow injured employees to choose their doctor if approved by the state's industrial commission. If you're injured, ask your employer or human resources department for help.

Q: What is an independent medical exam (IME)?

  • The workers' comp insurance carrier hires a doctor to examine an injured employee, and provides a report to the carrier. The insurance carrier's decisions depend in large part on IME results.

Q: What can be done if my doctor doesn't agree with the findings of the IME doctor?

  • A: Each side, you and the insurance carrier, are entitled to trust in the findings of your respective doctors. Often workers' comp litigation involves disputes about which doctor's opinion is the correct one, and the end result is an Industrial Commission trial.

Q: What is temporary total disability (TTD)?

  • TTD is your disability, under medical authorization, which leaves you unable to work. Benefits are paid for TTD after your accident to replace lost wages while you're recovering from your injury, and it's expected you'll return to work. Benefits may be paid every week or two, and the amount is a percentage of your average weekly pay.

Q: How long do total temporary disability (TDD) payments last?

  • TTD benefits are paid while you have medical authorization to be off work, or your employer doesn't have any work for you to do that falls within your work restrictions.

Q: What is permanent partial disability (PPD)?

  • PPD is your lasting disability, resulting from your injury at work. For example, a complete or partial loss of use of a limb due to your accident.

Q: Must I return to work before I've completely recovered?

  • Yes, if there's work that's within your doctor's work restrictions, such as light duty work. Typically, you receive your regular pay for light duty work.

Q: How long does the medical portion of my claim stay open, and can I keep it open if my treatment is going last for a while?

  • Help from your attorney is usually needed to factor medical benefits into your settlement. Proper medical proof is needed. Usually insurance companies don't allow medical claims to remain open.

Q: How much time can the insurance company take for approval of my medical treatment?

  • Workers' compensation provides for care that is reasonable and necessary. Disputes can come up between the IME doctor and your treating doctor, delaying approval. The dispute often ends with a decision by the state Industrial Commission on the necessary course of treatment, based on medical evidence presented by both sides.

Q: Does a nurse caseworker have the right to go to my doctor's appointments?

  • The best solution is to meet with your doctor first, and arrange for the nurse caseworker, who is hired by the insurance carrier, to meet with the doctor after your appointment. You should receive a copy of any report made by the caseworker.

Q: What can be done if I don't agree with functional capacity exam (FCE) test results and my rating?

  • If you don't agree with test results, review them with your doctor. It's supposed to be an objective test, and if after review, you still don't agree, ask for another test. The insurance carrier likely won't want to pay for the exam, so your lawyer's help may be needed.

Q: What is a functional capacity exam (FCE)? How are the results used?

  • This test is an objective evaluation of your ability to do certain tasks, such as gripping, walking, bending, kneeling and lifting. The results are used in determining what type of work you can do when you return to your job after an injury.

Have a Workers Compensation Question?
It’s Free & Easy. Verified Content legal editors have reviewed and verified that the content included in this article reflects accurate and up to date legal information.

Ask a Lawyer

Have a Workers Compensation Question?
  • It’s simple, free and safe.
  • Submit your legal question confidentially with ease of mind.
  • Receive multiple answers from top rated lawyers.
Workers Compensation Law Firms
In Herndon, VA change location

(888) 789-2291 | Contact Now

Herndon, VA
(571) 286-5492 | Contact Now
State *