Who picks your doctor in a New York workers’ compensation case?

You have brushed off a lot of bumps and bruises over the years, but you are smart enough to know when you are injured and need medical care.

Who decides what happens next? Do you have control over what doctor you see, or does your employer get to make that call?

In New York, injured workers enjoy more freedom of choice

Generally speaking, an injured worker in this state has more autonomy than injured workers in many other states. You can seek emergency medical care anywhere (and any time) you need it.

To determine what you need to do next or for non-emergency care, you first need to know if your employer’s insurance is a preferred provider organization (PPO). Then, the rules work like this:

• If your employer has a PPO and you have been properly notified of this in advance, you have to choose a doctor who is part of the PPO as your treating physician for the first 30 days of treatment.
• If your employer does not have a PPO, you can see any medical provider you wish so long as they are authorized by the Workers’ Compensation Board. The state even maintains a searchable database to help you find a provider.
• If you have been using a provider that was part of your employer’s PPO and the initial 30 days have passed, you can notify your employer that you intend to seek new care outside of the PPO system.

Why is this so important? Well, to start with, there’s probably nothing more personal than the relationship between a patient and a physician. You want a physician who listens to you, treats you like a vital part of your own health care team and makes good decisions.

You should not be stuck with someone you do not want. Second, you want a doctor who will not put the company’s concerns above your health. That can happen when a physician is selected by an employer.

Get answers to your questions

It can be confusing to understand your rights under workers’ compensation – and too many insurance companies and employers are willing to exploit that. Experienced legal guidance can help you.