Can You Sue a Workers’ Comp Doctor?

You can sue a workers’ comp doctor in certain situations. Let a workers’ comp lawyer from our firm determine whether your circumstances warrant a lawsuit.

You cannot sue a workers’ comp doctor because you don’t like the determinations they make on your case, but you can sue when a physician commits medical malpractice and causes you harm. This standard applies to workers’ comp doctors in the same way it does every other type of health care professional.

Our workers’ comp lawyers have the experience necessary to determine whether you might be entitled to compensation from a case like this. We offer a free, no-obligation consultation so that you can explain the circumstances of your individual situation and allow us to assess whether it’s a good idea for you to file a lawsuit. If legal action is warranted, we’ll start building your case right away.

Call us at (516) 399-2364, or fill out the contact form on our website, to get started.

How Do I File a Complaint Against a Workers’ Comp Doctor?

Depending on the situation, you can either file a complaint with the New York Workers’ Compensation Fraud Inspector General or lodge a medical malpractice claim in civil court.

Filing a Claim With the Workers’ Comp Board

Workers’ comp is insurance that provides wage replacement and medical care benefits for workers who suffer an illness or injury as a direct result of their job. New York law requires employers operating in the state to carry workers‘ compensation insurance coverage for their employees, including part-time workers, with limited exceptions.

To receive workers’ comp benefits, you must see a doctor authorized by the Chair of the New York Workers’ Compensation Board. If your employer’s insurer belongs to a preferred provider organization (PPO), they will have some choice regarding the doctor you see for your initial treatment. However, employers must provide at least two choices in each medical specialty and give you an option of at least two hospitals to visit. After 30 days, you may generally switch to a doctor you choose, as long as they are authorized by the Workers’ Compensation Board.

New York has a Workers’ Compensation Fraud Inspector General (WCFIG), established by §136 of the NY Workers’ Compensation Law, that is responsible for investigating violations of the laws and regulations pertaining to the operation of the workers’ compensation system. It is considered fraud when a healthcare provider intentionally submits a material misrepresentation about medical treatment for a workers’ compensation claimant in a bill or invoice. If this has happened to you, you can file a complaint using forms available on the WCFIG website.

Filing for Medical Malpractice

According to this study from Johns Hopkins Medicine, medical error is the result of around 250,000 deaths in the United States every year.

Medical professionals are expected to adhere to the standard of care that other reasonably competent professionals in their field would follow under similar circumstances. If they fail to do so, and you suffer harm as a result, they may be liable for civil damages arising from medical malpractice.

Not everything that goes wrong medically amounts to malpractice. However, if a workers’ comp doctor acts negligently in diagnosing or treating you, they should be liable to compensate you for any harm you suffer as a result.

Injuries Caused by Independent Medical Examinations (IMEs)

In order to file a successful application for workers’ comp, you must attend an independent medical examination (IME). During this appointment, a doctor selected by the insurance company will examine you and then file a report about your condition and the extent to which it’s preventing you from working.

If your doctor sends you back to work while you’re unfit to do your job and you suffer a reinjury as a result, you should have the right to file a malpractice claim against them. For a claim like this to succeed, you must be able to prove the following:

  1. The doctor gave you incorrect advice.
  2. It was reasonably foreseeable that you would rely upon this advice.
  3. Your reliance on the advice caused you harm.

Additionally, if you suffer an injury or a worsening of your condition during an IME due to negligent examination practices by your physician, they may be held liable for this as well.

Damages for Medical Malpractice

Workers’ comp doctors must provide care of a reasonable standard compared with what competent healthcare providers in the same field would, on average, provide. Any deviation from the appropriate standard of care on the part of the workers’ comp doctor may make them liable for damages. Both economic and noneconomic damages are usually available from successful medical malpractice cases.

Economic damages are those that have a specific dollar value. They may include:

  • Medical bills
  • Loss of wages and future earning capacity
  • Costs related to modifying a home or vehicle to accommodate a health condition caused by the defendant’s negligence
  • Funeral expenses, if the victim of the medical malpractice dies.

Noneconomic damages are those that do not have a specific dollar value, such as:

  • Physical and emotional pain and suffering
  • Mental anguish
  • Loss of enjoyment of life
  • Loss of consortium and companionship.

Punitive damages are available in cases where defendants act with spite, malice, or a fraudulent or evil motive, or with a conscious and deliberate disregard of the patient’s interests. More often than not, the facts of medical malpractice cases fail to meet this high standard, which means punitive damages are the exception rather than the rule. 

To win a medical malpractice case, an attorney must set out the standard of care that applied to the defendant healthcare practitioner, and prove that they failed to meet this standard; that a doctor-patient relationship existed; and that their failure to adequately care for you caused real damage to your health or caused you another type of loss.

Specific examples of missteps that may amount to medical malpractice include:

  • Incorrect diagnoses
  • Surgical errors
  • Errors in administering anesthesia
  • Failure to respond appropriately to test results
  • Breaches of doctor-patient confidentiality.

Settlement Amounts

There are a wide range of settlement amounts you may receive in a medical malpractice case, depending on your individual circumstances. Potentially relevant factors include the extent and permanence of your injuries, whether you will need continuing care, your age and family situation, and your earning capacity.

Medical malpractice lawsuits are some of the most expensive for defendants to settle. Though it’s difficult to come up with accurate, recent numbers, statistics show that the median award in healthcare-related suits is many times greater than the average award in personal injury cases in general.

If you schedule a consultation with Tucker Lawyers, our team will evaluate your situation to assess what a fair settlement might look like in your case.

Workers’ Comp Doctor Misdiagnosis

Diagnostic errors are potentially harmful on two fronts. Your original illness may go untreated, and you’re also at risk of experiencing serious side effects from unsuitable or unnecessary treatment.

Sadly, misdiagnosis is much more common than you might think. Studies show that around 12 million Americans are affected by misdiagnoses annually, and that between 40,000 and 80,000 die from issues related to these diagnostic errors.

To win a misdiagnosis case, you must prove that the diagnostic issue caused you actual harm and that this harm could have been avoided.

Examples of harm include:

  • Shortened life expectancy
  • Emotional trauma
  • Expenses and pain related to inappropriate treatments
  • Avoidable degradation of your medical condition
  • Scarring and disfigurement from unnecessary surgery

Call Our Workers’ Comp Lawyers for Help

New York laws regarding medical malpractice are complicated, and making mistakes can be costly, so you should not try to handle a case like this on your own. If you or a family member has been injured because of a mistake by a workers’ comp physician, our attorneys will help you to pursue justice and ensure that your financial future isn’t compromised by someone else’s mistakes.

Contact our workers’ compensation lawyers or personal injury lawyers in Manhattan and let us handle the investigative process, the negotiations with insurance companies, and the legal hurdles involved so you can concentrate on your recovery.

Call us today for your free, confidential consultation at (516) 399-2364.

john tucker

Managing Attorney John. J. Tucker, Esq.

John has personally handled thousands of clients who were victims of another’s negligence and fights relentlessly for their rights. John enjoys bringing closure to a client’s matter so that the injured party can move forward with their life. His background enables him to evaluate complex liability related claims and bring resolution to claims in a record time frame. [ Attorney Bio ]

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