What role do physicians play in workers’ compensation cases?

On Behalf of | Nov 18, 2022 | Workers' Compensation |

When an employee in Virginia sustains an injury on the job, it is important that medical care be the first thing on the schedule. Whether the injury or illness is a chronic one or resulted from an immediate accident, medical care is vital for avoiding future problems, even before making a claim.

The Virginia Workers’ Compensation Act

According to the Virginia Workers’ Compensation Commission, medical providers have access to remedies and certain rights when dealing with these types of claims. Once an injury occurs, an employer must provide the employee with a panel of physicians to choose from, with at least three options. The injured party is then able to choose their treating physician.

A claim is likely to cover the following types of charges:

  • Prescriptions needed relating to the injury
  • Diagnostic measures and necessary medical treatment
  • Physician charges if the initial physician refers the injured to a specialist
  • Charges from the initial treating physician

If there is a dispute related to one of the physician’s charges, the professional has a right to three different remedies to make sure they get paid.

Medical provider potential remedies

Based on when the injury occurred and when the implementation of changes to the state’s workers’ compensation occurred, a medical provider may opt for one of the following when there is a conflict regarding payment:

  • Administrative review and determination
  • Alternative dispute resolution
  • Judicial review

Workers’ compensation insurance exists to protect workers when accidents and illness occur on the job. While there may be disputes between the employer’s insurance and medical providers, the injured is usually protected from bearing most of these costs.