Call us today for a FREE consultation / Ll├ímenos hoy para una consulta GRATIS  206-682-3436

ATTENDING PHYSICIAN: The Role of the Attending Physician in Workers' Compensation Claims

Posted by Foster Law on February 15, 2013

When a covered worker is injured at work or develops an “occupational disease” (for instance, carpal tunnel syndrome or other repetitive stress injury) caused or aggravated by distinctive conditions of his or her employment, the injured worker is entitled to receive proper and necessary medical and surgical services at the hands of a physician or licensed advanced registered nurse practitioner of his or her own choosing so long as the medical provider is an authorized member of L&I's new Medical Provider Network.

The physician or licensed advanced registered nurse practitioner who is generally responsible for treating the injured worker and coordinating care under the claim is referred to as the “attending physician”. For most injured workers, doctors or other medical providers play a critical role in the workers' compensation system. The workers' compensation system relies on medical providers to not only assist their patients to recover from their injuries and return to work as quickly as possible but also give injured workers information and guidance about workers' compensation. Attending physicians are expected to provide the Department of Labor and Industries or self-insured employers (typically via a third party administrator such as Sedgwick CMS) with information regarding work-related medical problems and initiate workers' compensation benefits, treat workers for work-related injuries or disease, educated patients about the benefits they should and should not expect to receive from the workers' compensation system, report on injured workers' ongoing progress while they are being treated, help return workers to a productive work life, help determine which workers needs assistance to return to work (for example, through job modification or retraining), rate permanent impairment when a worker's condition has reached maximum medical improvement, report unsafe work conditions that may be identified while treating patients injured on the job, and agree to accept and abide by the Medical Aid Rules and Fee Schedules.

Because the attending physician plays such a critical role, it is important that injured workers and attending physicians maintain a strong physician-patient relationship including open lines of communication. However, injured workers frequently do not realize they have a choice when selecting an attending physician. Oftentimes, the attending physician initially associated with a claim is the medical provider who completes the “Report of Industrial Injury or Occupational Disease” or the “Self-Insurance Physician's Initial Report”. The worker may select this provider on an emergent basis, for convenience, or because the injured worker has a prior treatment history with the provider. It is not uncommon for the provider who becomes generally responsible for treating the injured worker and coordinating care under the claim to be different from the provider who completes that initial paperwork. It is important for the new treating provider and the injured worker to notify the Department or the third party administrator of this change of attending physician. There are two ways to notify the Department or the third party administrator of a change in attending physician: (1) Send a letter to the Department or the third party administrator noting a change of attending physician by identifying the name and address of the new attending physician and the reason for change; or (2) complete and submit a “Transfer of Care” card (Department form F245-037-000) to the Department or the third party administrator. The “Transfer of Care” card is available on the Department's website at http://www.lni.wa.gov/FormPub/Detail.asp?DocID=1618

At Foster Law, P.C. we are expert, we are fierce, and we are compassionate. Our team offers decades of experience to helping literally thousands of injured workers obtain the benefits that are so crucial to maintaining their welfare and that of their families. If you are an injured worker or medical provider and have questions or concerns about attending physicians or any other aspect of workers' compensation law in this state, we invite you to contact us. Initial consultations are complimentary. Don't leave your workers' compensation claim to chance; consult with experts.

Contact Us

{{Status.Message}}