The Role Of Attending Physician In A Workers’ Compensation Case
If you are treating a patient with a work injury, it is important to establish yourself as the “attending physician.” This is important to get paid for your services, as well as to proper processing of your patient’s Workers’ Compensation claim.
The “attending physician” is the doctor or physician who is primarily responsible for the treatment of a worker’s compensable injury. The attending physician must be a licensed medical doctor, doctor of osteopathy or oral and maxillofacial surgeon. A chiropractor may also be the attending physician, but only for 30 days from the first visit on the initial claim or for 12 visits, whichever occurs first.
Your patient with a work-related injury may have only one attending physician at a time. The worker may change attending physicians two times. After that, approval from the Director of the Department of Consumer and Business Services may be required.
In order to establish yourself as the attending physician, you must complete and submit Form 827, Doctor’s First Report on a claimed injury. If you have assumed responsibility for the work-injured patient from another doctor, you must sign a Form 829, “Change of Attending Physician.” (This may be on referral from the other doctor, or the patient’s decision to change attending physicians.)
If you are a consulting physician (i.e. the patient is sent to you for tests), you should not complete a form to become attending physician unless you intend to provide treatment and assume the role of attending physician from the other doctor.
If you do not properly establish yourself as attending physician, your treatment may not be compensable. For example, a worker goes to Dr. Jones for treatment, then later goes to Dr. Smith. However, the claim “closes” before Dr. Smith establishes him/herself as the attending physician. Dr. Smith’s treatment may not be compensable. Dr. Smith must end Dr. Jones’ status as attending physician by completing and filing the proper form. Otherwise, the claim may be closed based on Dr. Jones’ report, even if Dr. Smith believes further treatment is necessary and is still providing treatment.
As attending physician, you are required to make decisions key to the progress of your patient’s Worker’s Compensation claim. Only you authorize time loss (temporary disability compensation). Only you declare when your patient is medically stationary or release your patient to return to work and state restrictions if the patient cannot return to pre-injury duties. You should notify the worker at the same time you notify his/her employer or insurer of the worker’s release to return to work.
Upon declaring your patient medically stationary or releasing the patient to regular or modified employment, your patient’s Workers’ Compensation claim may be closed by the insurer or employer.
You evaluate your patient’s limitations resulting from the work injury or condition and provide data used to determine the degree of your patient’s impairment (for the purpose of permanent partial disability compensation). See (Volume 5 for a more detailed explanation of the treating physician’s role in this particular function.)
As you can see, your patient with a work injury will be looking to you not only for treatment towards healing and recovery, but also for decisions, opinions and reports of legal significance to the progress and status of his/her Workers’ Compensation claim.
In a future article, we will discuss other functions of the attending physician in more detail to help you and your office administer your patient’s claim efficiently and effectively.
This article was prepared by Robert F. Webber.