Can You Sue a Workers’ Comp Doctor?

You can sue a workers’ comp doctor in certain situations. Let a workers’ comp lawyer 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 them when they commit medical malpractice and cause harm, the way you would any other medical professional who violated the standard of care. You may also be able to sue in some situations where their decisions result in your injury getting worse, rather than better.

How do you know if your situation warrants a lawsuit? The workers’ comp lawyers at Kaplan Law have the experience necessary to make this determination. We offer a free consultation to examine the circumstances of your individual situation and, if warranted, file a lawsuit against a workers’ comp doctor who was negligent and you were injured as a result.

Call us today for your free consultation at (516) 399-2364 to get started.

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

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

Filing with the Workers’ Comp Board

Workers’ comp is insurance that provides monetary benefits and/or medical care for workers who are injured or become ill as a direct result of their job. New York law requires employers operating in the state to carry workerscompensation coverage for their employees, including part-time employees, with limited exceptions. Benefits are meant to cover medical expenses and part of lost wages.

To receive benefits, you must see a doctor authorized by the Chair of the New York Workers’ Compensation Board. There are some exceptions for insurers that are part of a preferred provider organization (PPO), which gives them some choice over the doctor you see for initial treatment. Employers are required to 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.  In this case, you can file a complaint through forms available on the WCFIG website.

Filing for Medical Malpractice

Medical professionals are expected to adhere to the standard of care that other reasonably careful professionals in their field would follow under similar circumstances. If they fail to do so and you were harmed as a result, they may be found negligent and guilty of malpractice in a civil lawsuit.

A workers’ comp doctor can be sued for medical malpractice, just like any other doctor. While not everything that goes wrong medically is malpractice, if the workers’ comp doctor acts negligently in diagnosing or treating you, and you were injured as a result, that doctor can be held responsible.

Injuries Caused by Independent Medical Examinations

One of the requirements of workers’ comp is for injured workers to attend an independent medical examination (IME). At the IME, a doctor selected by the insurance company will examine you and then generate a report about whether you can return to work. In cases where you were injured during an IME exam by a workers’ comp doctor, you could file a malpractice claim against the doctor for the injuries you received. Also, if the doctor sent you back to work before you were medically ready and you were reinjured or your injuries were made worse as a result, you could file a claim for that as well.

IME doctors can be sued for medical malpractice if:

  1. They give incorrect advice,
  2. it was foreseeable that the person would rely upon the advice, and
  3. reliance on the advice causes harm.

Damages for Medical Malpractice

Workers’ comp doctors must provide acceptable care that meets the standards of what other health care providers in the field would provide. Any deviation from the appropriate standard of care and the workers’ comp doctor may be liable for your damages.

In a successful medical malpractice case, our attorneys may recover a compensation award, called damages, for both your economic and noneconomic damages.

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

  • Medical and rehabilitation bills and expenses
  • Loss of wages and future earning capacity
  • Cost of continuing care
  • Cost of modifying a home or vehicle
  • Funeral expenses in case of death.

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 and quality of life
  • Loss of consortium and companionship.

Punitive damages can also be sought in exceptional cases, where a defendant acted with spite or malice or a fraudulent or evil motive, or with a conscious and deliberate disregard of the patient’s interests.

To win your case, our attorneys would have to prove what is the standard of care for which the medical professional’s treatment should be measured; that a doctor-patient relationship existed; and that there was malpractice because the medical professional:

  • Had a duty of care not to cause you harm
  • Breached that duty by acting negligently or failing to act
  • Caused your injuries by the breach
  • Caused you to suffer damages as a result.

Examples that may be medical malpractice include:

  • Making an incorrect diagnosis
  • Making surgical errors
  • Making errors in giving anesthesia
  • Ignoring test or laboratory results
  • Breach of doctor-patient confidentiality.

Settlement Amounts

There is a wide range of settlement amounts you may receive in a medical malpractice case, depending on the individual circumstances involved. Consideration may be made for factors such as the extent and permanence of your injuries, whether you will need continuing care, your age and family situation, and your earning capacity. When you consult Kaplan Law, our attorneys will evaluate your situation to come up with what a fair settlement amount should be.

Workers’ Comp Doctor Misdiagnosis

When a doctor misdiagnoses a patient, the consequences may be a serious worsening of a condition that can even lead to death. A misdiagnosis is harmful because the original illness is left untreated and also because patients may suffer serious side effects from incorrect treatment and medications wrongly given.

To win your case based on doctor misdiagnosis, our attorneys would have to prove that the misdiagnosis caused you actual harm and that the harm could have been avoided.

Examples of harm include:

  • a shortened life expectancy
  • emotional trauma
  • expenses and pain of inappropriate treatments
  • unnecessary worsening of the medical condition
  • scarring and disfigurement from unnecessary surgery
  • death from the treatment or lack of treatment.

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 this on your own. If you or a family member has been injured because of a medical mistake from a workers’ comp lawyer, our attorneys will pursue a settlement that can help you recover from your losses, as well as protect other people from similarly dangerous doctors.

If you or a loved one has suffered medical malpractice from a workers’ comp doctor in New York, the workers’ compensation lawyers at Kaplan Lawyers will be there for you to fight for the maximum benefits and best medical care available. Let us handle the necessary 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.

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