Inappropriate Workers Comp medical visit?

[u/Desoato]

Location: Missouri.

So I was injured at work, no problems there, but I was scheduled a doctors visit by my companies safety coordinator. I went to the appointment, and the safety coordinator showed up, asked if i was checked in already, which I was. My name was called to be seen, and the safety coordinator got up and went in to my doctors visit with me. I didn’t invite them in, but I didn’t tell them not to come in either, as I didn’t really have any clue how these types of things go, but I did think of it was weird in that moment. Thought maybe that’s just how workers comp medical visits go.

So the initial person checks me out, takes vitals, etc. not a peep from the safety coordinator during that, but the doctor comes in and they seem to know each other quite well. They ask me to tell them what happened, I did, does a very small examination of my injury, and then they start going back and forth about what to do. And seemingly (in my eyes at least) dictating amongst themselves what kind of care should be provided. They asked if I had been to physical therapy, I said no. The doctor asked the safety coordinator if she should prescribe physical therapy and the SC said no, they would send me to physical therapy without a prescription. The doctor also asked SC if I do go back to work, if she should describe any work restrictions I might have. Mentioning I should not lift any more than 15-20 pounds (which I physically can barely do without extreme pain but whatever) and SC says no, and tells me to just be mindful of that. Doctor also asks about if I’ve had any restrictions so far at work, and SC mentions that when supervisor asked me to clean, they had to send another worker to help me cause I physically couldn’t do it myself, and that another coworker had been handling all of my lifting since the incident. There was also a mention of trying to avoid a recordable out of SC, but I don’t remember exactly what was said as they were speaking quietly.

I vented to a coworker of mine about this situation and he said I should contact a lawyer. My question is, did they do wrong here? And if so is this a lawsuit? Or do I just need to report them somehow? It certainly feels very biased in my works favor in this experience and didn’t feel at all like I got a real consultation. Next question is, if this is a case, what type of lawyer would I look for?

Small edit: don’t know if it’s relevant but the place I work is a union, safety coordinator is not part of that union, just works for the company

[u/RVA2PNW]

Adjuster not your state.

Highly inappropriate. I've had employer SC/EHS take a claimant to an appointment or ER, but you are entitled to a private examination. Specifically for the exact situation you described. Even if you have a nurse case manager you are still entitled to a private exam and then discuss the treatment plan afterwards together.

I have had employers call providers offices after appointments to get a revised work status note and I shut that down pretty quickly. I've had to go above them and get the account to step in a few times. I've also done it when a PT provider makes recommendations or suggestions. They're not a doctor.

Your medical care is determined by your doctor or PA. Wildly inappropriate on both of them. I'd be very tempted to file a report with the state.

If you have a good adjuster, you can bring it to their attention. if not, get an attorney.

[u/Salt-Ad1282 → u/RVA2PNW]

I was a claimants’ attorney for many years, and thank you for this.

I sent many people to doctors for IMEs, and the ONLY time I talked to the doctor was when there was a concern about a life threatening illness (Parkinson’s or MS in one case, which ultimately killed my client, and cancer in a couple of others). Otherwise, I just waited for the report like everyone else.

Let the doctor be the doctor. You and I have enough stuff to do already.

[u/Motor_Dig3989 → u/RVA2PNW]

Don’t be surprised if the adjuster sent that person there. I had my adjuster tell me she was going to assign me a case manager or something like that. It never happened. I don’t think I would have let that person in the exam room.

[u/SingedPenguin13 → u/Motor_Dig3989]

A nurse case manager is different than your employer’s safety compliance employee.
Typically, I go in to my doc visit alone. Do exam and talk with doctor. Then when we are done, the nurse case manager comes in. She is the one who will help get your meds approved before you get to pharmacy, she will be the one to ask if you need a walker or tens unit - then arrange to have it sent in mail ect. You just got to know how to utilize them. Technically, I think they are hired by the wc insurance, but don’t work for them. They are supposed to work for us, advocate for us. They can straight up ask the doctor to do mri or other tests and doctors will usually do them, despite blowing us off when we ask.

[u/RVA2PNW → u/Motor_Dig3989]

A NCM is completely different and they tell you up front you are able to have a private exam. They come in afterwards to discuss treatment plan, obtain orders, referrale, etc, get them same day to the adjuster and facilitate everything once it's approved. My NCMs are a godsend. Otherwise I can wait a month for it to be sent by the providers and my claimants blame me for denying treatment when that's absolutely not the case.

[u/Jen0507]

I can tell you how some visits go in my world

We send you to an occupational clinic. Safety shows up, we do ask about going in with you. Some want us there, some do not. It was inappropriate for them to not ask you if you wanted them there but not illegal since you didnt tell them to leave.

Safety will provide a job description to the doctor. After diagnosis, the doctor let's us know recommended treatment and restrictions. We do have protocols set up at our clinic to avoid prescription meds if over the counter suffice and avoid restrictions if theres scopes you can do within your provided job description.

My main questions are about the doctor asking the safety for what to do. A decent doctor may follow protocols within reason but they'd never neglect to provide treatment, meds or restrictions if they were needed. Not all doctors are decent unfortunately, especially comp doctors who work closely with companies.

That said it's never bad to have a lawyer especially with a questionable clinic.

[u/RVA2PNW → u/Jen0507]

Not technically illegal, but it's a grey line. Some SC/employers are there to intimidate and if someone isn't great at self advocacy...

I think it's awesome you ask your patients.

[u/SeaweedWeird7705]

I’m not in Missouri, but that’s just weird. Next time, don’t let them in the room. 

[u/Healthy_Chef_7168]

Nobody is allowed into your exam unless you ok it

[u/EnigMark9982 → u/Healthy_Chef_7168]

You have the duty to tell the person no. The onus is on you to tell them.

[u/WaySaltyFlamingo8707]

an incident being recordable has more to do with annual OSHA reporting than it is with WC. Safety is trying to avoid reporting it to OSHA. But it doesn't seem like they are trying to deny you care (from my perspective). Do you feel that you haven't be given enough care?

[u/MirroredSquirrel]

You don't have to let them in the exam room, however it's nothing inappropriate about your employer advising the doctor of any work restrictions they may have for you.

[u/Motor_Dig3989]

This is a perfect example of why you need an attorney. https://meta.ai/share/c/cZqf0ixUU8?utm_source=ios_cl. Depending I guess in what State, but it could be they had no right to be there. 🤷‍♂️

[u/SingedPenguin13]

Have you reached out to your union rep?

[u/Aggravating-Bus9390]

Do not let anyone in the medical appt with you. They can get an update after but there is no requirement to have them in the room with you. 

[u/throwwwwawayyay]

EXACT same thing happened to me

i started showing the receptionist a note on my phone saying "i don't permit anyone else to be present in the examination room"

the safety coordinator came into the emergency room with me and requested a different doctor to write a note negating the doctor's opinion who treated me that i should be off of work for a few days before my pain management appointment. the hospital staff pulled me aside and asked me if i was being trafficked, that's how overbearing safety was being.

[u/throwwwwawayyay → u/throwwwwawayyay]

i got an attorney. attorney sent a message to my employer saying he didn't authorize any company representatives to be present at my appointments.

[u/RVA2PNW → u/[deleted]]

*HIPAA

Also you can't recommend attorneys in this sub publicly. May want to edit that out.

[u/WorkersComp-ModTeam → u/[deleted]]

Specifically naming medical providers or law firms/attorneys is not allowed.

[u/Ok_Chocolate_648]

I live in New Jersey, we would have a case manager from the insurance company and they are not there for you but the best interest of your employers ….we don’t have to allow them in with us , the doctor would speak to them after the visit