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NY State Workers’ Compensation Medical Trials

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So what happens if your doctor says you can’t return to work but the company doctor (insurance company IME) says you can? Or your doctor says your condition is work-related but the carrier’s doctor says no? Or your doctor says you should be receiving $600 per week in payments based on your condition but the carrier’s doctor says it should be $150 per week?

Well in America you get to take the case to court and let a judge decide. What this means in NY Workers’ Compensation is that a comp judge will make the decision. Formally, New York State Workers’ Compensation judges are called referees and are making administrative rulings. But, we just call them judges. Sometimes you get to go before them at a workers’ compensation hearing. More and more often, you just get a decision by mail.

If the parties can’t agree on medical issues, the Workers’ Compensation Board will direct depositions to be taken by phone. What this means is the following: First of all, you have to go to the insurance company doctor who is paid by the insurance company to render a report. If a doctor files reports that don’t favor the carrier’s position, the doctor will be out of a job and the doctor knows it.

Often the exam is quick and cursory. The doctor sends notes to a typist who sends the report back to the doctor for review. And then the insurance company gets the final report and forwards a copy to the Workers’ Compensation Board, your workers’ compensation lawyer and you.

Now, when it’s time to go to trial, the testimony is taken by phone. Usually, you are not involved at all as the insurance company lawyer and your lawyer ask the doctors questions by phone. The carrier’s doctor likely hasn’t seen you in months or even years and doesn’t remember you or your exam. Yet, the doctor will testify about a medical opinion based on the report. Then, the transcripts are sent to the judge.

In turn, the judge may not have ever met you or asked you any questions. In fact, your attorney and you may not even know which judge has been assigned the case. Then the judge who doesn’t remember you reads the transcript of the company doctor who doesn’t remember you. The judge may decide in your favor, or, you may lose out on lots of money and receive a decision in the mail stating that the judge found the insurance doctor more believable.

Contact Robert A. Koenigsberg – New York Workers’ Comp Attorney

This doesn’t seem fair and doesn’t make sense. Yet, the workers’ compensation system is designed more as a way for insurance companies to make money and employers’ to hold down costs than as a safety net system for workers injured on the job. So, if you understand things from that standpoint, then the fact that the system is unfair to the worker makes plenty of sense after all. And, this might be all the more reason to consider hiring a lawyer. Please call me, a New York workers’ compensation attorney at (212) 964-9292 or fill out an online contact form to schedule a consultation if you have any questions.