Nevada Workers' Compensation Law Blog : Nevada Workers' Compensation Lawyer & Attorney : Virginia Hunt Law Firm : Las Vegas Job Injuries & Worker Accidents

Both employers and injured workers are unsure about the law on firing an injured worker who is actively treating with a doctor on an accepted workers' compensation claim in Nevada.  Most people know that an injured worker cannot be fired simply because he or she files a claim for workers' compensation benefits. There is an old case from the Nevada Supreme Court that allows an injured worker to sue his employer for money if he can prove that the employer fired him for filing a workers' compensation claim. Not too many employers are apt to make the mistake of not having some other reason, real or not, for terminating an injured worker.   In the past, I've only encountered one employer who wrote on a termination notice that  the employee was fired because he "filed a comp claim".  

Most job terminations instead  result from an injured worker not wanting to work temporary light duty work that the employer offers to accommodate the physical restrictions given by a doctor.   If the temporary light duty  work is mindless, and it's a hassle for the injured worker just to get to work, bad feelings quickly develop between the employer and the injured worker.

It may seem like the light duty job is punishment  for getting hurt at work and filing a claim.  And maybe the employer's light duty work program is a thinly veiled threat to employees not too file claims or to get hurt at work.  But, the law only says that  permanent light duty job offers cannot be demeaning and degrading.  Permanent light duty jobs have a completely different set of rules.

Employer can create "special jobs" just for injured employees with open compensation claims and point to statistics that show that injured workers on light duty get better faster.    That  means that the employer can have a policy or rule that injured workers who refuse temporary light duty (and who don't have any FMLA, or vacation or personal time left) can be disciplined, including fired.

In general (and you should  seek individual  legal advice for your circumstances), Nevada employers can and will fire  employees who are working light duty jobs after their job accidents if they have a good reason for firing the employee.  Again, common reasons given by employers pertain to the employee  for not showing up for light duty  work, calling in sick too many times,  and not performing the light duty job.

The present statute allows insurers to deny compensation benefits to injured workers who are fired while working temporary light duty,   if the insurer denies compensation benefits within 70 days after learning about the job termination.  Benefits should only be denied if the injured worker was fired for gross misconduct., but insurers routinely deny benefits for any kind of job termination and bet on the employee not appealing.  

Employees who complain that their injuries prevent them from going to work at all, need  to be aware that their employer is entitled to rely on the  treating physician's progress report . If that report says the patient can work with restrictions, and the employer offers such work, the injured worker won't win any  battles that depend on self-serving statements of his inability to work light duty,  Employers, and hearings and  appeals officer will  rely almost exclusively on the physician progress report. For example, if the progress report doesn't restrict  the number of hours an employee can stand at work, the employer can assume that the employee can stand for his entire shift.  

The injured worker must make sure that the treating doctor is aware of what kind of work the employer is likely to offer so that they injured worker can request  restrictions that make sense. Instead of complaining  to the employer that he cannot do temporary light duty work, the injured worker should quickly return to see his physician to discuss any necessary  additional restrictions.  Meanwhile, the employee should try to do the light duty work.  Not showing up for light duty work may get the employee fired, and it will be a legal fight to get benefits.  

I have had a lot of success in obtaining compensation benefits for employees who are fired during temporary light duty.  Employers and insurers don't always know or follow the law.  However, an injured worker doesn't want to go without a paycheck or a comp check while filing an appeal.  The best course is to show up for the temporary light duty job, get any necessary additional restrictions from your doctor, and to quickly get a free consultation with a lawyer to discuss your particular case. While you still may have to do some kind of temporary light duty eventually, your attorney may be very helpful in guiding you through these problems. 

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A blog post by Thomas A. Robinson for Lexis Nexis discusses a recent case  involving Utah's law that presumes that an injured worker is intoxicated and that the accident was caused by intoxication if any illicit drug or alcohol is found in the injured worker after the accident.  The case concerns a construction worker who stepped off the edge of decking at a construction project and fell fourteen feet to concrete below. A urine sample taken from him at the hospital on the day of the accident tested positive for cocaine metabolites. The construction worker won the appeal on his denied claim by subpoenaing witnesses to testify that  the worker was not acting impaired before the accident.

Nevada's law, NRS 616C.230  is similar to Utah's law with its rebuttable presumption that  a work injury is caused by a worker having any amount of alcohol or a controlled substance in his system.  The presumption has been rebutted in two past Nevada Supreme Court cases involving marijuana. 

Last year I settled a case that was similar to the Utah case.  My client, a drywall installer, had coffee and chatted with supervisors for about ten minutes before starting work.  Shortly after he began working, he had to use a short step-up ladder on an uneven floor,  He lost his balance, fell, and  fractured his wrist.  He tested positive for marijuana metabolites at the hospital, and his claim was denied.  If we didn't win his appeal, he would be on the hook for large medical bills, a long period of off work with no benefits, and no award to compensate him for being unable to move his wrist normally. 

I was able, however, to rebut the legal presumption that marijuana intoxication caused my client  to fall from a step-up ladder that should not have been used on this project.  Our expert toxicologist was prepared to testify that the amount of marijuana metabolites found in the client's urine did not prove that he used it recently or that he was impaired when he had the accident.  Additionally, he had supervisors and co-workers who observed him acting and moving normally when he reported for work and had coffee with them.  

Some of these intoxication cases can be won by experienced workers' comp attorneys.  You do need to cooperate with your employer's request that you submit to blood or urine testing immediately after your injury.  You also need to be aware that while you may win your workers' comp appeal and get the claim accepted, your employer may nonetheless fire you for not complying with their company policy on drug or alcohol use.  

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I went to University of San Diego School of Law with criminal law attorney Mace Yampolsky.  Mace is a board certified criminal law specialist who has over 25 years' experience defending people in southern Nevada against all types of criminal charges, including DUI, drug crimes, weapons charges, and domestic violence.   He is a fierce protector of an accused's rights, and has dedicated his career as an attorney to holding the legal system accountable to the law it is sworn to maintain.  Below is a guest blog post he wrote discussing the importance of obtaining an experienced attorney if you are ever accused of spousal abuse:

The state of Nevada takes allegations of domestic violence very seriously and will frequently pursue a criminal action against an alleged spousal abuser-  even if the victim does not want to prosecute. A conviction of domestic violence charges carries stiff penalties, including the loss of the right to own a firearm, fines, probation, or even jail time for a first time offense.  With so much at stake, it is essential to have an experienced attorney who can  protect your rights and build a powerful defense on your behalf.

In some domestic violence cases, false accusations are made out of spite or to further the alleged victim's own agenda.  In a divorce proceeding, for example, a mother may claim spousal abuse in order to harm her husband's credibility in a custody battle.  A diligent and seasoned attorney knows how to expose these accusations for the lies that they are.  if the charges are legitimate, an experienced attorney will work to plead the case down to a lesser offense, such as breach of the peace or trespassing.

At the Las Vegas law firm of Mace Yampolsky & Associates, we work tirelessly to protect the rights of clients who have been charges with crimes. Each case is prepared as if it were going to trial with the goal of restoring your freedom.  We fight to win.  

Mace J. Yampolsky

625 South Sixth St., Las Vegas, NV 89101

Las Vegas, NV 89101

Ph: 702-385-9777

fax: 702-385-3001

Website:  www.macelaw.com

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If your claim is accepted and your authorized treating physician prescribes medication for you, but your pharmacist tells you that there is a problem, follow these steps

1. Have a copy of your claim acceptance letter with your claim number and name and address of your third-party administrator or insurer in hand when you go to the pharmacy.

2. Do not confuse things by giving your pharmacist your health insurance card.  Instead, you want the workers' compensation carrier billed.

3. If the pharmacist tells you that your prescription has been denied, pay for the medication so that you can get it started if it is essential that you start it right away.  For example, it you just had surgery and need an antibiotic, don't wait.  Or, if you need pain medication right away, just get the medication, and then straighten out the problem.  It can take a day or two to get medication problems resolved, so don't drive yourself crazy by not getting the medication if you can afford it.   Keep a copy of the receipt that shows what medication you paid for, and send it to your adjuster, requesting reimbursement. 

4. Call your adjuster or fax or email the name of the medication, who prescribed it, and the name and phone number for your pharmacy.  Don't just leave a message or complain that you didn't get your medication authorization. Make sure you give the adjuster information she can use to fix the problem. 

5. If you have a nurse case manager assigned to you case, instead of calling the adjuster, you can call the nurse case manager. She is likely to be more familiar with what the doctor prescribed, and may be able to help you quicker. Again, give her your pharmacy phone number.

6.  Expect delays if the medication ordered is an expensive proprietary formula, as the insurer may question why generic wasn't prescribed, or whether other medications were tried first.  Maybe your doctor can give you some samples to start if he knows that insurers usually drag their feet on authorizing this particular medication. 

Unfortunately, I expect more problems in the future obtaining medication for injured workers.  According to an recent article in Business Insurance, there is a growing trend among states to creating medical guidelines for doctors prescribing opioid pain medications to workers' compensation claimants.   Additionally, many insurers now use intermediary companies that involve another step in the authorization process, and thus, more delays.

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Injured workers in Nevada who do not have proper written proof of their right to legally work in the United States are entitled to the same benefits as any other injured worker, except for vocational rehabilitation benefits.  All injured workers are entitled to medical care for a work-related injury while working for a Nevada employer, even if they are working in the United States illegally. 

The injured worker does need to be able to prove that he was working for a Nevada employer at the time of the accident at work.  That may be difficult if he is paid cash instead of a proper paycheck.

Assuming that the worker lied to the employer about immigration status to get the job, the worker is nonetheless entitled to medical and most compensation benefits once the employment relationship is proven.  

In addition, undocumented workers may receive temporary total disability benefits, payable at 66 2/3 of their average monthly wage, up to the state maximum, if they are taken off work by their treating physician as a result of the work accident.   These compensation benefits are also payable if the employer is unable to provide temporary light duty employment while the injured worker is treating for his injury.  Even more surprising to most undocumented injured workers, they are entitled to receive a permanent partial disability award at the end of treatment  for any permanent injuries.  

What undocumentated injured workers  may not receive are vocational rehabilitation benefits.   Only injured workers who have an Employment Eligibility Verification Form I-9 that can be verified, are  entitled to a continuation of bi-weekly checks while he or she participates in a retraining program.    And, only documented injured workers may request a vocational rehabilitation lump sum buy-out if they chose not to participate in retraining.   

Most workers' compensation attorneys offer a free consultation to reveiw your particular case to advise you.   Don't make the mistake of thinking that you cannot get proper medical care or compensation benefits or  an award just because you are in the United States working illegally.  Call for a free Guide to Nevada Workers' Compensation Law in Spanish.  (702) 699-5336.

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Attorney Laura Stubberud is an experienced estate planning attorney who wrote the following guest blog post.  I thought it was important information for injured workers.  For more blog posts on estate planning and elder law, please visit  Attorney Stubberud 's blog at www.nvestatelaw.com.             

By Laura Stubberud

I am often asked what is the one thing that every person needs in an estate plan.  The answer is easy:  Health Care Directives.   Regardless of whether you have any money or property, you need to address decisions to be made during your life in the event of serious injury, illness or incapacity.  I tell all of my clients that as soon as their children turn 18 years old, they need to sign a durable power of attorney for health care. 

 They are almost always surprised until I remind them of that funny law known as HIPPA (the Health Insurance Privacy and Accountability Act - http://www.hhs.gov/ocr/privacy/).  You know what that is.  Every time you go to a new doctor or are admitted into the hospital, you must sign a HIPPA release.   Under this law, health care providers are not allowed to share your medical information with anyone who is not legally entitled to receive that information, including family and friends. 

 Imagine if your adult child were in a car accident and unconscious and you were denied information about his or her medical condition.  A durable power of attorney for health care allows you to specify who can receive your medical information.  In addition, the power of attorney allows you to set forth your desires regarding medical care if you are unable to communicate those desires yourself.  These directives allow you to specify your decisions regarding end-of-life matters as well as  religious provisions, decisions regarding nursing home care, surgeries, etc.  

Everyone over the age of 18 needs a durable power of attorney for health care.  It may be a matter of life or death, but it is definitely a matter of love.

 The Law Office of Laura E. Stubberud , 2831 St. Rose Pkwy., Suite 303, Henderson, NV 89052. Phone 702-589-4804,  email at laura@stubberudlaw.com.

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Workers' compensation insurers and their TPA's often suspend compensation benefits when an unrelated  medical problem  surfaces to delay surgery or  treatment for the work injury.  Insurers call it "Care Interrupt". I call it kicking an injured worker when he's already down.

For example, I had an injured worker last month who was scheduled for a work-related back surgery.  She was already receiving TTD benefits when her surgery was scheduled for the following week.   She had to get an EKG done as part of the usual pre-surgery clearance.  Her EKG was slightly abnormal and her doctor thought she should have a cardiac treadmill stress test just to make sure she didn't have a heart problem before she underwent back surgery.   It took her almost four weeks to get an appointment with a cardiologist to get the stress test done and to have her primary care doctor review it and give the workers comp doctor clearance for the back surgery.

When the work comp adjuster heard that she had an abnormal EKG, my client's TTD benefits were suspended until she gave the work comp doctor surgical clearance.  I successfully argued before a hearings officer that the adjuster was wrong in stopping  benefits,  because my  my client did everything as quickly as she could to get surgical clearance. 

I argued this issue before the Nevada Supreme Court years ago, and the Court agreed with me that suspension of benefits is wrong under  NRS 616.230(5) when the injured worker is not deliberately delaying treatment for the work injury.  Unfortunately, the Court did not publish that decision. The  Court  does not publish its decision in every case, and an unpublished opinion cannot be cited as legal precedent.  This means I have to present this same legal argument in each new  case, and that insurers keep suspending benefits, betting on the fact that most injured workers don't pursue an appeal.  

If your benefits are suspended because you  need medical treatment for an injury or illness that is not work-related, make sure that you talk to an experienced attorney.  Each case is different, but many suspensions for "care interrupt" can be reversed on appeal.  Fight back!

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Most injured workers are able to keep working while they get medical care for their work injury.  That makes it difficult for some to find time during usual business hours to see an attorney for a free initial consultation regarding their workers' compensation claim.  I am therefore experimenting with keeping the office open one night a week into the evening and one Saturday afternoon each month as a way to allow more injured workers access to information.  It is very important when you have a serious injury that could result in permanent impairment  that you get reliable information about your Riggs and the claims process as soon as possible.  Appeal times on the decisions made by adjusters on claims on very short- only 70 days, and you could lose thousands of dollars in benefits now and in the future by not knowing your rights.   If you cannot get away for an initial consultation during normal business hours, be sure to mention that to my legal assistant and we will make every effort to accommodate you.  In the meantime, call us at 699-5336  for a free guide written for injured workers by Virginia Hunt, Esq.

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 Injured workers, employers, and even doctors on workers' comp provider lists in Nevada remain confused about whether an injured worker who is able to return to work full duty is entitled to a permanent partial disability award.  Depending on the injury, an injured worker may be entitled to a rating evaluation and an award,  even though the worker has been released to return to his pre=accident job without any permanent work restrictions.

The criteria for determining whether an injured worker has a ratable impairment is in the AMA Guide to Evaluation of Permanent Impairment 5th edition.  That criteria focuses on anatomic alteration or dysfunction , as opposed to an inability to perform particular job requirements.  For example,an inability to move an injured shoulder in one or more  of the measurable planes of motion may result in a whole person percentage of impairment even if the injured worker  has a sedentary job that requires very little use of the shoulder.

Another example of how this works would be an attorney and a piano player who both have a serious injury at each of their jobs resulting in the amputation of one of their pinkie fingers.  Even though the attorney may be able to return to her job full duty, learning how to type with nine fingers, she would receive the same percentage of impairment as the piano player for an amputation of the pinkie finger.  The piano player, if  unable to return to work playing piano, would also be entitled to a retraining program or a vocational rehabilitation lump sum settlement  in addition to a permanent partial disability award. 

If your treating doctor checks off the box "no ratable impairment" on your final progress report, your adjuster will send you a letter stating that your claim will be close without an impairment evaluation.  If you think that determination is in error and that  you do have a ratable impairment, take advantage of a free consultation with an experienced attorney before you go through the appeals process and before you pay $693.31 to obtain a rating yourself.   If your doctor tells you that you won't get a rating because you can return to work full duty, you should check with an attorney whether the doctor is  correct or not .  Make sure that you file an appeal within 70days of the insurer's determination letter closing your claim without a rating.   

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Most injured workers who call me for advice are frustrated with poor medical care or problems obtaining good care as a result of insurance issues.   Making sure that injured workers get the best possible medical care is what I do for a living, so I didn’t need a personal experience to convince me how important a patient advocate is when a person is ill and hospitalized. Nonetheless, last month I personally got a huge dose myself of bad medicine and lousy insurance practices when I was unexpectedly hospitalized. During my brief (thankfully) hospital stay, the following occurred:

•      A typographical error in a CT scan report wasn’t caught until after I was given IV medication for another serious condition I did not have. 
•      I was medicated and then strapped to a gurney and transported at midnight against my wishes to another medical facility from the hospital. My condition was actually worse when I was released from the hospital. This happened without any notification to my family.
•        I was lied to by a doctor as to whether a prescribed IV antibiotic could be given at home as opposed to at the dirty secondary facility my insurance company supposedly required for another week.
•     I was denied access to my own medical records for several hours while administrators grappled with what the law and their own policy says about patients’ rights to review their own records.

These  occurred during a 72-hour period when I was too sick to demand that I speak to insurance adjusters and hospital administrators. Fortunately, I have two highly-trained and very loyal legal assistants who stepped up to make sure that nothing worse happened to me.   When I was able to talk and demand better care for myself from my insurance company and from medical providers, things changed significantly for the better.  

At a minimum, if you or a family member need hospitalization, have someone go with you who can act as a patient advocate. That person should be comfortable  with asking a lot of questions, particularly during check-in and discharge.  Make sure that your advocate has a list of medications you take daily. Give the phone number of this person to hospital personnel and ask that this person be contacted if you are moved or scheduled for a surgical procedure. Bring a cell phone and a charger with you so that you have easy contact with your advocate and family. Bring a small notebook so that you can keep notes and write down important phone numbers. 

Do not be intimidated, and be persistent in getting answers to your questions as to what is happening to you. Make sure that you understand what treatment you are getting, what medications you are being given, and who ordered them for you.  Do not assume that people know what they are doing.  Finally, bring a huge bottle of hand sanitizer with you. The AARP Bulletin, March 2012, has frightening statistics on the number of people who are victims of hospital mistakes, and what else you can do to protect yourself when hospitalized.

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If your treating physician on your accepted workers' compensation claim in Nevada reports to your claims adjuster that you may have a ratable impairment, you should be scheduled for an impairment evaluation  30 days later.  This evaluation, also called a rating,  will be done by one of the 138 doctors and chiropractors who have been tested and authorized by the state agency, DIR, to perform ratings.  The purpose of the rating evaluation is to  determine your percentage of impairment so that a  permanent partial disability award can be offered.  (The additional two factors that determine a PPD award in Nevada are the injured worker's average monthly wage at the time of the injury, and the injured worker's age when he or she has the evaluation.)

As of  March 1, 2012, the Medical Unit at DIR has138 physicians  and chiropractors on a rotating list.  When a claims adjuster requests a rating,  the Medical Unit secretary must  assign the next one from the rotating list.  If the injury is to a muskuloskeletal part, such as the shoulder or neck, a chiropractor may be assigned to do the rating. Some of the chiropractors on the rotating list are excellent rating doctors-   fair, knowledgeable about the Guides and anatomy, and they correctly explain their findings and conclusions.

Nevada law allows adjusters to suggest and agree with injured workers on a particular rating doctor.  If the injured worker, or his attorney,  agree to a doctor suggested by the adjuster, the agreed-upon doctor can do it instead of the doctor assigned by DIR.  Some adjusters will send unrepresented injured workers a list with the names of about six doctors and ask whether the injured worker will send back an agreement to one.  If the agreement isn't returned, the adjuster must use a DIR-assigned doctor from the rotating list.  You don't lose your right to obtain a second rating if you disagree with the rating physician you agreed to rate you.

An injured worker asks me:  Should an injured worker agree to a rating doctor suggested by the insurer, or insist that the insurer schedule him with one of the 138 doctors on the rotating list? 

The answer depends on whether the injured worker has an experienced attorney.  Otherwise, it is likely that the injured worker will not be  knowledgeable about each of the doctors on the insurer's short list . If the injured worker, or his attorney,  doesn't  know anything about the doctors , he should NOT agree. The insurer will likely suggest doctors that find lower or average impairment percentages, or that are aggressive on apportionment and like to subtract percentage points for pre-existing conditions.   Despite the objective of the AMA Guides to Evaluation of Permanent Impairment to have rating methods that will easily duplicate results , there can be a  significant difference depending on which doctor is doing the exam.

If the injured worker has a lawyer , he should hope that his attorney is familiar with how each of the different rating doctors are likely to apply the Guides.  Sometimes attorneys for injured workers agree to a rating exam with a doctor suggested by the insurer.  Not all doctors suggested by insurers are necessarily a bad choice to rate a particular client.  The key is knowing how a particular rating doctor is likely to interpret the Guides.  That comes with experience.

There are injured workers, not knowing whether a suggested rating doctor is likely to be better than one assigned from the rotating list, will circle a name anyway and return the agreement    People who do that hope that the adjuster will act in the injured worker's best interests. The reality is that insurer's and their employees must act so that they can show a cost savings on claims to employers concerned with premiums.  Injured workers should understand that adjusters may be acting within the bounds of the law, but not be acting within the injured worker's best interests.  Therefore, my answer to the question is a resounding "NO".  Do not make agreements with insurers without knowing the consequences of what you are doing.

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Many injured workers with severe spinal cord injuries are reluctant to mention to their treating physician that they have had sexual dysfunction since their work accident in Nevada.  Males in particular are embarrassed to bring up this topic with their doctors.  Unless the doctor initiates the discussion and directly asks about any sexual  problems, the problem isn't noted in the dictated reporting, and isn't treated.  And if the problem is permanent, the injured worker isn't properly evaluated for impairment.

It is very important that if you have had a serious spinal injury that you tell your treating physician about any loss of control of the bladder and/or bowels (involuntarily urinating or soiling yourself), any loss of sensation to your genitals and surrounding area, and any  inability to engage in usual sexual activity. 

Orthopedic surgeons, neurosurgeons, and physiatrists are busy doctors, and your appointment may already seem rushed without you bringing up an embarrassing problem .  However, you should not delay in asking the doctor about these symptoms.   If there is a nurse case manager that is present at doctors' visits, you might want to ask the nurse to allow you to speak to the doctor privately about a symptom that is bothering you.   You have the right to see the doctor alone.  Unless you speak up and tell your doctor who is treating your spinal injury about theses problems, nothing Will be done to investigate and find the right treatment.  

Once you do discuss the  problem, your spine doctor may want to refer you to a urologist for testing, or to your own primary care doctor to rule out other possible  non-industrial causes for your complaints.    Adjusters will usually pay for consultations to determine the cause of the problem if your spine doctor makes the request for a  consultation.  If it's found that the spinal cord injury isn't the cause, at least you will know what you need to do to treat the problem. 

If there is a direct causal connection between your work injury and loss of bladder or bowel control, or sexual dysfunction, your  permanent partial disability  (PPD) award could be significantly increased when you are rated under the AMA Guides to Evaluation of Impairment, Fifth edition.  The injured worker must be vigilant about having these impairments included in the rating.

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I caution all injured workers to look carefully at the physician progress report (PPR) they are handed at the end of each  visit to their doctor assigned to treat their industrial injury.  Most doctors and clinics that are on the various third-party administrators' medical provider lists use the D-39 form approved by the DIR.    Sometimes the clinic or doctor will use a form that looks different, but all PPR's used by Nevada medical providers must show whether the doctor is taking the patient off work completely, or is giving work restrictions until the next scheduled appointment. 

If the doctor does not hand you a PPR showing you what your work status is, ask for  a copy  before you leave the doctor's office.  It is important that you get a copy of the PPR so that you know for certain whether the doctor has released you to return to work, and if so, whether you have work restrictions.  If the doctor's assistant tells you that you don't need a copy, and that they will fax a copy to your insurer and your employer, nicely explain that you are entitled to your own copy. 

Unfortunately, there are a few doctors on the Nevada provider lists that take a cowardly and unprofessional approach to releasing workers' compensation  patients back to work.  Instead of explaining to the patient that the doctor thinks it's time to return the patient to work, or to any available light duty job, the doctor says nothing when in the examining room with the patient.  If the patient doesn't get a copy of the physician's progress report, and the doctor didn't discuss work  release status, the patient only learns about what his doctor has done when he doesn't get his next  compensation check in the mail. 

These doctors shirk their responsibility to their patients because they want to avoid an argument from the patient.  The doctor may have good reason for changing the patient's work status, and if so, the doctor should be willing to discuss the reason with the patient.  Otherwise, It is extremely unfair and bad medical care not to inform the patient of his changed work status.

If this has happened to you, or you suspect that your doctor may not be up front with you later, be aware that you have an absolute right to change physicians within the first 90 days of your claim.  After 90 days you may still request it, but it will be harder if the insurer denies your request and you have to go to hearing. It is also very hard to change doctors after a doctor has just performed surgery on you. Just don't ignore your gut feeling that your doctor is not concerned with your well-being and at least get a free legal consultation to discuss what you can do to protect yourself.  Finally, please help other injured workers learn about their rights regarding choice of physicians by sharing this resource and the DIR's website information.   

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