April 7, 2015

Changing Workers' Comp Doctors (Attending Physician) in Oregon

Can you change your workers' compensation doctor?

Yes, up to three times.

Can you choose your workers' compensation doctor?

Yes, unless you are placed in an MCO (Managed Care Organization).

It is important to remember your workers' comp doctor is called the "attending physician."

What is an Attending Physician?

An attending physician is the primary doctor for a workers' compensation claim.  They are basically the go-to person for all your medical needs.  They coordinate your care under your workers' compensation claim.  The attending physician is the only doctor who can give you work restrictions, refer you to specialists, and prescribe you physical therapy or chiropractic visits.  The attending physician is also the only person who can declare you medically stationary and rate your permanent impairment.

Who Can be an Attending Physician?

Only M.D.s and D.O.s can be attending physicians for Oregon workers' compensation claims.  Often, at the beginning of a claim, an injured worker will initially treat with a physician's assistant, a nurse practitioner or a chiropractor.  This is okay for the first 30 days, but after that you must have an actual M.D. or D.O. as the attending physician.  After 30 days, any work releases or medical treatment by a physician's assistant, a nurse practitioner or a chiropractor will not be covered under your workers' compensation claim.  It is therefore very important to establish with an M.D. or D.O. as your attending physician as soon as possible after you are injured.

How to Choose an Attending Physician?

This is most often done by completing an 827 Form at the doctor's office.  This will designate the physician as the attending physician.  There is a specific box that can be checked on the form called "Change of Attending Physician."

How Often do I Need to See My Attending Physician?

You should have an examination with your attending physician every 30 days while your workers' compensation claim is open.  You should maintain this schedule even if your claim is denied.  The reason for this is that you must see your attending physician to renew your off-work notes every 30 days to keep them valid.  Even if you claim is denied and you are not receiving time loss, if you win an appeal of your denial, the insurer will have to pay back time loss for every period it was authorized by your attending physician.

Attending Physicians and Time Loss

In order to receive time loss, you must see your attending physician and obtain a new work note (with work restrictions or a no-work note) every 30 days.  Only your attending physician can authorize time loss.  Off-work notes from your physical therapist, a specialist, a chiropractor or a nurse practitioner are not sufficient to authorize time loss under Oregon workers' compensation laws.

Attending Physicians and Claim Closure 

At some point in your claim you will become medically stationary.  This simply means that you no longer need active medical treatment.  It does not necessarily mean that you are fully healed.  It just means that you are about as healed as the doctor can get you.  It is up to the attending physician to declare you medically stationary.  They can indicate in a regular chart note that you are medically stationary, or they can concur with another physicians's opinion that you are medically stationary.  This second scenario often happens if you have an IME exam and the IME doctor says you are medically stationary.  If your attending physician agrees, he will indicate so and this counts as he or she declaring you medically stationary.

When an injured worker is medically stationary, the attending physician must determine if there is any permanent impairment related to the accepted conditions and, if so, how much.  Often the attending physician performs a closing exam to makes these determinations.  It is also common for the insurer to schedule a closing IME which the attending physician will often concur with.  Either scenario meets the information requirements for claim closure.

When an injured worker is medically stationary, the attending physician is also the person who determines if the injured worker can return to the job at injury.  If the injured worker cannot return to the job at injury, the potential workers' compensation benefits increase substantially.  This is another reason why the attending physician is so important to an Oregon workers' compensation case.