Do You Need to See a Doctor for a Workers’ Compensation Claim in Massachusetts?

Workers’ Compensation may be paid to injured employees after they experience on-the-job injuries. One critical element in a Workers’ Compensation claim is proving that you were indeed injured and cannot return to work.

Although no statute requires that all injured workers filing Workers’ Compensation claims must see a doctor, you must do so if you want your claims approved. Your claim will be evaluated by the Massachusetts Department of Industrial Accidents (DIA), and they will be looking for information about your injuries from a medical doctor. In some circumstances, if medical issues in your case are in dispute, you are legally required to see a doctor to help resolve the issue. In any case, you should see a doctor immediately after you are injured, as your medical records and reports can be used as evidence in your claim.

Seeing a doctor in a Workers’ Compensation case is not always explicitly required, but it is crucial to getting the compensation you need. Contact our Boston Workers’ Compensation attorneys at the Law Office of John J. Sheehan for a free evaluation of your case. Call (617) 925-6407.

Seeing a Doctor After Filing a Workers’ Compensation Claim in Massachusetts

After being injured in a workplace accident, you should notify your employer or supervisor immediately before leaving to get medical care. While you are not barred from filing a Workers’ Compensation claim, you will likely not be approved if you do not see a doctor. Many injured workers do not think they are so badly injured as to warrant medical attention, but seeing a doctor is crucial no matter what. Our Massachusetts Workers’ Compensation attorneys can help you find a doctor to help you.

Workers’ Compensation claims are not decided by your boss but by the Massachusetts Department of Industrial Accidents (DIA). When filing a claim, the DIA requires certain information before they approve or deny compensation. Among your application materials should be information about your treating physician, where you received treatment, and the injured parts of your body.

The good news is that you are generally free to select your own doctor when being treated pursuant to a Workers’ Compensation claim. However, there are sometimes circumstances where the DIA or the insurance company paying for your Workers’ Compensation may need to choose or approve your doctor.

When Seeing a Doctor for a Massachusetts Workers’ Compensation Claim is Mandatory

As mentioned, seeing a doctor is not necessarily legally required just to start your application. However, there are circumstances in which you are required by law to undergo medical evaluations for your Workers’ Compensation claims. According to Mass. Gen. Laws Ch. 152 § 11A(2), you must see a doctor for evaluation if there is a dispute over medical issues in your case. For example, if the DIA is confused about the extent or severity of your injuries, you might be required to see a doctor for further evaluation. This issue often comes up when a Workers’ Compensation claim is appealed.

When this happens, you may choose your own doctor, but the other party must approve them. By the same token, you must also agree to a doctor selected by the other party. There is often a roster of pre-approved doctors that the parties may choose from. The doctor must then determine the following:

  • Whether a disability exists,
  • Whether the disability is partial or total and permanent or temporary, and
  • Whether the disability was predominantly caused or arose from the course of employment.

Additionally, the law states that when an employee fails to submit to required medical evaluation after receiving due notice and without any good cause, their Workers’ Compensation benefits, if they are receiving any, can be suspended.

When Should I See a Doctor for a Workers’ Compensation Claim in Massachusetts?

The process of filing a Workers’ Compensation claim is often complicated, and many injured workers do not know where to begin. Do you submit your claim and then see a doctor? Do you have to wait to file until after you have received medical treatment? Our Cambridge Workers’ Compensation lawyers can help you answer these questions and more.

In Massachusetts, you are not eligible for Workers’ Compensation until you have missed 5 calendar days of work because of your injury. These missed working days need not be consecutive, so more than 5 days might pass before you actually miss 5 days of work. Either way, there is time between your injury and when you become eligible, so people often think they do not have to see a doctor until they become eligible.

In truth, you should see a doctor for your injuries immediately. Once you become eligible to apply for Workers’ Compensation, the DIA will evaluate your medical treatment and records of your injuries. A gap between the date of the injury and the date you first received treatment might be a red flag and jeopardize your claim.

Using Medical Reports in Your Workers’ Compensation Claim

Although you are not necessarily required to see a doctor when you submit a Workers’ Compensation claim, doing so greatly increases your odds of success. As discussed above, the DIA will want to see information about where you received medical treatment and records of your injuries. The sooner you get treated by a doctor, and the more often you return for follow p visits, the more accurate your medical records are.

Even if you receive medical treatment right after tour accident, but there is a gap in time between treatment and when you file your claim, the DIA might poke holes in your case. Stronger medical records should reflect your medical condition not only after your accident but in the days, weeks, and months after. Otherwise, the DIA might not believe you are disabled and unable to work.

Call Our Massachusetts Workers’ Compensation Attorneys for Help Now

After a work-related injury, you should see a doctor even if not required. Sometimes, your Workers’ Compensation claim might become complicated, and a medical evaluation might be mandatory. In either situation, our Glouchester Workers’ Compensation lawyers can help you. For a free case assessment, call the Law Office of John J. Sheehan at (617) 925-6407.