Five Questions Adjusters and Employers Should Ask Before Referring an Injured Worker
Choosing the right treating physician affects everything downstream: recovery time, claim cost, and whether an injured worker returns to full duty or ends up with a permanent restriction. A few questions can help adjusters, employers, and case managers evaluate whether a practice is set up to handle a workers' compensation case well.
Does the practice have a dedicated workers' compensation contact or department? Practices that route work comp cases through a general scheduling line tend to be slower on records requests, authorization questions, and status updates than practices with a dedicated line or email for adjusters and case managers.
Do the treating physicians understand return-to-work planning? A physician who documents specific functional limitations and realistic timelines gives claims teams more to work with than one who writes generic restrictions.
Is the practice appointed or certified in any state workers' compensation program? Designations like Florida's Expert Medical Advisor appointment, or certifications like OM's WorkCompReady program, signal a practice has been vetted for workers' compensation experience specifically, not just general medical competence.
How does the practice communicate with adjusters and case managers? Ask about typical turnaround time on records and reports, and whether the practice will get on a call with a nurse case manager when a case needs it.
What happens when non-operative treatment isn't working? A good practice has a clear point at which it moves from conservative treatment to considering surgical options, rather than extending physical therapy indefinitely without reassessment.
None of these questions require special access. They can be asked directly of a practice's workers' compensation coordinator before the first referral goes out, and the answers say a lot about how a case will go.
