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Conflicting Medical Opinions of My Work Injury – What Will Happen to My Claim?

West Chester Workers' Compensation Lawyers at Wusinich, Sweeney & Ryan, LLC Advocate for Injured Workers Struggling With Their Claims

A work injury can be frustrating and difficult for you and your family. When you are injured at work, the severity of the injury and the timeframe when you can return to work may come into question, likely by your employer. When this happens, your employer may request that you get a second opinion from another doctor. However, if that second opinion conflicts with the original opinion, your workers’ compensation claim may be in jeopardy.

When you get a second doctor’s opinion for your work-related injury, there is probably a disagreement with your claim. This can happen because of several different scenarios, such as:

  • Your employer wants you to return to work, but you feel you are not entirely healed or ready to return.
  • You wish to return to work, but your employer does not believe you are ready or should be cleared to return.
  • You believe your injury is more severe than previously diagnosed or not as severe as once thought.

Pennsylvania Workers’ Compensation Laws

In Pennsylvania, your employer must supply you with a list of six providers, with at least three physicians, to choose from within 90 days of your injury. You could decide not to use that list and use your primary care physician; however, you may have to cover the costs yourself, and your claim may not be approved.

A workers’ compensation lawyer can tell you what your best option is, primarily if your employer does not supply a list at all. Another option to use your doctor is to wait 90 days for initial treatment from the employer-provided doctor.

It is entirely reasonable to want to choose your doctor for your injury. A doctor provided by your employer likely will not know your medical history, which can affect their diagnosis. You may also feel you cannot trust a doctor you just met.

What Should I Do if There Are Conflicting Opinions on My Work Injury?

Whether the doctor with the second opinion is your own doctor or another from the list of doctors your employer provides, a conflict between opinions can cause a delay in your claim approval or even with your treatment. When this happens, it will likely delay the benefits you receive as well.

The insurance company will take additional time to review both opinions. In a common scenario, one opinion may say you are ready to return to work, while the other may say that the injury is still present and you are not prepared to return. The insurance company may use this to prove that your injuries are not work-related, thus refusing to cover your claim.

If there are two disputing opinions regarding your injury, it will likely delay your claim, but it does not necessarily mean that your claim will be denied altogether. Your employer should do more than just go with the doctor’s opinion they had provided. Employers should work to resolve the conflict between the two doctors, either by allowing them to consult with each other or allowing a third opinion into the case.

If your work injury has two conflicting opinions, you should immediately contact a workers’ compensation lawyer. They can offer you guidance on how to proceed.

West Chester Workers’ Compensation Lawyers at Wusinich, Sweeney & Ryan, LLC Advocate for Injured Workers Struggling With Their Claims

Workers’ compensation claims may require careful legal guidance. If you have been injured at work and are struggling with your claim, contact our West Chester workers’ compensation lawyers at Wusinich, Sweeney & Ryan, LLC. Call us today at 610-594-1600 or fill out our online form for a free consultation. Located in Exton, Pennsylvania, we serve clients in Downingtown, West Chester, Exton, Coatesville, Phoenixville, Malvern, Lyndell, Wagontown, Uwchlan Township, Parkesburg, Chester Springs, Lancaster County, Reading, and Morgantown.