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The Difference Between Workers’ Comp Doctors and Primary Care Providers

The Difference Between Workers' Comp Doctors and Primary Care Providers

Workers’ compensation benefits are a form of financial assistance available to employees who have suffered a work-related injury. However, receiving financial benefits requires the injured worker to receive treatment from a suitable and authorized doctor. If you’ve searched online for “workers’ comp doctors near me,” you probably felt confused and overwhelmed trying to sort through the sheer amount of information out there. Learning the basics of workers’ compensation benefits is a great place to start. For example, what’s the difference between a workers’ comp doctor and a primary care provider?

At Workers’ Comp Doctors, we offer 100% services to connect you with a local and licensed workers’ compensation doctor. Our directory includes all the top-rated workers’ comp doctors in NY, making it easy to find an authorized healthcare provider that complies with the requirements of filing a benefits claim.

What’s the Difference Between Workers’ Comp Doctors and Primary Care Providers?

Primary care providers (PCP) and workers’ compensation doctors aren’t that different. They’re both licensed medical professionals with similar skills, medical training, and education.

Here’s the big difference between the two: workers’ comp doctors can provide medical care to injured employees with valid financial compensation claims. Conversely, standard medical providers don’t have the authorization to treat workplace injuries.

Should you visit a general PCP to treat a work-related injury, your insurance company will most likely not cover those expenses. In the event that your PCP does have the necessary authorization to treat injuries for a compensation claim, you can absolutely choose them as your doctor.

In New York, health care providers must have official authorization from the Workers’ Compensation Board (WCB) to treat and care for injured workers. NY workers’ compensation insurance will only pay for medical care from WCB-authorized doctors (emergency treatment is the only exception). New York employees have the ability to pick the doctor of their choice to provide care and treatment under their benefits claim.

Here’s a quick summary:

Workers’ Comp Doctors

Eligible workers’ comp doctors have the authorization to treat injured workers who have compensation benefits. Common medical fields for these providers include:

  • General medicine
  • Dental
  • Optometry
  • Prescription drugs
  • Surgery
  • Assistive medical equipment

Primary Care Physicians

PCPs usually offer routine and specialty medical care but lack the authority to treat workers’ comp injuries. The most common healthcare providers include:

  • General practitioners
  • Family medicine
  • Internal medicine
  • Pediatricians
  • Nurse practitioners
  • Advanced practice providers
  • Resident doctors

What Is an IME (Independent Medical Examination)?

Many insurance companies require qualified beneficiaries to undergo an Independent Medical Examination (IME) from a doctor of their choice. IMEs are actually very common, even if the employee already has another health care provider that’s treated their injuries for a long period of time.

The entire purpose of an IME is to give the insurance company more information to help them either verify or dispute the claim for compensation and benefits. Even if you don’t want to go to another doctor, if your insurer requests an IME, you need to attend. If you don’t go, the most likely outcome will be the termination of your benefits. 

Workers’ Compensation Coverage, Costs, and Benefits

Insurance companies in America pay out millions of dollars every year to cover medical care expenses for work accident injuries and compensation benefits. In 2020, there were 135,572 covered workers in the U.S., with coverage totaling $58.9 billion ($27.7 billion for medical expenses and $31.2 billion in cash).

How to Find Doctors Who Take Workers’ Comp Near Me

In the year 2021, the U.S. Bureau of Labor Statistics reported approximately 2.6 million non-fatal workplace injuries and illnesses occurring in the private sector. After experiencing an injury on the job, your first task is finding the right workers’ comp doctor and beginning a treatment plan. Of course, your chosen provider will directly affect the outcome of your benefits claim. Therefore, it’s vital to consider all the key factors before making a decision. Ideally, your doctor will be:

  • Officially authorized to treat injured workers
  • Knowledgeable about your state’s workers’ compensation board
  • Experienced at treating workers’ compensation injuries
  • Flexible regarding appointments and scheduling
  • Skilled at processing workers’ comp fees and expenses
  • Available to testify or produce documents related to your claim
  • Willing to provide thorough documentation of your medical care and treatment
  • Well-respected within their field with a positive reputation

Finally, always take your personal feelings into account. Receiving treatment from a doctor you don’t trust will feel uncomfortable and awkward.

We Connect You with the Top-Rated Workers’ Comp Doctors Near Me

Top-Rated Workers' Comp Doctors Near Me

So, which doctor should you see after a workers’ comp injury? That question brings us to our final word: the doctor you choose must have an official license or permission to treat injured employees with workers’ comp coverage. Remember, primary care providers with no authorization don’t provide eligible care coverage. In that scenario, your insurance company is highly unlikely to cover those medical expenses.

Instead of searching for “workers’ comp doctors near me” and then spending hours sifting through endless information, make it easier and head to the Workers’ Comp Doctors website. We’ll connect you with some of the best doctors for your needs in our free directory. The doctors in our directory accept most insurance plans, including workers’ compensation, no-fault, and PIP (personal injury protection). Get started now by calling us toll-free at 888-533-0870 – same-day appointments may be available.


1. What are the three things necessary to collect workers’ compensation in the U.S.?

To collect workers’ comp benefits in the U.S., you must meet three main requirements. You must:

  1. Be a valid employee
  2. Have a work-related injury
  3. Work for an employer with current workers’ compensation insurance

2. What is the longest you can be on workers’ comp?

The longest you can have coverage under workers’ comp benefits varies, but the general timeline is between three and seven years. In most states, there’s no limit for permanent disability benefits.

3. How long do most workers’ comp settlements take?

Most workers’ comp settlements take around 12 to 18 months, but it depends on the specific details and circumstances of your case. Then, financial benefits usually come within two to three weeks post-settlement. 

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