Medical Treatment & Second Opinions
If you've been hurt on the job, the medical side of your workers' compensation claim matters as much as the legal side. The treatment you receive affects how long your benefits continue, when you're expected back at work, and what your permanency award may be. I've handled workers' compensation claims in New Jersey since 1979, and I can explain how the process works and what to do if a problem comes up. Call me as soon as you're hurt.
When you're injured on the job in New Jersey, your employer's insurance carrier generally controls where you receive initial treatment. That means they direct you to a specific doctor or clinic — and in most cases, you're required to treat with that provider to keep your benefits in place.
How Medical Treatment Works in a New Jersey Workers' Comp Claim
The doctor the insurer sends you to is called the authorized treating physician. Their evaluations and treatment recommendations carry significant weight in your claim. They determine what care you receive, how long you're treated, and whether you're cleared to return to work. That's a lot of authority concentrated in one provider.
The Authorized Treating Physician
The doctor the insurer sends you to is called the authorized treating physician. Their evaluations and treatment recommendations carry significant weight in your claim. They determine what care you receive, how long you're treated, and whether you're cleared to return to work. That's a lot of authority concentrated in one provider.
What "Authorized Treatment" Actually Covers
Authorized treatment under workers' comp can include emergency care, specialist referrals, physical therapy, diagnostic imaging, surgery, and follow-up care — as long as it's tied to your work-related injury. The key phrase is "medically necessary." Authorized treatment doesn't have an arbitrary end date. If your condition requires ongoing care, that care should continue. Problems arise when the insurer's doctor decides you've reached maximum medical improvement prematurely.
Independent Medical Exams — What They Are and Who Orders Them
An independent medical exam, or IME, is an evaluation by a physician who is not your treating doctor. In New Jersey workers' comp, the insurer often requests an IME when they want a second medical opinion — typically one that supports reducing or ending your benefits. Despite the word "independent," these exams are paid for by the insurer, and the doctors who conduct them are frequently hired for that purpose. If the IME conflicts with your treating physician's findings, that dispute becomes part of your claim record and may need to be resolved before a workers' comp judge.
What to Do When You Disagree with the Insurer's Doctor
- Don't sign anything you haven't reviewed with an attorney. Medical releases and settlement documents can affect your future treatment rights.
- Contact me before the dispute escalates. The earlier I'm involved, the more options you have.
What to Do When You Disagree with the Insurer's Doctor
If something feels wrong about the care you're receiving — or the conclusions the doctor is drawing — here's what I advise clients in that situation:
Can You See Your Own Doctor for a Workers' Comp Injury in NJ?
In most circumstances, you are required to treat with the insurer's authorized provider for your work injury to be covered under workers' compensation. Treating outside that network — without authorization — can jeopardize your reimbursement and give the insurer grounds to dispute your claim. If you're unhappy with the care you're receiving, the answer is not to walk away from authorized treatment without a plan. The answer is to talk to me first.
How I Help Injured Workers with Medical Disputes in Gloucester County and South Jersey
I've been handling workers' compensation claims in New Jersey since 1979. Medical disputes come up in a number of the cases I handle. When you work with me, you work directly with me, not a paralegal or an associate who hands off your file. I review the medical record, identify where the insurer's position is vulnerable, and help you build the strongest possible evidentiary foundation for your claim. If you're in Gloucester County, Deptford, Washington Township, or anywhere in South Jersey, I'm ready to help.
Common Coverage Questions
Answers Designed To Keep You Protected
Does the insurance company get to pick my doctor for a workers' comp injury in NJ?
Yes. New Jersey workers' compensation law generally requires injured workers to treat with the employer's authorized medical provider. Treating outside that network without authorization can affect your coverage, so it's important to understand your options before making any changes to your care.What happens if the insurer's doctor says I'm ready to return to work but I'm not?
Call me.
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Law office of WIlliam A. Sheehan
I've been handling workers' compensation claims in New Jersey since 1979. Medical disputes — IMEs, conflicting diagnoses, premature return-to-work clearances — come up in a significant number of the cases I handle. When you work with me, you work directly with me, not a paralegal or an associate who hands off your file. I review the medical record, identify where the insurer's position is vulnerable, and help you build the strongest possible evidentiary foundation for your claim. If you're in Gloucester County, Deptford, Washington Township, or anywhere in South Jersey, I'm ready to help.
