Can a P.A. or nurse practitioner send you back to work?

Nebraska has strict rules about what kind of expert reports can be used in workers’ compensation cases. Often times these strict rules can make it harder for injured workers to collect benefits.

But workers’ compensation insurers and claims administrators play fast and loose with those rules when it suits them. I saw that double-standard in action recently.

In this scenario a medical doctor had taken an individual off work. But a day later, the workers’ compensation adjuster calls the clinic stating the employer has work light work available. Based on the hearsay assurance from an adjuster, a physician’s assistant (P.A.) signs a note returning the injured worker to work

Now if an injured worker went to court and their only medical evidence came from a P.A., that case would likely get dismissed. P.A’s aren’t so-called Rule 10 experts so, their opinions don’t have any legal weight unless they are signed by a doctor.

But when a workers’ compensation insurer wants to avoid paying temporary benefits for a lost time injury, a P.A’s report without a doctor’s signature is just fine.

So, yes a  P.A. or nurse practitioner can send you back to work. An injured worker who doesn’t go back to work after getting a return-to-work note signed only be such a provider risk getting fired. Because of the at-will employment doctrine, the judges who often decide wrongful termination cases on summary judgment aren’t likely going to split legal hairs in favor an injured worker who disregard a return-to-work note signed by a P.A.

But workers can take some steps to protect themselves from unfair treatment from a medical clinic and or workers’ compensation insurer.

Pick your doctor

Occupational medicine clinics or so-called “workers comp. doctors” tend to let insurance companies and nurse case managers more or less draft their medical records. Employers like to route their employees to these clinics. Employees have a right to see their own doctor, but employers often try to cajole and threaten workers to seek treatment at occupational medicine clinics.

Have your own doctor

Doctors are a lot less likely to let a workers’ compensation insurer call the shots in the treatment for an injured worker if they have a relationship with the patient. In short, if you have insurance get a family doctor. It’s very possible your health insurance plan covers a free annual physical. But many workers’ don’t have a regular doctor and insurers take advantage of this fact in a workers’ compensation case.

Talk your union or to an attorney

Workers can also talk to their union if they think their insurer or medical provider is being unfair about their work injury. Though not everyone is represented by a union, you can also contact a workers’ compensation attorney with those concerns.

Often an attorney can’t force an insurer to pay workers’ compensation benefits instantly. Insurers can often delay payment of workers’ compensation benefits without legal penalty.  But if an employer is relying on the opinion of a P.A. or nurse practitioner to deny workers’ compensation benefits, a decent attorney can force an employer to pay penalties and attorney fees to the employee if they go to court.