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Pre-existing Injury New Mexico

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  • Pre-existing Injury New Mexico

    I hurt my knee going down stairs at work. My knee was healed from previous injury/operation. I am documenting the injury with an accident report but want to know if I can go to my doctor. I have concerns the workman comp doctor will not effectively address the injury. If I go to my doctor and mention this is a on the job injury my insurance will not pay. So I guess I answered my own question. Whats the best way to handle a on the job injury and get the best results?

  • #2
    You should always report an on the job injury to your supervisor immediately.
    The way WC traditionally works is that if you have a pre-existing or underlying condition and have an on the job injury that aggravates the prior condition, WC is responsible to returning you to your baseline which is where you were prior to the second injury.

    For example, if you have a torn ACL and have not had surgery but have been doing ok and twist your knee at work and that aggravates the torn ACL, WC is responsible for taking care of the aggravation. It would not be responsible for surgery to repair your knee, since that condition existed previously. Once you are back to doing Ok again, WC drops out of the picture since you are back to your baseline condition.

    CHeck with your company. Some states require you to go to specific Doctor's for WC or it is not covered.
    I find that the harder I work, the more luck I seem to have.
    Thomas Jefferson


    • #3
      Straight from your state's website

      Who selects my doctor if I'm injured?
      The law allows your employer to initially select which doctor you are to see, or the employer can allow you to pick your own doctor. If the employer picks the doctor, then you have the automatic right to change to a doctor of your own choosing after 60 days of treatment.

      Likewise, if you initially pick the doctor, the employer can send you to their doctor after 60 days of treatment. Whoever is allowed to change doctors, must notify the other of the change by completing and sending to the other a form called "NOTICE OF CHANGE OF HEALTHCARE PROVIDER."

      Whether your employer picks the doctor or you initially pick the doctor, if you are not happy with the doctor you are seeing, you may be able to see another doctor, but only with the permission of the employer's insurance adjuster. If you are initially treated in an "emergency room" and referred to a certain doctor, you should first check with your employer about who is to select the doctor before continuing treatment.

      Why do you believe you will not get adequate care from the doctor you were sent to? It is in your employer's best interest to see that you heal fully and are able to return to work. While less than quality physicians exist everywhere, do you have a reason to think this one is not appropriate?
      I post with the full knowledge and support of my employer, though the opinions rendered are my own and not necessarily representative of their position. In other words, I'm a free agent.


      • #4
        No, I don't have any reason with this company. I worked for several years in middle management and the employer I worked for always seemed to have the upper hand in worker compensation issues. The Doctor seemed abnormally skewed towards the employers needs. The employee would always be at fault and cases would drag out forever without rapid closure.

        I know my doctor would be aggressive if I want him to. All I have to do is ask. Would the company doctor do the same? We will see. It may not come to that. This is good conversation though. Thanks for the information.


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