Worker’s Compensation Coverage of Doctor’s Appointments During Working Hours

Posted on Monday August 14, 2023

If you’re injured or get sick from a job-related event, you need to seek medical help if you’re planning to file a worker’s compensation claim. Don’t overlook getting the proper medical care even if your injuries don’t seem all that serious. You’re entitled to schedule a medical appointment if your injury or sickness resulted from your conditions at work, work activities, or an accident while working.

Not only is getting medical help vital for your overall well-being, but it will also help you reap the maximum benefits for your claim – ensuring a fair reimbursement when paying for your rehabilitation or time off from work. If you are having any difficulty with benefits, speak with an employment lawyer who can help. 

Your Responsibility as An Employee Under the Fair Labor Standards Act

Under the worker’s compensation law in California, getting medical care is a major part of the compensation claim. Appointments involve getting checked and assessed regularly, including getting an evaluation, if applicable, for permanent disability.

Some recipients of worker’s compensation wonder if they can schedule their medical appointments related to their claims during a shift at work. 

According to the Fair Labor Standards Act (FLSA), the time spent on doctor’s visits counts as work hours. A recent appellate court decision suggests that workers might take a sick day or sick time to schedule doctor’s appointments.

However, according to the law, it’s best to schedule doctor’s appointments before the work day or at the end of a work shift. To ensure you understand what you can and can’t do, you should review the care you’re receiving with a labor attorney.

Immediate Medical Care

If you’re directed by your employer to seek immediate medical care after you’ve been injured on the job, it counts as hours worked. Your employer is not required to accompany you or provide transportation if you need to receive medical care.

Follow-Up Visits

If follow-up doctor visits are required during a normal work day, and your employer instructs you to get the treatments, the time you spend traveling to and from the doctor and waiting to be seen is counted as hours worked. This is true as long as the appointment is made during your normal hours of work.

However, if you and your physician arrange follow-up medical treatments without any employer intervention, they are not counted as hours worked. This is true even if you’re given permission from your employer to take time off to see your doctor.

Sick Time and Personal Time

If you wish to take sick time with pay to heal from an injury, your employer does not have to accept your request, nor are they required, by law, to allow you to take a personal day with pay for the same reason. This type of agreement is a private matter between the employee and employer – not a legal requirement of the employer.

Some insurance companies will schedule medical appointments–related to a worker’s compensation claim–on an employee’s behalf. However, this does not mean they can manage all aspects of your treatment. While they do have some flexibility in coordinating doctor’s visits, you don’t want them to get carried away.

What an Insurance Provider Can and Cannot Do

That means you have the right to determine what course of treatment you want to pursue and how you want to handle your appointment scheduling or which doctor you want to oversee your care. Insurance providers cannot limit you to these choices. 

However, providers do have some rights with respect to appointment scheduling that you may not know about. While they can’t cancel an appointment and reschedule it, they may require that you visit an authorized doctor if you don’t keep in touch with them on a regular basis or haven’t visited the doctor in a while.

Keep a Proactive Mindset

The whole idea, when seeking worker’s comp benefits, is to be proactive about the medical treatments you receive. When you take this approach, you’ll maximize your benefit amount while showing your commitment to continued care. This also includes transitioning back to work or working part-time until you’re feeling like your old self again.

You’ll need to schedule regular doctor’s appointments until your doctor says that you’re fully healed or that you can go back and start working full-time.

Contact a Worker’s Compensation Attorney in California

If you have questions about your worker’s compensation claim, you need to consult with a worker’s comp attorney about anything you don’t understand. In California, schedule an appointment with the Mara Law Firm. Make sure you understand all your rights and benefits.