After every visit to a treating doctor, the injured worker should make sure that he or she leaves with a copy of a physician progress report (PPR). Most doctors who are on insurers’ provider lists use the DIR- approved physician progress report form. However, some doctors have forms on their own stationery that have the same information, but in a different lay-out. If the nurse or assistant checking you out after the doctor’s visit does not offer you a copy of the PPR, please insist that they give you a copy before you leave. Then read the PPR before you leave the doctor’s office to make sure that the information is correct and that you understand what the doctor has written.. A copy of this form will be sent to the adjuster handling your worker’s compensation claim, and a copy is often sent to your employer.
The top portion of this form states in abbreviated medical terms what your injury and diagnosis is. If you have injured more than what is stated in this section of the form, you should have a discussion with the doctor to make sure that he or she has examined and noted all body parts that were injured and that need treatment.
The second section of the form is important when the doctor releases you from care. In that section, the doctor checks boxes that state that you are, or are not, ratable and may have suffered a permanent disability. If the doctor checks "no" to those two boxes, the adjuster is not likely to schedule you for a permanent partial disability evaluation, which is necessary to receive a settlement for your injury.
The section entitled "Treatment plan" often tells you whether the doctor will be requesting approval for MRI’s, more physical therapy, or a referral to a specialist. Hopefully, your doctor’s staff will then follow-up with the proper authorization request form so that the treatment plan is approved and put into motion.
The bottom third of the PPR is very important and tells the injured worker whether the doctor has taken you off work completely (totally temporarily disabled), or whether the doctor has given you work restrictions. If the doctor gives you temporary work restrictions, it is your responsibility to give a copy of the PPR with these restrictions to your employer and ask whether your employer has work available within these restrictions. Keep in mind that a copy of this PPR goes to your adjuster, and if the employer tells the adjuster that light duty work is available, the adjuster will not continue to pay bi-weekly TTD benefits to you.
Read the PPR before you leave the doctor’s office to make sure you know whether the doctor has released you to full duty or with temporary work restrictions. Often injured workers misunderstand what their doctors verbally tell them about returning to work. You need to know what the doctor writes on the PPR, and if you disagree with what the doctor writes, you want to calmly and politely ask to speak to the doctor again to get a clarification before leaving the doctor’s office.
Some doctors tell injured workers that they are prohibited by Nevada law from taking an injured off work completely. That is false information. The doctor has a legal obligation to provide care for his patients regardless of who is paying for his services. Many doctors, however, feel pressure from adjusters and case managers to give work restrictions instead of taking injured workers off work completely for extended periods of time. So long as the employer provides work within whatever restrictions the doctor gives on the PPR, the injured worker must show up for work, or take leave without pay if available, or use whatever sick leave is available. The only other recourse the injured worker has is to request a change of physicians to a more caring doctor.
