As the attending physician, you are primarily responsible for treatment and authorizing time loss.
The Oregon workers’ compensation system places considerable responsibility on attending physicians for all of the following:
- Directing and managing treatment of patients
- Authorizing time loss
- Determining the patient’s physical ability to stay at work and return to work
- Deciding when the patient becomes medically stationary
- Making impairment findings
If you are the attending physician and you refer the patient to an ancillary care provider (e.g., physical therapist), the ancillary care procider should send you a treatment plan for signature within seven days. You must sign a copy of the treatment plan and send it to the insurer within 30 days of the start of ancillary treatment.
As the attending physician, you can also refer your patient to a specialist physician for a consultation or specialized treatment, and you will continue to serve as the patient’s attending physician (you are responsible for authorizing any time loss).
Attending physician timeframes
As a chiropractic physician, you may treat the patient as the attending physician up to 60 consecutive days or 18 visits (whichever occurs first) from the date of the initial visit. As a chiropractic physician, you may authorize time loss for up to 30 days from the date of the initial visit.
If you have authorized time loss for 30 days and the patient continues to need time loss authorized, the patient must choose a new attending physician or authorized nurse practitioner. However, if you have authorized time loss for 30 days and the patient no longer needs time loss authorized, you may continue to treat as the attending physician up to the limit of 60 days or 18 visits.
Tip: As a chiropractic physician, you need to find out if the patient has already been treated by a physician assistant, a naturopathic physician, or another chiropractic physician because the 60-day/18 visits clock starts when the patient chooses one of these providers as their attending physician.
Stay at work / Return to work
As the attending physician, you have primary responsibility to determine whether the patient is able to continue regular employment or whether there are any limits on the patient’s ability to perform work activities. Keep in mind, you can only authorize time loss for 30 days from the initial visit. If you determine that the patient is unable to continue regular work duties, the Workers’ Compensation Division strongly encourages you to contact the employer or insurer and discuss potential modified work duties the patient is able to perform.
If you place, modify, or lift any work modifications, you must immediately inform the patient and notify the insurer in writing within five consecutive calendar days. Prompt notification to the insurer will reduce insurer inquiries and promote timely payment of benefits to the patient.
When you release a patient to return to work, you must do so in writing and specify work restrictions, if any. You may use Form 3245, “Return-to-Work Status”; however, you are not required to use this form unless the insurer requests it.
Click here for more information about return to work.
Tip: You are allowed to communicate with the employer regarding what type of work the patient is able to perform.
Treatment after the patient is medically stationary
Once the patient becomes medically stationary, you can no longer be the attending physician. However, you may continue to provide compensable medical services as an ancillary provider if authorized by the attending physician.