What is the Treating Doctors Presumption?
For injuries from 1/1/94 – 12/31/02, the primary treating physician (PTP) had a presumption of being correct. In other words, if your PTP said one thing, and the insurance companys evaluator said something else, the PTP was almost always followed. This could be good or bad, depending on whether the PTP favored the injured worker or the insurance company, since the presumption also applied to employer designated doctors who were selected by the employer during the first 30 days after the injury, when they control treatment if there has been no pre-selection by the injured worker (See Can I select my own treating doctor). For injuries after 1/1/03, there is no longer a presumption of correctness attached to the PTP unless the PTP was pre-selected prior to the injury and actually provided some treatment to the injured worker. This is an evolving and complicated area of the law, please call our office if you have questions.
