Workers’ Compensation

Ca. Workers' Comp. Quarterly 2021, Vol. 34, No. 3

PTP Medical-Legal Reports: Pay Now, or Pay a Lot More Later



Can primary treating physicians (PTPs) write medical-legal reports on denied cases and disputed body parts? Yes, they can, and they should. PTPs who follow the documentation and billing rules that apply to all medical-legal reports and write reports properly will be paid for them. If they aren’t paid, a law firm like mine will collect and litigate for them and get a 10 percent penalty, 7 percent interest, and attorney fees so they won’t have to give up a percent of their billing. Some PTPs are afraid of being kicked out of medical provider networks, so they placate the carrier by refusing to address denials and disputed body parts or bill lengthy reports as medical-legal.

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