Virtual doctor's appointments have gone from an occasional convenience to part of everyday healthcare.

Workers' compensation doesn't always follow the same rules as ordinary health insurance, though. An appointment that works perfectly well over video for one patient may not meet New York's requirements for a workplace injury.

Whether telehealth fits into your treatment depends on the type of visit, your medical condition, and New York's workers' compensation rules. Here's how those pieces fit together.

Key Takeaways: Can You Use Telehealth for Workers' Compensation Treatment in New York?

• New York allows telehealth for many workers' compensation appointments when a Board-authorized provider determines a virtual visit is medically appropriate.
• Telehealth can be used for many follow-up appointments, though some examinations still require an in-person visit.
• Board-authorized physicians, nurse practitioners, physician assistants, psychologists, and podiatrists may offer telehealth under New York's regulations.
• Qualifying telehealth visits may be billed to the workers’ compensation insurer when they comply with the Board’s medical, provider, reporting, and billing requirements.
• Medical records from virtual appointments become part of your workers' compensation file and may affect future treatment decisions.
• If an insurance carrier disputes telehealth treatment, the reason for the objection and the medical documentation both matter.

Can You Use Telehealth for Workers' Compensation Treatment in New York?

New York made telehealth a permanent part of its workers' compensation system on July 11, 2023, when the Workers' Compensation Board adopted permanent regulations. Since then, Board-authorized providers have been able to treat injured workers remotely when telehealth is medically appropriate and the requirements of the regulation are met.

The purpose of the appointment matters as much as the injury itself. 

For some injuries, the answer is yes. A follow-up visit to discuss how you're healing, review test results, adjust medication, or check on your progress may be a good fit for telehealth. If your doctor needs to examine an injury, test your strength or range of motion, or perform another hands-on assessment, an office visit may still be the better option.

Not every healthcare professional can provide telehealth through New York's workers' compensation system, either. The regulation applies to Board-authorized physicians, podiatrists, nurse practitioners, physician assistants, psychologists, and licensed clinical social workers. Chiropractors, physical therapists, occupational therapists, and acupuncturists cannot provide workers’ compensation treatment through telehealth under these rules. It also recognizes both two-way audio and video technology and, in some circumstances, audio-only appointments. 

Providers offering telehealth must also be able to see injured workers in person within a reasonable travel distance when an office visit becomes necessary.

A virtual appointment can save time, reduce travel, and make follow-up care easier. At the same time, telehealth isn't designed to replace every office visit. New York's rules give healthcare providers room to decide which format best fits the care you need at each stage of your recovery.

What Workers’ Compensation Appointments Can Be Conducted Through Telehealth?

Telehealth may work well for appointments that primarily involve discussion, observation, or reviewing information that has already been collected. After an appropriate in-person examination, a provider may use a virtual visit to monitor recovery, review imaging or laboratory results, discuss medication side effects, evaluate work restrictions, or answer questions about the treatment plan.

For example, a worker recovering from a wrist fracture may be able to discuss pain levels, review recent X-rays, and talk about the next stage of recovery through a video appointment. Behavioral health counseling and psychological follow-ups may also be well suited to telehealth because those visits often depend more on conversation than a physical examination.

Other appointments still need to take place in person. A provider may need to examine swelling, test strength or reflexes, measure range of motion, evaluate instability, or look for signs of nerve damage. Procedures, emergencies, permanent impairment evaluations, and other visits that require objective physical findings generally cannot be completed reliably through a screen.

The appropriate format may change during recovery. One visit may take place online, while the next requires an office examination because the worker’s symptoms have changed or the provider needs additional physical findings. New York’s rules allow providers to use telehealth when it is medically appropriate, but that discretion remains subject to the Board’s requirements for in-person care.

How Often Are In-Person Appointments Required?

Even when telehealth is medically appropriate, New York requires certain appointments to take place in person. For treatment by a physician, podiatrist, nurse practitioner, or physician assistant, the first visit with that provider must be conducted in person.

During the first three months after the injury or illness, the provider must perform an in-person assessment at least every third visit. Once more than three months have passed, an in-person assessment is generally required at least once every three months until the injured worker reaches maximum medical improvement.

After maximum medical improvement, telehealth may still be used for appropriate follow-up care, but the provider must conduct an in-person assessment at least once a year. Maximum medical improvement means the worker’s condition has reached a point where substantial further improvement is not expected.

Different rules apply to psychologists and licensed clinical social workers. Behavioral health treatment may begin and continue through telehealth when an in-person visit would not provide an added benefit or would create an undue risk or hardship for the worker. The provider must document why telehealth is appropriate.

These minimum intervals do not guarantee that every appointment between them can take place remotely. An earlier office visit may still be necessary if symptoms change, the provider needs physical findings, or the Workers’ Compensation Board’s Medical Treatment Guidelines require an in-person examination.

When an In-Person Exam May Still Be Needed

Telehealth can save time, but New York requires in-person care for certain visits. These can include examinations involving permanent impairment, disability, range of motion, procedures, emergencies, complex medical issues, and other situations in which a provider cannot make a reliable assessment remotely.

A healthcare worker who develops a shoulder injury after repeatedly lifting or repositioning patients may be able to discuss symptoms during a virtual follow-up. Measuring shoulder strength, stability, and range of motion often calls for an office visit.

The same applies to many other orthopedic injuries. Measuring shoulder stability, evaluating a knee after surgery, or determining whether swelling has improved often requires more than observation through a camera.

Some appointments also mark important milestones in a workers' compensation claim. One of them is determining maximum medical improvement (MMI). MMI doesn't necessarily mean an injured worker has fully recovered. It means the condition has reached a point where substantial additional improvement isn't expected with continued medical treatment. An examination conducted to evaluate permanent impairment must take place in person. After a worker reaches MMI, other appropriate follow-up visits may still occur through telehealth, but the treating provider must conduct an in-person assessment at least annually. The New York Workers' Compensation Board's Impairment Guidelines rely on objective clinical findings when evaluating permanent impairment.

Another appointment injured workers sometimes encounter is an Independent Medical Examination (IME) requested by the insurance carrier. Under New York's telehealth rules, a virtual IME is permitted only when all parties agree and the examiner will not be offering an opinion on permanent impairment. Many IMEs therefore continue to take place in person.

Moving from virtual care to an office visit doesn't mean something has gone wrong with the claim. More often, it reflects the type of medical information your provider needs at that stage of recovery.

How Telehealth Records Can Affect a Workers' Comp Claim

A video appointment generates the same type of medical record as an office visit. The format changes; the documentation does not.

Those records help create a timeline of your recovery. Your provider may document:

• how your symptoms have changed since the previous visit;
• work restrictions or whether you're ready to increase activity;
• medications, dosage adjustments, and any side effects you've reported;
• recommendations for imaging, specialist referrals, or additional treatment; and
• your response to physical therapy or other rehabilitation.

Those notes don't exist in isolation. They may later be reviewed by another treating physician, an Independent Medical Examiner, the insurance carrier, or the Workers' Compensation Board if questions arise about treatment or benefits.

One small detail can make a meaningful difference over time: keeping your medical information accurate. Virtual appointments provide an opportunity to review your medication list, confirm current dosages, and mention any new side effects or allergies. If something in your chart isn't correct, asking your provider to update the record helps prevent the same information from appearing in future reports.

Consistency matters, too. If your pain has improved, describe what has changed. If you're still struggling to lift, bend, sit, or return to your regular job duties, explain those limitations clearly. Detailed medical notes give your provider a more complete picture of your recovery and help explain why treatment recommendations may change from one appointment to the next.

What to Do if Telehealth Treatment Is Disputed

Most telehealth appointments move forward without any issues. Every now and then, an insurance carrier may question whether a virtual visit was appropriate under New York's workers' compensation rules. Receiving that notice can be frustrating, though it doesn't automatically mean your treatment was improper or that your claim has reached a dead end.

The first step is figuring out why the visit was challenged.

Some disputes involve medical necessity. Others focus on whether the appointment should have taken place in person, whether the provider followed the Board's telehealth requirements, or whether additional medical documentation is needed.

The New York Workers' Compensation Board makes an important distinction here. A payer generally cannot object to a bill merely because the appointment occurred through telehealth. However, an objection may be permitted when the regulation expressly required an in-person visit, such as an initial medical appointment, an examination to determine permanent impairment, or a visit with a provider who is not permitted to use telehealth. In other situations, the payer may ask the Board to direct the provider to conduct a required in-person examination. If a carrier believes telehealth wasn't appropriate for a particular appointment, it may request that future treatment be provided in person through the Board's established process rather than refusing payment based only on the format of the visit.

If your provider recommends an office visit after a disputed telehealth appointment, that isn't necessarily a setback. Sometimes an in-person examination answers the remaining medical questions and allows treatment to continue without further disagreement.

A few practical habits can also make the process smoother:

• keep copies of appointment confirmations, medical reports, and any letters from the insurance carrier;
• tell your provider if your symptoms have changed since the virtual visit;
• attend scheduled follow-up appointments, whether they're online or in person; and
• ask questions if you don't understand why a treatment recommendation or coverage decision has changed.

Recovery doesn't always follow the same path from beginning to end. Someone receiving treatment for a repetitive stress injury, for example, might start with virtual follow-up visits, transition to in-person examinations as symptoms change, and later attend an Independent Medical Examination if questions arise about work restrictions or ongoing benefits. Different appointments often serve different purposes.

Frequently Asked Questions:

Can my first workers' compensation appointment be virtual?

For most medical treatment, no. The first visit with a physician, podiatrist, nurse practitioner, or physician assistant must take place in person. Psychologists and licensed clinical social workers may sometimes provide an initial behavioral-health appointment through telehealth when remote care is appropriate and the provider documents why it is being used.

Are audio-only appointments allowed?

Yes. New York’s workers’ compensation telehealth rules recognize audio-only appointments as well as two-way audio and video. The visit must still be medically appropriate, provided by an eligible Board-authorized provider, and consistent with any requirement for an in-person examination.

Will workers' compensation pay for a telehealth visit?

Workers’ compensation generally pays for a telehealth visit when the care is medically appropriate, the provider is authorized to offer it, and the visit complies with the Board’s telehealth and billing rules.

Do telehealth appointments become part of my workers' compensation file?

Yes. Virtual appointments generate medical records just like office visits. Those records may be reviewed throughout the claim when treatment decisions, work restrictions, or other medical issues are evaluated.

Can I still be asked to attend an Independent Medical Examination?

Yes. A telehealth appointment with your treating provider doesn't prevent an insurance carrier from requesting an Independent Medical Examination when permitted under New York's workers' compensation process.

Brandon J. Broderick, Attorney at Law, Is Ready to Talk Through Your Situation

Recovering from a workplace injury already asks enough of your time and energy. Sorting through telehealth rules, insurance paperwork, and medical requirements shouldn't become another full-time job.

Whether your appointments have been virtual, in person, or a combination of both, having reliable information can make each decision a little easier. If you'd like guidance tailored to your circumstances, contact Brandon J. Broderick, Attorney at Law. We'll take the time to answer your questions, explain the workers' compensation process in plain language, and help you understand where you stand before you decide what comes next.