Provider Access: Work Comp has a Friction Problem

When workers’ compensation professionals talk about provider access, the conversation usually centers on geography… are there enough clinics nearby for injured workers to reach?

That’s the wrong question.

The real access problem is simpler and more uncomfortable: oftentimes, physicians don’t want to treat workers’ compensation patients.

Talk to doctors about workers’ comp and you hear the same complaints. Too much paperwork. Burdensome prior authorization requirements. Slow, unpredictable payments. No technology integration with their existing systems. Workers’ comp often asks more of physicians than commercial insurance and gives them less in return. So physicians opt out. They limit their workers’ comp caseloads or stop accepting these patients altogether. The injured worker technically has “access” to care, but the physicians nearby aren’t available to them.

This is the access problem that rarely gets addressed … because it requires fixing the experience of participating in workers’ compensation, not just expanding who’s eligible to do so.

And the timing couldn’t be worse. The workers’ compensation industry’s provider problem doesn’t exist in isolation. It’s colliding with a system-wide physician shortage that’s only getting worse. In 2021, more than 40% of primary care physicians reported plans to reduce their clinical workload. Projections estimate a shortfall of 70,000 primary care physicians by 2036. The drivers are well-documented: growing administrative demands, increased compliance requirements, and the relentless expansion of time spent in electronic health records, even as visit volume declines. These pressures exist in commercial health, where insurers at least have partial EHR integrations that reduce some of the friction. Workers’ compensation has no such integration. As physicians face increasing demands on their time, they will make choices … and workers’ compensation will not be their first choice.

Regulators have noticed the problem. Their solutions, while well-intentioned, don’t address the root cause. New York Governor Hochul’s 2026 State of the State called out provider access directly, proposing to eliminate a special authorization requirement that only 10% of eligible New York physicians have completed. Other states are expanding the types of providers authorized to treat injured workers … nurse practitioners, physician assistants, physical therapists. Telehealth adoption is growing, with some specialties handling more than 20% of visits virtually.

These are reasonable steps. But they expand the pool of eligible providers without making workers’ compensation more attractive to participate in. Notably, the specialties most relevant to injured workers … orthopedics at 4.7% and emergency medicine at 4.3% … are among the lowest Telehealth adopters. The tools expanding fastest aren’t the ones work comp needs most.

The underlying problem remains: workers’ compensation is more difficult, more burdensome, and less integrated than commercial health. Until that changes, through better technology, streamlined authorization, and improved payment processes, physicians will continue to opt out and injured workers will feel it.

Expanding the pool only works if physicians want to swim in it.