In most states, you are allowed to choose your own doctor to treat you while you are suffering a work-related injury. However, the rules around choosing your own doctor can often be complicated. For instance, in some states you must designate your preferred doctor before you become injured, and in some states you must choose a doctor who is within your employer's preferred network. Below are five tips for selecting your own doctor or changing your doctor while you are suffering from a work-related injury.
Become Familiar with the Approved Network of Doctors
Most often, you are allowed to choose your treating physician from a list of doctors approved by your employer or their insurance company. This is because these doctors have already agreed to work with your employer's insurance company. It is a good idea to familiarize yourself with the list of approved doctors. You may find that their backgrounds, specialties, and credentials vary greatly. You will want to select a doctor who can fully understand your injury and make recommendations to specialists when necessary, so it is important to research the background of any doctor you may switch to.
Additionally, you should check out reviews from other patients who have seen those doctors for workers' compensation claims. This will allow you to know how thorough each doctor is and whether they are sympathetic regarding work-related injuries.
Figure Out How Long You Are Required to Stay with an Employer-Assigned Doctor
Many states require that you stay with an employer-assigned doctor for a set period of time before you are allowed to change your treating physician. This period is usually around a month. You can find out how long you need to stay with your employer-assigned doctor by reading your workers' compensation guidelines or asking the insurance representative or nurse handling your case.
Know How Many Changes of Doctors You Are Allowed
You may only be allowed to change your treating physician a limited number of times. If you change your doctor too many times, your employer's insurance may cease to pay for your medical care, often without warning. It is important to know how many times you can change your doctor and then select your treating physician carefully so you do not go over your allotted number of treating physicians. It is also important to note that most insurance companies consider returning to an old physician after changing to a new one an additional change of physician.
Discuss Your Change of Doctors with Your Case Agent Before You Switch Doctors
Before you change your physician, you should discuss the change with your case representative, who is usually an insurance agent or a nurse handling your case for the insurance company. This will allow you to fill out all necessary paperwork in advance and make sure that your medical claims can be covered as soon as you make your transition. It will also allow you to double-check all of the rules and make sure you are selecting an approved physician.
Hire a Lawyer When Necessary
If your employer's insurance is refusing to cover your work-related medical bills, you may need to hire a lawyer, such as one from Prediletto, Halpin, Scharnikow & Nelson, P.S., to help you figure out how to get back under your workers' compensation coverage. They can also make sure the insurance company is abiding by the laws in your state that cover physician selection. Additionally, a workers' compensation lawyer will help make sure you are getting your full benefits and not only adequate medical treatment.
It is important to note that if you experience an emergency and need immediate medical attention, you are generally allowed to see any doctor who is able to treat you, whether they are approved by your employer's insurance company or not. Additionally, you can choose your own physician for treatment of conditions not related to your work injury, such as a pregnancy or chronic disease.
Share6 September 2016
Like many people, I once found learning about law very intimidating. My brother went to law school and I remember glancing through a few of his books and wondering if I was actually reading English due to all of the legal jargon in them! However, when I ended up in a sticky legal situation due to accidentally breaking a small law I didn't know existed, I realized that I needed to learn more about the law, so I could make sure to follow it precisely in the future. My brother helped to break down some complicated legal concepts to me, and I have since been studying up online. I want to post what I have learned and continue to learn about law in the future on my new blog, so my knowledge cannot only help myself, but also help others!