During the course of your medical treatment following your workers’ compensation injury, it becomes very important to obtain treatment from the most qualified and helpful doctor that is available under the law.
Selecting the right doctor is important for several reasons:
1. Some physicians are answerable to the workers’ compensation carrier. Many times, physicians are expected to spend less time on your case than with private-pay patients. They are also pressured by the insurance company adjusters and nurse case managers to finish up care faster, and quickly releasing the injured worker back to work.
2. Some states, such as Florida and Texas, have very insurance-company favorable laws. In these states injured workers have little or no choice in choosing their own doctors. These doctors are also those who are conditioned to return injured workers back to work the soonest, or to finish up medical treatment quicker than their private-pay patients, or those covered under private health insurance.
Whether or not you can select your own doctor to treat you under your workers’ compensation case is the first important step in assessing your workers’ compensation injury.
First of all, does the workers’ compensation law in your state permit you to select the treating physician? Under some states that answer is no. Florida, for instance, does not permit the injured worker from selecting her own doctor. If the injured worker is unhappy with care, then the insurance company must select another physician. However, so long as the insurance company authorized the one time change in physician timely under the law, the insurance company selects the alternative physician as well.
Emergency care immediately after the injury, such as initial trips to urgent care or the hospital emergency room, are usually covered, regardless of who selected the doctor/facility. However, once the emergency is over, then follow up care with a doctor selected or approved by the insurance company is usually required.
The Defense Base Act and the Longshore Act both provide the injured worker with free, unfettered choice in selecting their physician. That is great news because these laws encourage doctors to treat so long as medically necessary. Doctors are often paid usual and customary fees, rather than the much lower fees paid under many state workers’ compensation laws.
However, even where you can choose your own doctor, selecting that physician becomes extremely important. Since Defense Base Act and Longshore patient are not given a statutory right to a one-time change, it is very important to choose that initial doctor wisely. Consulting with an experienced workers’ compensation attorney can help move your case in the right direction by engaging the help of qualified physicians who can properly diagnose your injuries. These physicians will take the time to determine the extent of disability, and will not rush the injured worker back to work too early. Such early releases back to work often lead to re-injuries.