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Workers' Compensation Newsletter

Choice of Doctor in a Workers’ Compensation Claim

The Workers’ Compensation system was created to help protect and provide for employees injured on the job. An injury that qualifies for workers’ compensation is one that occurs while the employee is at work. Each state has their own Workers’ Compensation system; as a result, rules and procedures may differ from state to state. One such rule governs the selection of a doctor to treat a worker injured on the job.

Selection of a Doctor in a Workers’ Compensation Claim

A typical Worker Compensation Act specifically states that it is the duty of the employer to provide a clearly written notification of the employee’s rights and duties involving the employee’s privileges regarding medical treatment. In most cases, either a doctor is assigned to the employee by the employer’s insurance company, or the employer will provide a list of doctors selected by the employer’s insurance company, and the employee is to choose a doctor from the list.

Some states allow employees to see a doctor of their choosing for a workers’ compensation claim provided that this request was made prior to the on-the-job injury. However, most states hold that an employee must pay out of his own pocket to see a doctor not chosen from the list offered by the employer.

What About Getting a Second Opinion?

There are discrepancies among states as to the rights of an employee to see a second doctor under workers’ compensation. Some states allow an employee to visit a second doctor when they are completely unhappy with the first doctor provided by the insurance company. In some cases, the employee is provided with a list of physicians by the workers’ compensation insurance company, and allowed to choose a second doctor from that list. Other states hold that after 90 days, the employee can see their own personal physician with the expenses still covered by workers’ compensation. Some states also allow for a second opinion, depending on the severity of the injury.

Further Treatment for the Injury

Again, states vary in the extent of coverage offered by workers’ compensation. In most states, after the treating doctor has released the employee from his care, if the employee feels that he is still in need of further medical care, the employee is free to see a doctor of his or her own choosing, but this expense is not covered by workers’ compensation.

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