{"id":4677,"date":"2019-03-21T12:48:52","date_gmt":"2019-03-21T16:48:52","guid":{"rendered":"https:\/\/joemillerinjurylaw.com\/?p=4677"},"modified":"2019-03-21T12:48:52","modified_gmt":"2019-03-21T16:48:52","slug":"can-i-choose-my-own-doctor-in-a-workers-compensation-case","status":"publish","type":"post","link":"https:\/\/joemillerinjurylaw.com\/can-i-choose-my-own-doctor-in-a-workers-compensation-case\/","title":{"rendered":"Can I Choose My Own Doctor in a Workers\u2019 Compensation Case?"},"content":{"rendered":"

Most workers who are hurt on the job make arrangements to go their nearest emergency room \u2013 or someone makes the arrangements for them. The ER facility takes your history and may conduct some initial diagnostic tests such as taking an X-Ray. They then make an initial diagnosis. In serious cases, they\u2019ll then advise you whether they think you should be admitted \u2013 or not. If you are admitted, then your local hospital generally performs whatever procedures are necessary.<\/span><\/p>\n

After the visit to the ER, or if you never went to the ER, the next normal step is to see the physicians who can help you. These doctors include family doctors, orthopedists, pain management doctors, neurologists, psychiatrists, psychologists, cardiologists, and many other types of doctors. You may also need to treat with physical therapists, vocational therapists, and other health care providers. Some workers also find that working with a chiropractor can help.<\/span><\/p>\n

Unfortunately, in a worker\u2019s compensation case, you typically don\u2019t get to make the initial choice as to which health providers you see. You can\u2019t choose your own doctors and therapists. Instead, in Virginia, unless you have a catastrophic injury that requires immediate surgery\u2014in which case whatever surgeon is on call at the hospital typically becomes your treating physician—the workers comp insurance company will give you a list of <\/span>3 of their preferred doctors<\/b> for each type of doctor or health provider you want to see. This is known as a \u201cpanel\u201d of doctors. For example, the employer may give you several pain management doctors and give you the right to choose one of the several doctors listed. <\/span><\/p>\n

Employees should understand that most, if not all, of the doctors on the list were chosen by the employer for a reason. The employer wants doctors who will get you back to work as soon as possible. While company doctors are duty-bound to help employees, company doctors tend to certify patients as ready to return to work (or to work with restrictions) much more readily than non-company doctors. These doctors will be looking to see if you have any pre-existing injuries that might disqualify you from work injury benefits. They will be aware if you state that the you\u2019re not really hurting that much. They\u2019re less likely to recommend long-term or expensive treatments than everyday doctors.<\/span><\/p>\n

That being said, on most of these panels, it is our experience that there is at least one doctor who is \u201cless bad\u201d or even helpful, as compared with the other two on the panel. <\/span><\/p>\n

In North Carolina, there is no such ability to choose even from a panel. The insurance company gets to choose which doctor the employee sees. That being said, as will be further explained, North Carolina has a mechanism in place to request either a change in treating doctors or an <\/span>Independent Medical Examination<\/span><\/a> to be paid for by the defense. Virginia has no such provision. <\/span><\/p>\n

When it comes to the initial visit to doctor, therapists, and others \u2013 particularly in North Carolina—there isn\u2019t much the employee can do. <\/span><\/p>\n

How to make the switch to a doctor you prefer<\/i><\/b><\/h3>\n

Most workers feel more comfortable working with a doctor of their own choosing. The lines of communication are usually better. Workers understand that the doctors they choose will be looking out only for their interests and not the interests of the company or organization that hired you.<\/span><\/p>\n

There are several ways that a switch can be made<\/span><\/p>\n

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  1. You have the right, under North Carolina\u2019s workers\u2019 compensation<\/a> laws, to get a second opinion. Injured employees can make a written request to have a doctor in the same specialty or area of care examine you \u2013 at the expense of the employer. The request is first made to the employer. If the employer denies the request, you can appeal to the state industrial commission. There are a few things to keep in mind if you get a second opinion through the employer. The original treating doctors can review the report and contest the findings. The employer and the employer\u2019s insurance company also have the right to review the second doctor\u2019s report.<\/span><\/li>\n
  2. You can, normally with the help of an experienced North Carolina work injury lawyer, request permission to switch doctors or to switch health care providers. If the doctor who gives you a second opinion thinks that you need treatment or care that the first original doctor is not providing, then you can make a formal request to switch to the new doctor. The North Carolina Industrial Commission will have to approve the switch. An experienced North Carolina lawyer will explain what situations will likely result in an approval of the switch. He\u2019ll fight to show the switch is necessary. Generally, the switch has a greater chance of success if some or all of the following factors apply:<\/span>\n
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    1. Sufficient time has elapsed to show the treatments from the original doctor aren\u2019t working<\/span><\/li>\n
    2. You can show some inherent bias against you from the first doctor<\/span><\/li>\n
    3. The original doctor isn\u2019t using reasonably available treatments<\/span><\/li>\n
    4. Other factors depending on your health condition<\/span><\/li>\n<\/ol>\n<\/li>\n<\/ol>\n

      There are some situations where the employer will be required to pay for a doctor who wasn\u2019t pre-approved or for a hospital that wasn\u2019t pre-approved. The main situation\/exception is in response to an emergency. Emergencies include the initial injury. They can also include an emergency that appears during your treatment phases \u2013 such as an allergic reaction to a medication that requires immediate attention.<\/span><\/p>\n

      How an experienced workers\u2019 compensation can help increase the likelihood of seeing a different doctor<\/i><\/b><\/h3>\n

      Insurance carriers and defense lawyers will normally fight any request to switch doctors or health care providers. An experienced lawyer will help you in several ways. A skilled North Carolina workers\u2019 compensation lawyer normally works with many different work injury doctors. He\u2019ll help you make an appointment with a doctor who has trained for your type of injury. A good work injury attorney will understand what objections the insurance company will likely make and what objections or responses the original treating doctor will make.<\/span><\/p>\n

      The law on second opinions and switching health providers can be found at <\/span>N.C.G.S. \u00a797-25<\/span><\/a>. Medical treatment and supplies. Some key considerations in the law, in addition to the above summary, are:<\/span><\/p>\n