What are my options if I don’t agree with the workers’ comp doctor?

The options you have if you don’t like your workers comp doctor may vary. In some states, you are permitted to change doctors by putting in a request to the insurer and you may do this as many times as you want. In other states, you can change doctors but are limited to a specific list of approved physicians. In still other jurisdictions, you may be allowed to change doctors only once or you may not be able to change unless a given amount of time has passed.

Workers’ Comp Doctor Rules

While you may not be able to just change doctors whenever you want, the doctor that you are dealing with is required to be reasonably competent. If you feel that you are getting inadequate care from your physician, then you need to talk to a lawyer. Your attorney can assist you in dealing with the workers comp insurer, or if necessary with the workers compensation board in your state, in order to make sure you get the medical care you need. You should also make sure you keep detailed records of exactly what your doctor does for you.

In some instances, a problem will arise not because you don’t like the doctor but because you don’t like the diagnosis. For example, if your insurer sends you to a doctor to be examined to determine if you really are impaired or disabled, and your doctor says that you are not impaired or gives you an impairment rating you do not agree with, that diagnosis can jeopardize your ability to receive benefits at all. In such instances, you will need to get a second opinion. If the second doctor’s diagnosis is different, you will have to provide convincing evidence to the workers comp board or the insurer as to why your doctor’s opinion is the correct one.

Case Studies: Dealing With Workers’ Comp Doctor Disagreements

Case Study 1: Requesting a Change of Doctors

Lisa, a worker who suffered an injury on the job, was dissatisfied with the treatment she was receiving from her workers’ comp doctor. In her state, she had the option to request a change of doctors from the insurer. Lisa decided to exercise this option and put in a request to see a different physician. The insurer approved her request, allowing her to switch to a different doctor who better understood her medical needs and provided her with more competent care.

Case Study 2: Seeking a Second Opinion

John was sent by his workers’ comp insurer to a doctor for an impairment evaluation. However, he strongly disagreed with the diagnosis provided by the doctor, as it jeopardized his ability to receive benefits. Realizing the importance of a second opinion, John consulted with an experienced lawyer. The lawyer helped him obtain a second evaluation from a different doctor.

Armed with this new diagnosis, John presented convincing evidence to the workers’ comp board, showing why his doctor’s opinion was the correct one. As a result, John successfully secured the benefits he deserved.

Case Study 3: Dealing With Inadequate Care

Sarah had an ongoing workers’ comp claim but felt that her doctor was not providing her with adequate care. Worried about the impact on her recovery, Sarah sought legal assistance. Her attorney helped her address the issue with the workers’ comp insurer and the state’s workers compensation board. By documenting and presenting evidence of the inadequate care, Sarah’s lawyer ensured that the necessary medical attention was provided, enabling her to receive the proper treatment to aid in her recovery.

Getting Help

In any instance where you are having a problem with your workers’ comp benefits, you need to consult with an experienced lawyer to determine what your options are.