Am I Forced to Use My Company’s Doctor?

Every employee deserves a safe and fair workplace. Unfortunately, on-the-job injuries remain a problem for workers in all types of jobs. If you were hurt on the job, it is crucial that you seek immediate medical care. Not only is this important for your well-being, but injured workers will not be able to file a workers’ compensation claim unless they have seen a doctor. You must have official medical documentation to apply for medical benefits.

Unfortunately, you don’t always get to choose your own healthcare provider after a workplace injury. In some states, you can select your own doctor. In other states, you have to see the doctor selected by the workers’ comp insurance company. To find out about your medical treatment options in your state, talk to a local workers’ comp attorney.

The Right To Choose a Medical Provider

Different states have different laws for choosing the medical provider in workers’ comp cases. In some states, the employer can select the doctor. In other states, the injured worker gets to choose their own doctor. States also have different policies for when you can change or get another treating doctor.

Employer Choice States

In Georgia, employers must post a list of treating doctors for referral. “Usually, it is explained in orientation or an orientation packet that, when you’re hurt at work, this is what you choose a doctor from,” says Atlanta workers’ comp attorney Sarah E. Stottlemyer. “If you have a smart HR person, they ask [an injured worker] to initial their selection and circle it, then they photocopy it and keep it.”

By law, the employer needs a minimum of six medical providers for that list to be valid. “The panel is the most important thing an attorney can help you with,” Stottlemyer says, “because we know all the doctors, and if they’re infamously employer-insurer friendly or if they’ll give you a fair shake.”

If it’s a valid panel, you are therefore restricted to those six doctors; however, the physician you choose can refer you to someone not on that panel—say, a specialist. You’re also entitled to a one-time change from the panel doctor you first visited to another on that same panel. “But if you’ve already gone to one panel physician and they were terrible, I would advise calling an attorney as fast as possible,” Stottlemyer says.

Worker Choice States

For example, Minnesota workers can choose their own medical provider after a work accident. Injured workers in Minnesota are not forced to use their company’s doctor for a work-related injury.

The Minnesota Department of Labor and Industry notes that employers are only allowed to require injured workers to see a designated health care provider in limited circumstances, such as when the employee is covered by a collective bargaining agreement that includes an explicit provision listing pre-agreed-upon medical providers.

Another exception, notes Tom Atkinson, a workers’ comp attorney at Atkinson Gerber Law Office in St. Paul, is if the worker has a managed care health insurance plan. Otherwise, “The employee always has the choice,” he says.

“But what insurance companies sometimes do is tell you to go to a specific clinic or doctor to be evaluated. They don’t tell the injured worker that, ‘Hey, you have a right not to do this and choose your own doctor.’ They hardly ever tell you that. I just got off the phone with a client whose initial care was with a company-recommended doctor.”

The Right To Change Doctors, QRCs, and Judges

Minnesota does not allow injured workers to repeatedly change treating workers’ comp doctors without cause.

However, loss of faith in a doctor’s skill or lack of improvement in the underlying medical treatment may be sufficient to establish the valid cause needed to support a change of medical providers.

“You can request a change of treating physician through the Department of Labor and Industry (DOLI), and articulate why you want a change,” Atkinson says. “It’s not too hard to do that.” A specialist at DOLI makes the determination.

Within 60 days after first reporting the accident, an injured employee can also request a new qualified rehab counselor (QRC). The QRC is assigned to aid with things such as a worker’s medical management and facilitating their return to work. Should the case go to a court hearing, the employee also has the right to strike a judge.

Of course, they won’t know whether to do that or not without legal counsel.

Challenging the Employer’s Doctor Panel

Invalidated panels do happen, Stottlemyer says, and can be as simple as one of the doctors retiring, thus making the list of six physicians actually five. Similarly, if a doctor moves to another state or no longer handles workers’ comp cases, that panel can be invalidated.

“The attorneys and staff immediately get to work on the panel,” Stottlemyer says when she takes a case. “We can also make the argument that they didn’t show the panel to the worker, and just sent them to one of the industrial clinics. Sometimes they don’t post it in, say, the break room, but it just sits in a desk drawer. All of those things would get you around the panel.”

When you get a work-related injury, Stottlemyer recommends taking a picture of the panel list—or asking a coworker to do so. “Because sometimes I’ll ask the adjuster to send me the panel that was posted, and they’ll send me one that is totally different from my client’s.” She goes further to say documenting everything is the best tip, since it can only help your case.

In Georgia, another way to get power over doctor selection is if you have received income benefits within the past 120 days. You can get an independent medical evaluation by a doctor of your choosing and paid for by the employer-insurer.

Why Seek Out a Lawyer in a Workers’ Comp Claim

Employers and workers’ compensation insurance companies probably aren’t looking out for your best interests. Take it from Atkinson, who used to work on the other side.

“Half the insurance companies in Minnesota have staff lawyers, and I was one of them,” he says. “[If the adjuster has any questions] when a new injury claim comes in, they would roundtable with us and talk about the case. They’re getting legal advice while the injured worker often doesn’t.”

The other side takes advantage of workers’ lack of knowledge in this arena, not to mention their vulnerability.

“When you have a work injury, it’s an adversarial claim against the person who pays your paycheck, so you don’t want to make any waves or rock any boats. There’s an assumption that the insurance adjuster is like when you get in a car accident, but it’s not. So, early on, usually an injured worker wants to get better and return to work, so they are trusting and compliant,” Atkinson says.

Don’t let your employer or their insurance direct you to a certain clinic, doctor, or QRC. If they do that, it’s also possible that they’ll ask you to sign an authorization allowing the QRC to communicate directly with the doctor.

What you want is a medical opinion based on your well-being and the highest quality care, not based on the least impact for them.

Find Legal Help and Learn More

“If you’re injured, just call us,” Atkinson says. “We’ll tell you what work comp is, give you a little primer of what to expect, and the red flags to look out for. Work comp is always free; we never charge a retainer.” The insurance company covers the fees when the case settles.

If you believe that you are not getting the proper medical treatment from your current doctor, you should speak to a workers’ compensation attorney. An experienced workers’ compensation lawyer will be able to assess your situation and help you understand your options. he insurance company honest longer.”