Often, employees who have been injured at work and call our office want to know why they can’t receive treatment from their primary care doctor or a specialist recommended by their primary care doctor. The best analogy we can come up with is the difference between seeing a doctor out of network versus in-network under your health insurance coverage. Can you do it? Yes. Will it be paid for? No.
Similarly, you can see your primary care doctor for your work injury as long as you understand that your employer’s workers’ comp insurance company will not pay the bill, and more importantly, will not recognize your doctor’s diagnosis/treatment plan. It is only after your treatment ends with the work comp doctor that you have the option of seeing another doctor for your independent medical exam (IME).
Can I switch my workers’ comp doctor?
Unfortunately, there are very few situations in which you can receive medical care from another doctor and still retain your workers’ comp benefits. In all these cases, the alternate doctor usually must also be a doctor who is approved by your workers’ comp carrier or the care needed is urgent in nature.
Care from another doctor can occur when:
- There is an emergency: if you suddenly need or surgery or treatment for complications related to your work injury, and your assigned physician is somehow unavailable, you may receive treatment from another doctor.
- Care is not provided by the employer or the carrier: if doctors that the carrier has provided have agreed that you need urgent treatment that employer or carrier will not authorize, then you may receive that treatment from another doctor.
- There is any other good reason: this is clearly vague and must be approved by the workers’ comp board. Speak with an Indiana workers’ compensation lawyer to review your case and assess if your circumstances constitute a compelling reason.
As you can see, not liking a particular physician is not enough reason to request a change in doctor under your workers’ comp claim. For more reliable answers on your rights and options as an injured worker, contact us a Kooi today. Our experienced and compassionate professionals pride themselves on ensuring that our injured clients have the support and resources they need to put their injury behind them as soon as possible.
Get a dedicated advocate on your side. Call us at 888.366.4215 today.