Workers Compensation

Can I Choose My Own Treating Doctor in My Workers' Compensation Case?

By Carey Worrell, Attorney (J.D., Harvard Law School)
Find out whether you can choose your own doctor to treat your work-related illness or injury.

If you are injured on the job, your treating physician will play an important role in helping you recover as fully as possible and getting you the maximum benefits you’re entitled to. Having a good treating physician is invaluable, but workers comp’ rules can sometimes limit your ability to choose the doctor you want to treat with.

Which Doctors Can I Choose?

Whether you are allowed to choose your own doctor to treat your workers’ comp injury will depend on which state you live in. In some states, such as New York, Ohio, and Texas, an injured employee can choose any doctor that is certified or approved by the workers’ compensation agency. On the other hand, states such as Florida and New Jersey allow the employer or its insurance company to choose the treating physician. However, even in states that allow the employer to choose the treating physician, an employee can usually choose any doctor in an emergency situation.

And some states, such as California, have much more complicated systems for choosing treating physicians. In California, if the employer offers group health coverage, a worker can predesignate a primary care physician to treat work-related injuries at the time the worker is hired. If the employee doesn’t predesignate a doctor, the employee must typically see a doctor from the employer’s medical provider network.

If your state allows you to choose your own doctor, it makes sense to do so. When an employer or its insurance company chooses, the doctors have a tendency to downplay an employee’s injury in order to save the employer money. (See What to Do If You’re Not Getting the Medical Treatment You Need for more information).

Whatever the rules in your state, it is important to follow them. If you receive treatment from an unauthorized physician for your work-related injury, the treatment may not be covered. If you need help figuring out the rules in your state, consult your state workers’ compensation agency or a workers’ comp attorney.

What Should I Look for in a Doctor?

The first thing you should ask a doctor is whether or not the doctor is willing to treat work-related injuries. Because the rules for treating injured workers and getting paid for that treatment can be complicated, not all doctors are willing to work on workers’ comp cases.

Apart from finding a doctor willing to treat work-related injuries, you should confirm that whatever doctor you choose is competent and easy to work with. The best way to find a good doctor is to ask for referrals from coworkers or friends who have suffered work-related injuries. It’s also helpful to find a doctor’s office that is open during hours that are convenient for your schedule.

You may also want to confirm with the doctor’s office that the physician is certified in whatever specialty your injury requires. Doctors who are certified in a particular specialty have received extra training in that field and have had to take additional exams to become certified. For example, if you have a broken bone, you would want to find a doctor that is certified by the American Board of Orthopaedic Surgery.

Finding a doctor who comes across professionally is also important, because your doctor may have to prepare reports or testify at a hearing on your behalf. Your doctor’s opinion can have a large impact on the amount of benefits you receive, so it’s very helpful to have a doctor who is familiar with the ins and outs of the workers’ comp system.

What Role Will My Doctor Play in My Workers’ Comp Case?

In addition to helping you get well, your treating physician will have a big role in determining how much time off you need due to recover and what restrictions you will need when you return to work. A good doctor will make sure that you get as much time as you need to heal, instead of rushing you back to work before you’re ready.

Your treating physician will also have a major role in determining the amount of your permanent disability payments. Your payments will be based on the permanent disability rating you are assigned, which indicates the severity of your injury and its permanent effect on your ability to work. The higher your permanent disability rating, the higher your payments.

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