After a workplace injury, your employer and their insurance company will choose what doctor you must see. You can see your own doctor, but you’ll be responsible for the cost of your care. In some circumstances, your employer and their insurance company might agree to allow you to see your normal doctor as your workers’ compensation provider, but those circumstances are rare.
Empowering the insurance company to select the medical provider does give them an advantage. That’s because the insurance company and the doctor often build a relationship. That way, the insurance company can get the doctor to recommend less expensive treatment methods first. And in many cases, the insurance company can convince the doctor to give lower Permanent Partial Impairment (PPI) ratings, which further lowers the amount the insurance company must pay out.
When a Second Opinion Is Necessary
While the employer has the right to direct medical care, you also have a right to get a second opinion. Going to a different doctor will cost you some money upfront. But the diagnosis from the second doctor might give you grounds to dispute your workers’ compensation claim amount and the care you’re receiving from your employer’s hand-chosen doctor.
What Is an Independent Medical Examination?
You have the right to request an Independent Medical Examination (IME) in certain circumstances. But an IME could hurt or help your case. So before you file that request, consult with a workers’ compensation attorney who can review your case and offer advice about the best next steps.
Injured workers can request an IME when they receive notification of their workers’ compensation benefits being terminated. You’ll get this note once your doctor believes you are ready to return to work or you’ve reached maximum medical improvement (MMI). MMI means the doctor determined that you have improved as much as possible and that further medical treatment will not improve your medical condition.
However, injured workers sometimes disagree with this determination. If you believe you need further care, you can request an IME. You must do so within seven days of the date you receive your letter of workers’ comp termination of benefits.
During an IME, the Workers’ Compensation Board appoints a doctor to review your medical history and conduct a medical exam. Based on what the doctor finds, he or she will advise the board as to whether you truly have reached MMI or if you have an ongoing permanent impairment because of your workplace injury.
Do I Need a Workers’ Compensation Attorney?
Injured workers can work through the process of filing a workers’ compensation claim on their own. However, employers and insurance companies are focused on getting injured workers back to work as quickly as possible with as few medical bills as possible. That is not always in the best interest of the employee.
To have a true advocate overseeing what is best for you, hiring a workers’ compensation attorney is often a good idea. If you’re undergoing unfair treatment or your benefits are being discontinued prematurely, your attorney will ensure that you get your benefits back while making a full recovery.
In some cases, challenging the insurance company is the only way to ensure you receive a fair outcome for your case.
Your goal should be following your doctor’s orders and getting better. You don’t want to spend your time and energy arguing with an insurance company. Allow a trusted attorney to handle that for you. Contact Stewart & Stewart for a team of expert attorneys ready to fight for your rights and ensure the best possible outcome for your workers’ compensation case.