Can I See My Own Doctor While on Workers’ Compensation?
After a workplace injury, you may wonder which doctor you can visit for medical treatment. South and North Carolina workers’ compensation laws require injured workers to follow specific requirements to receive medical benefits. An experienced workers’ compensation attorney at Stewart Law Offices can guide you through this process and help you seek the care and workers’ compensation benefits you deserve. Contact us today for a free consultation.
Who Gets to Decide Which Doctor I Can See After an On-the-Job Injury?
The workers’ compensation laws in North and South Carolina dictate which doctor an injured worker is allowed to see after an on-the-job injury.
Employer’s Right to Choose
In South Carolina and North Carolina, your employer or workers’ compensation insurance provider has the right to choose the workers’ compensation treating physician. Employers may select a network of approved doctors familiar with handling work-related injuries with workers’ compensation claims. Under the North Carolina Workers’ Compensation Act, your employer or their insurance company can request information from the treating physician regarding your treatment and work restrictions. South Carolina law provides a similar provision, allowing your employer or their workers’ compensation insurance company to obtain medical records and reports from the approved physician who is treating you as part of your workers’ compensation claim.
You may not receive medical care benefits if you go to a healthcare provider other than your treating doctor without permission from your employer or their insurer. Doing so could result in your medical bills not being covered by their insurance, and you could be left paying out of pocket or using your own health insurance to pay for treatment.
Legal Regulations
Workers’ compensation liability is a form of no-fault insurance provided for the employer by the employee. The North Carolina Workers’ Compensation Act requires employers with three or more employees to carry workers’ comp insurance. In South Carolina, employers with four or more employees are required to have coverage.
Why Can’t I See My Doctor?
State-specific regulations influence the physician selection process. South Carolina law and North Carolina law require you to use one of the employer’s selected doctors unless you receive special permission to see a different doctor.
Employer Control
Employers or insurers select the doctors they allow injured workers to see so they can control costs and ensure the treatment aligns with the workers’ compensation system. By choosing doctors who agree to be paid by workers’ compensation insurance, employers can help their workers’ comp carriers manage the treatment process more efficiently, monitor the progress of recovery, and ensure that the medical care provided is necessary and appropriate. This system also aims to reduce fraudulent claims, as the selected doctors are trusted to give accurate and honest assessments of the injuries.
Compliance and Reporting
The employer’s approved physicians understand the specific needs and requirements of workers’ compensation cases and can communicate the medical information needed to process claims efficiently. By having consistent and reliable documentation, employers and their insurers can better comply with state regulations, and the workers’ comp claims process can run more smoothly.
However, this system is not perfect. An injured employee may be concerned about whether the doctor is acting in their interest or the employer’s so they can continue to receive business from them. If you are concerned about your treating doctor’s opinion, you can call our law firm for a free consultation with an experienced workers’ compensation lawyer to learn more about your legal options.
Can Workers’ Comp Force You to See Their Doctor?
Yes, workers’ compensation regulations can require you to see the doctor chosen by your employer or their insurance carrier. These regulations ensure that your treatment aligns with the company’s workers’ compensation policies and helps control costs. You may lose your benefits if you fail to comply with this requirement.
Your employer’s workers’ compensation carrier may require you to undergo an independent medical examination if there are disputes regarding the extent of your injuries or the proposed treatment plan. In an independent medical exam, a doctor who is not your treating physician evaluates your condition to provide an unbiased opinion. This exam can help resolve disagreements about your diagnosis, the necessity of specific treatments, or your ability to return to work. Refusing to attend this exam can put your benefits at risk, making it crucial to comply with these requirements to maintain workers’ compensation coverage.
On the other hand, you may also request an independent medical examination if you believe your treating physician is incorrect in their assessment of your injuries and impairments.
What If I Required Emergency Care?
After a work-related injury, it is critical to get proper medical attention. In some situations, you may require emergency care. Here is what you need to know about obtaining emergency medical treatment if you were injured on the job.
Immediate Treatment Rights
If you require emergency medical care after a work injury, you can seek immediate treatment from the healthcare provider of your choosing. Emergencies demand prompt action, and workers’ compensation recognizes the need for urgent care. However, you must notify your employer immediately after receiving emergency treatment and seek approval for continued care so your medical expenses are covered.
Coordination of Subsequent Treatment
While workers’ compensation typically covers emergency care, any follow-up appointments or subsequent treatment must be coordinated through the employer’s chosen medical providers. This ensures all ongoing medical care adheres to the company ‘s workers’ compensation policies and procedures. Following these guidelines can help maintain your eligibility for continued benefits and support recovery.
What If I Want a Second Opinion?
Employees have the right to seek a second medical opinion if they disagree with the initial assessment of their injury or treatment plan. A second opinion typically requires approval from your employer or the insurance carrier. To obtain a second opinion, you must follow specific steps and protocols. First, you must provide valid reasons for requesting a second opinion, such as disagreements with the initial diagnosis or proposed treatment plan.
If your request for a second medical opinion is denied, you may need to appeal to the North Carolina Industrial Commission or, in South Carolina, to the Workers’ Compensation Commission. A workers’ compensation attorney can help you argue your appeal before the state’s workers’ compensation commission board.
Let Our Experienced Workers ‘ Compensation Attorneys Help You with Your Claim
Understanding the workers’ compensation process can be challenging. Our attorneys at Stewart Law Offices have extensive experience handling workers’ compensation cases in North and South Carolina. We can help protect your rights. We can assist you in obtaining necessary medical treatments, filing claims, appealing denied claims, or requesting second opinions.
Contact Stewart Law Offices today for a free consultation to discuss your case and learn how we can help you secure the medical care and benefits you deserve. Let us take the stress off your shoulders and guide you through the workers’ compensation process.