The insurance company picks the medical provider. The injured worker can request a change in treatment.
When you need a doctor, of course you choose to go to the one you know and trust. But when you have a workers’ comp claim and the insurance company is paying for your medical treatment that is not the rule. You must accept the treatment provided for you by the insurance company unless you have permission to go elsewhere. And if you go in your own for treatment you could even endanger your rights to get your compensation. Perhaps you want to see your own doctor so much that you are willing to pay for a second opinion. You still need to know the proper way to have that opinion count.
Chris’ Workers’ Compensation Case
Chris, a bus mechanic, fell at work on a slippery floor in the garage. By the end of the day it was clear that his knee was getting worse and he reported the injury. He was told to go to the urgent care center where he was given work restrictions, including no lifting objects heavier than 50 pounds. With no work fitting that description available for him at the bus company, Chris sat at home.
The only treatment offered to Chris was physical therapy and return visits to the physician’s assistant that he thought didn’t listen to him and wasn’t making him any better. So he went to see an orthopedic surgeon on his own. That doctor, Dr. Goode, performed an MRI and scheduled surgery for three weeks later. Chris put the MRI on his health insurance that he got through work. But when he received a letter from the health insurer asking if the treatment was work-related, he didn’t know what to do.
Chris called the workers’ comp insurance adjuster, who was angry that he had gone to an unauthorized doctor. She refused to pay for the treatment with Dr. Goode and threatened to stop paying for any treatment at all. Chris was confused: how could his workers’ comp claim go so bad, so quickly?
READ MORE ABOUT CHRIS’ WORKERS’ COMPENSATION CASE, AND GET OUR TOP 10 TIPS FOR WORKERS’ COMPENSATION CLAIMS IN NORTH CAROLINA BY DOWNLOADING A FREE COPY OF WORKERS COMP 101 HERE.
Author Bio
Valerie Johnson
Founder
Valerie Johnson is a North Carolina personal injury and workers’ compensation attorney dedicated to helping injured and working people across the state. A board-certified specialist since 2000, she is the Immediate Past President of the North Carolina Advocates for Justice and author of North Carolina Workers’ Compensation Law: A Practical Guide to Success at Every Stage of a Claim.
