Can I Choose My Own Doctor for My WC Claim

If you have suffered an injury at work, you may be entitled to compensation for lost wages and out-of-pocket medical expenses. Immediately after being injured, you must seek medical attention and then be evaluated by a health care provider. At EMD Law, we are often asked whether or not individuals can choose their own healthcare provider to treat them for a work-related injury. The answer, however, is not a straightforward yes or no as there are several factors at play.

In many cases, your employer or their insurance carrier will opt to to use a network of providers known as a Preferred Provider Organization, and because of this, you will be required to seek initial care from one of these providers. You will be notified of this in writing, and you will have access to a list of the providers within their preferred network.

While you must use one of their preferred providers for your initial treatment, after 30 days you may select any authorized healthcare provider outside of their PPO if you feel you are not receiving adequate care. You must notify our employer or their insurance provider in writing to inform that that you will be selecting a new provider that is not within their PPO.

In some cases, you may be able to choose your own healthcare provider if your employer or their insurance provider does not opt in to a PPO. While you are able to choose your own provider, be aware that they still have to be accepted by your states Workers’ Compensation board to ensure that they are qualified to evaluate and treat work-related injuries and illnesses.

There are benefits to choosing a provider that is within the PPO, or is known for treating work-related injuries. These benefits include being treated by someone who is very familiar with work-related injuries, the steps they have to take, and the information they must relay for workers’ compensation claims. Your provider is required to create reports regarding your diagnosis and treatment, and send those reports to the workers’ compensation insurer. If you are unable to work for an extended period of time, and in order to remain eligible for lost wage benefits, medical reports are required every 90 days. While choosing a doctor that you may have an established relationship with can provide comfort, they may not be as familiar with the workers’ compensation process. This could potentially cause delays or complications in your claim.

Our Erwin, McCane, and Daly team understands the ins and outs of workers’ compensation, and the extreme importance of receiving the benefits you deserve after being injured at work. If you are unsure about your options, or have questions regarding your claim,  contact our team today.  Having a qualified attorney to walk you through your options and help you make informed decisions can ensure that you receive the care and compensation you are entitled to. Visit our website to learn more or request your free initial consultation today!