Can I Choose My Own Workers’ Compensation Doctor?

Can I Choose My Own Workers’ Compensation Doctor?

If you’ve been injured at work, then you may be eligible to file a workers’ compensation claim. As part of the claim process, you are asked to seek medical treatment after obtaining necessary first aid and care.

Workers’ compensation is a type of insurance that will pay injured workers with cash benefits, while also providing medical care, if an injury or illness occurs because of their job responsibilities.

Employers are responsible to pay for this insurance. Employees do not contribute to the cost of this type of insurance policy. When authorized by the Workers’ Compensation Board, weekly cash benefits and medical care are paid by the insurance carrier which holds the policy for the affected employer.

The amount you receive is not decreased because of personal carelessness or increased because of employer issues.

Many workers want to know if they can choose their own doctor if they have a workers’ compensation incident at work. In many cases, employees can choose a doctor that has been authorized by the Workers’ Compensation Board, such as the specialists on our team.

There are notable exceptions to this capability. If your circumstances meet these exceptions, then your choice of doctor may be limited.

#1. Your injury is a medical emergency.

The Workers’ Compensation Board puts the health and welfare of the worker above anything else. If your injury qualifies as a medical emergency, then you can seek treatment from any doctor. Immediate treatment may require a visit to an emergency room, which would be covered.

What qualifies as an emergency can sometimes be difficult to define. Everyone has different medical needs. The bottom line is this: if you feel like you need to go to the emergency room, then go.

#2. Your employer is a PPO or ADR participant.

In the State of New York, some employers are authorized to participate in an Alternate Dispute Resolution program or a Preferred Provider Organization. Workers that are injured on the job, with a non-emergency injury, may be required to obtain their medical treatment from a provider that participates in these programs.

You will know if your employer is a participant. The State of New York requires participating employers to notify all employees, in writing, of the details that pertain to the program and what they should do if they suffer a work-related injury.

#3. You have specific tests or medicine that is required.

Some work-related injuries may qualify as a non-emergency, requiring specific treatment options to promote wellness. In this situation, the insurance carrier may require you to obtain your tests from a diagnostic network or a designated pharmacy.

Our clinic is a diagnostic and treatment center.

Some employers may have the ability to require injured employees to obtain tests or medicine from designated providers because of authorized contracts they have negotiated.

The guidelines in this area should be provided by your employer. In many instances, they are visibly displayed in a high-traffic area at your workplace. These requirements should also be available through your human resources representatives.

The amount you receive is not decreased because of personal carelessness or increased because of employer issues.

Section 32 Waiver Agreements occur when an injured worker and the insurance provider settle on a lump-sum benefit payment. This is a decision that is between you and the provider – not your workers’ compensation doctor. Agreements must be approved by the Workers’ Compensation Board before they will be treated as a valid and binding document.

Once the agreement is approved, no ongoing or future benefits are paid. Any future visits or treatments become the responsibility of the individual.

What to Do if You Suspect Employer Discrimination

If you have been injured at work, for any reason, then employers are not permitted to discriminate against you. They may not fire you or discriminate against applicants who have attempted to claim workers’ compensation. Workers who may testify in proceedings or who have testified are also protected by this provision.

If you believe your employer may have discriminated against you because of a claim, you have up to two years to file Form DC-120. Send the completed for to the Workers’ Compensation Board.

Workers are also protected by the Americans with Disabilities Act of 1990.

Most employees who suffer a work-related injury are permitted to choose their own authorized doctor to treat their condition. Workers are also protected from discrimination while pursuing a workers’ compensation claim.

If you’ve been hurt at work, then follow the necessary procedures and then schedule your appointment right away. That way, you will have access to all your potential rights and benefits.