Can You Choose Your Own Doctor for a Work Injury?

After being involved in a work-related accident, you may be anxious to get the medical treatment and care you need to recuperate. If you have a primary care doctor or prefer a specific hospital location, you may be able to use that provider if you are in an emergency situation. Otherwise, you will need to obtain a list of pre-approved doctors and healthcare facilities from your employer and use one of these options for your medical treatment.

If you do not use your employer-selected physician, the insurance company may refuse to cover your medical expenses. If you have just cause to choose your own doctor for a work injury, you may be able to convince the insurance company your benefits should still be covered with help from a trial-tested Atlanta workers’ compensation lawyer from John Foy & Associates. Find out more about how to get your personal physician to handle your injuries and what to expect from your workers’ comp claim when you contact our office for a free consultation.

What Are Workers’ Compensation Benefits?

Your employer may provide you with workers’ compensation benefits that offer some financial protection in the event you suffer a work-related injury. Benefits are designed to help you cover necessary expenses while you are temporarily out of work. Examples of such benefits, according to the Georgia State Board of Workers’ Compensation (SBWC), include:

1. Wage replacement disability benefits of up to 66 ⅔% of your income
2. Complete coverage of injury-related medical expenses
3. Vocational rehabilitation benefits when you need further training
4. Death benefits for surviving family members when workers suffer fatal injuries

However, to obtain these workers’ comp benefits, you need to comply with state laws. This means you will need to see a pre-approved healthcare provider to get your medical expenses covered, according to the Georgia Department of Community Health. If you do not see an employer-approved doctor, it may be more challenging to get the insurance company to cover your healthcare costs.

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Georgia Workers’ Comp Laws

Every company that has three or more employees is legally mandated to protect their workers with workers’ comp insurance coverage, according to the Georgia State Board of Workers’ Compensation (SBWC). This means employees who work full-time, part-time, temporarily, or seasonally should be protected. However, certain types of workers, including farm workers and railroad carriers, for example, may be exempt from these laws.

You do not need to prove that someone else is at fault to collect workers’ compensation benefits. As long as your injuries occurred while you were working, you should be eligible. However, if you were under the influence of drugs or alcohol, violating your employer’s code of ethics, or were not on the clock at the time of the incident, you may be disqualified from workers’ compensation.

If someone else is responsible for causing your work-related injury, you may have the right to file a third-party liability claim against them. According to the Georgia State Board of Workers’ Compensation Employee Handbook, you give up your right to file a personal injury lawsuit against your employer in exchange for workers’ comp protection coverage. However, if someone else is at fault, filing a personal injury lawsuit gives you an opportunity to recover certain types of damages workers’ comp does not pay for, including emotional distress, pain and suffering, and reduced earning potential.

What to Do Immediately After a Workplace Accident to Collect Workers’ Comp

Immediately after your work accident, you need to report the incident to your employer. Georgia law, according to the SBWC, requires you to report your injury to your employer within 30 days. In emergency situations, you can select the hospital or doctor of your choosing.

However, if it is not an emergency situation, you can speak with your employer to find out which facilities and doctors have been pre-approved. Do not hesitate to get medical help. These medical records will be valuable evidence that can be used to prove the severity of your injuries.

Once you have been evaluated, follow your healthcare provider’s treatment protocol. Failure to comply with your doctor’s treatment plan could result in your workers’ comp benefits being terminated. If you are unhappy with your treatment or diagnosis from your employer-approved healthcare provider, contact your workers’ compensation attorney to find out whether you can get a second opinion from a doctor of your choosing.

When Can I Choose My Own Doctor for a Work-Related Injury?

Employers have discretion when choosing which healthcare providers should be used to treat their employee’s work-related injuries. There are several ways in which your employer can inform you of available doctors. These include:

• Working with a Worker’s Compensation Managed Care Organization (WC/MCO), which is governed by “managed care organization procedures.”
• Posting a list of at least six professional associations, corporations, or physicians that the employees can choose.

The panel of physicians list must include up to two industrial clinics and at least one orthopedic doctor, according to the SBWC. Employees do have the authority to switch to other pre-approved doctors without obtaining authorization. The pre-approved physicians have the authority to refer injured workers to other specialists as needed.

How to Get a Second Opinion

If you believe the authorized doctor has misdiagnosed you, you have the right to request an independent medical evaluation (IME). According to the link above, you must request an IME within 120 days of receiving wage disability benefits. Your physician will not be able to repeat diagnostic testing or procedures that have already been completed unless you are willing to cover the costs should they exceed $250.

Consult a Top-Rated Georgia Workers’ Compensation Attorney for Help Protecting Your Rights Today

Your employer has the right to select pre-approved healthcare providers and facilities. If your doctor is not on this list, in an emergency or other justifiable situation, you may be able to choose your own healthcare provider. If you are unhappy with the medical treatment and care you receive from the physician your employer chose, you may be able to get a second opinion from your own doctor.

Do not make the mistake of choosing a healthcare provider that is “out of network.” You do not want to get stuck covering the costs of your medical care. Your dedicated workers’ compensation lawyer from John Foy & Associates can help you assert your rights and access the financial support you need when you contact our legal team by phone or through our quick contact form to schedule a free consultation today.