Legal•Info

Can I Be Treated By My Own Doctor

When an employee reports an on-the-job injury and requests medical attention, the employer or the workers' compensation insurance company is obligated by law to select a provider and arrange for the necessary care. Often the selected physicians are specialists, or have additional training in occupational medicine. Initially, the employees own physician will not treat him or her for a work-related injury, and the employees personal health insurance provider will not approve expenses to personal physicians for on-the-job injuries. Therefore, the employee will be obligated to pay out of pocket for all expenses that do not have prior approval.

Just like a personal physician, the occupational medicine practitioner will have standard credentials as required by the state for any doctor, and may also have additional credentials earned through supplementary study and practice. However, this is a doctor whose own interest is in serving the best interest of the employer; therefore his or her statement to the employer or insurance company will have significant impact on the outcome of benefits paid or provided under the claim. The physician/patient relationship should remain closely guarded, and any information provided to an occupational medicine practitioner kept to a minimum.

The doctor's report will have a tremendous impact on the benefits that the employee will receive. The employee should bear in mind that the doctor is paid by their employer, and the doctor may be inclined to downplay the seriousness of the injury in order to receive future patients from the business. Unless they have had previous significant injuries in the past, it would be against the employee's best interest to delve deeply into their medical history.

If an injured employee has an objection to the physician, facility, or treatment received, or if he or she would like a second opinion, a request must go through the assigned claim adjuster. It is wise to have a copy of specific state laws, and to understand their intent regarding each aspect of the workers' compensation process. Some state laws allow the injured employee to be treated by his or her own physician after a specified period of time, and some state laws grant the right to second opinions.

An insurance company or self-insured employer is obligated to provide a disclosure of rights to an injured employee but that disclosure is not the comprehensive content of the law. It is the claimant's responsibility to take the initiative to discover what he or she needs to know in order to use what is entitled by the law. While a claim adjuster may be a friendly person who appears to be interested in helping, this person's real job is to keep costs to a minimum while adhering to the law. The claim adjuster is not likely to volunteer additional services. It is up to the injured party to contact the adjuster and make a clearly stated request for whatever he or she feels is needed for a fair execution of the claim.

Anyone who has been injured on the job, or who has contracted an illness as a result of working conditions, should consult with a qualified workers' compensation attorney as soon as possible after stopping work. The attorney can advise the injured employee about the entire process of the workers' compensation claims process, and guide them through the confusing and sometimes intimidating health-care channels. The attorney will help the employee by taking care of the legal matters, so that the injured employee can focus on getting better.