How Doctors Are Selected In Workers' Compensation Cases

As an injured worker, the Workers’ Compensation process can be overwhelming and frustrating, particularly when it comes to getting medical treatment for your injuries. We have talked with many workers who have run into similar issues, with long delays to see doctors, with not having a choice in which doctor they see, and with worry over whether they’ll be able to receive ongoing medical treatment after they move.

Antonio Bruni is a workers’ compensation attorney at Michles & Booth who has experience working for employers and employees in workers’ comp cases. In this blog post, he talks about these three important questions about doctors in workers’ compensation cases.

Why is it taking so long for me to see my doctor?

This is the most common concern that injured workers have. The wait times to see doctors can be longer in workers’ comp cases than in other cases. This can be caused by two factors.

First, the doctor can be very busy, especially when you are trying to get into seeing specialists, orthopedic surgeons, and neuro surgeons. If you were a cash pay patient or had private health insurance, their wait time can be six, eight, or even twelve weeks to get in if it’s not an emergency basis.

When you add the extra red tape of Workers’ Compensation, a normal wait time to get in to see a specialist in workers’ comp case can be two, three, four months, which is fairly standard throughout the medical profession. A lot of it has to do with the doctor’s offices and them being very busy, so there’s not much we can do to speed that up.

The second factor that can be affecting the wait time is the adjuster. The adjuster who has been assisted in your case could be just ignoring your claim. This is something that we can speed up. We can file a “Petition for Benefits” which is basically asking the judge of the compensation claims to get involved and order the insurance carrier to authorize the doctor. That’s usually enough to light a fire under the adjuster, getting them to authorize the doctor.

If you are experiencing a delay in getting in to see a doctor, you will want to talk to an attorney to try to pinpoint what the problem is. Is it the adjuster ignoring your file? Or is it your doctor’s schedule backed up? If you’re asking for a specialist in an area like neurosurgery in north west Florida, there are very limited doctors that can do that, so there’s going to be a wait no matter who’s paying the bill, whether it’s Workers’ Compensation or Blue Cross, Blue Shield.

Why can’t we pick our doctors?

One of the basic rights that has been taken away from injured workers in the state of Florida is the ability to choose their physician.

The Florida Legislator took the right to choose your physician away from injured workers and gave it to the insurance companies. They pick which doctors you can and cannot see. As an injured worker, you have the right to a one-time change but, as it implies, you can only do it one time throughout the life of your claim. And the new doctor is also chosen by the insurance companies – not you.

You never get to pick your doctor in a workers’ comp case, which means that the doctors who are chosen tend to be more insurance company friendly. You need to keep this in mind when you are seeing these physicians; just because they tell you something, that doesn’t mean you have to agree with it.

If a doctor tells you something that you don’t agree with, you might need to seek the counsel of an attorney. The doctor can tell you that there is nothing wrong with you, but you know your body better than they do. Yes, they have gone to medical school, but they don’t live inside of your body. If they tell you that nothing is wrong but you think something is, you need to see an attorney.

If they tell you that everything is pre-existing, but you’ve never been to a doctor before for the injury/condition that you’re complaining of that happened at work, you need to see an attorney.

I want to be very clear – there are a lot of good doctors out there. A lot of workers’ compensation doctors are very good doctors, but there are some that are very clearly not on your side. These doctors don’t want to bite the hand that’s feeding them, and you need to take what they say with a grain of salt. Be skeptical of what they say and see an attorney if you disagree with what they are saying.

What happens to my medical treatment if I move?

This is a less common question that comes up, and the answer is quite surprising. Your workers’ comp claim and your right to medical treatment are not bound by your employment or where you are living. So, if you need to move, the insurance company has to provide you with a doctor close to your new location.

That means that if you have to move from Pensacola, Florida to Tampa for work or for family, the insurance company has to provide you with doctors in Tampa. If you find a better job working in the oilfields in South Dakota, they have to find you a doctor in South Dakota. At our firm, we had a client who wanted to move to a semi-retired state in Merida, Mexico, and she was born and raised in the Florida Panhandle. The insurance company has to provide her a doctor in Merida, Mexico.

If you need to move out of the city, county, state, or country, the insurance company has to provide you all new doctors wherever you move. And if you have to move back, they have to provide you all new doctors when you move back. And if you need to move again, they have to provide you all new doctors again.

They can’t say that your moving around is inconvenient for them. They can’t say that they’ll just put you on a 40-hour cab ride to come back and see your doctor here. If you need to move, they get to provide you a new doctor, no matter where you’re moving to.

Have questions about your case?

If you have any questions about your workers’ compensation case, just give us a call. We have free initial consultations with no obligation. We’d be happy to talk to you about any of these issues or any other issues you’re having with your Workers’ Compensation or social security disability claim. Give us a call or contact us online!