Can I Pick My Own Doctor In My Workers Comp? Or Do I Have To Use The Company Doctor?

December 19  

The Company Doctor? or My Own Doctor?

There's another thing that comes up all the time when I talk to people who've been involved in a work injury. So the question they have is, "The company wants me to treat with the company doctor, do I have to treat with the company doctor or can I pick my own?"

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Two Doctor Rule

The short answer is you can pick your own doctor. Under Workers comp, there's something called the two doctor rule. The best way to explain it is by an example. So here's the example, you go to a doctor of your choice and you don't really like that doctor. So then you go to a different doctor of your choice and then that second doctor refers you to therapy, x-ray, an MRI, a surgery center and an orthopedic specialist or a headache specialist.

Chain Of Referrals

Even though you've seen like a dozen doctors, that treatment falls within the two doctor rule. Because the two doctor rule says, you have to have treatment in the chain of referrals. You get a chain of referrals and you use both of them up. Because you didn't like the first doctor and so you went to a different doctor and then saw a bunch of doctors through that doctor. So because the second doctor referred you to all those people, it's in that second chain of referral so you're okay and they should have to pay.

Third Chain of Referrals

Now if you go outside the to doctor rule and let's say, in that scenario, you went to doctor one, then you went to doctor two and then you say, yeah I want an independent opinion. And then you go to a third doctor, but you're not referred to the third doctor. That's technically a third chain of referrals. And if you treat with the doctor outside the two doctor rule, the workers comp insurance may not have to pay that doctor. They'll still want to send you a bill and get paid somehow but you want to make sure that you're within the two doctor rule.

Company Doctor

Now, the company has a right to send you to their doctor and they have a right to have you examined as pretty much as much as they want. So if they set an appointment for you to be examined by their doctor, you have to go. You don't have a choice. They can cut off your benefits if you don't. But here's the difference, the doctor you choose is the guy who is going to direct all of your treatment. That's what a treating doctor does. Even though the company can make you be examined by their guy, their doctor doesn't actually give you treatment and more importantly their doctor does not direct treatment.

Just Building A Defense

In other words, their doctor doesn't get to prescribe you medicine or tell you, yes you can have therapy or no you can't, or yes to surgery, no to surgery. They pretty much just hire those company doctors to build a defense. The way it works with company doctors, is the company doctor gets referred a lot of injured people through the insurance company. So the company doctor is loyal to the company, not to the patient. Because that's the case, they know that the company doctor is going to write them a nice report saying that, you're exaggerating or you're not hurt as bad that thing.

Make Sure Doctor Is Legitimate

It goes to my last point. Sometimes people want to be treated by the company doctor and sometimes that's okay. If the doctor is legit and I know he's a really excellent doctor, then it's perfectly okay for you to treat with them. But there are a lot of doctors out there who are a hundred percent on the side of the insurance company. And that's obviously my concern. I don't want you to treat with a doctor who is all about protecting and saving the insurance company money and not really about protecting the patients. So if you decide to treat with a company doctor, it's your choice. But I would say be very very careful about doing it.

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