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Who gets to pick the doctor you see after you get hurt at work?

On Behalf of | Jan 27, 2021 | Workers' Compensation |

The worse a workplace injury or job-acquired illness is, the more medical care you need to fully recover. Some workers only need first aid, but others could require hospitalization or extensive rehabilitative care.

While you may not care about who bandages a minor contusion that you suffered at work, you may have stronger feelings about the surgeon who will have to operate on a hernia or the professional overseeing your physical therapy and rehabilitation. 

Workers’ compensation insurance is a kind of coverage carried by companies that protects them from liability and their workers from financial losses if they get hurt or sick and due to their work. The laws on workers’ compensation claims in Virginia aim to balance protections for workers with the practical needs of companies paying for coverage and care. Who gets to decide what doctor you see when you receive medical care paid for with workers’ compensation benefits?

Your employer has the right to limit the pool of physicians

Doctors, hospitals and medical practices have different billing rates and insurance policies. Insurance companies negotiate special reimbursement rates with their preferred physicians and care providers to help keep their costs low.

Your employer and their insurance provider have a say in the care that you receive after a workplace injury or a diagnosis with a work-acquired illness. They can provide you with a list of acceptable physicians that you can pick from when you need care. That means they might eliminate physicians that you have a relationship with because those doctors don’t participate with their insurance or meet certain other requirements.

However, while the company can limit the physicians that you choose from, they can’t demand that you see a certain doctor.

The ultimate decision is up to the patient

While you can’t simply pick any medical professional that you want to see, you do get to have the final say in who oversees and provides your care.

Provided that your medical care provider is on the list of approved providers from the insurance company or your employer, you get to make a decision about who you are most comfortable working with during your upcoming recovery. Pushing for your rights, including your right to determine who provides care, often requires support and information about how workers’ compensation benefits work.