Whether you suffer an illness or injury that requires medical attention, you want to be certain that whoever attends to your needs is the right healthcare provider for the job. This is true whether your illness or injury is job-related or otherwise.
However, in North Carolina, you can’t normally pick the doctor who gets to treat your work-related illness or injury. Your employer (or their insurer) has the right to select the healthcare professional you’ll see for your workers’ compensation claim. Some employers might even have a panel of physicians that you can pick from, but you still can’t select an outside provider.
It’s possible to change doctors to the one you want, but only after you’ve paid a visit to the provider your employer has initially assigned.
Approval for healthcare provider switch
Before you see another doctor, you’ll have to submit a request to your insurance adjuster first. You’ll need to explain why you want to change – perhaps you want a second opinion on your health condition, or you’re unhappy with the employer-recommended doctor’s treatment.
If the adjuster denies your request, you may petition the North Carolina Industrial Commission for a physician change. Of course, you’ll still have to prove why you need to switch doctors.
You’ll want to receive approval for the switch from either the insurance adjuster or the Commission because payment for medical expenses from a doctor not supported by your employer or carrier isn’t guaranteed.
The right to quality care
Remember that the goal of workers’ compensation is to ensure that you’re receiving the best possible care to recover from your work-related injury or illness. You should document all your concerns about the treatment you’re receiving from the employer-recommended doctor because this will prove why you’re unsatisfied with the provider’s medical service.
If you continue to encounter resistance to your requests from your employer or carrier, consider consulting a legal professional. An attorney can help you navigate the complex workers’ comp process and appeal a denied doctor switch.