What Happens if I’m Not Happy With My Workers’ Compensation Doctor?

Filing a workers’ compensation claim puts you at the mercy of the insurance provider. They get to choose the doctor you’ll see, and it’s quite possible you aren’t happy with the one they’ve selected for you.

Whether it’s because of their care, accessibility, or another reason, the insurance company ultimately has the final say in the matter. Opting to visit another medical professional outside of workers’ compensation’s approval can leave you stuck with the cost, and requesting a one-time change out of sheer frustration, is often not the answer; workers’ compensation gets to select this doctor as well.   If the situation becomes too complicated, it’s best to speak with a workers’ compensation attorney about your situation and explore your options with their guidance.

Can I See My Own Doctor?

Unfortunately, insurance providers won’t cover medical treatment outside of their network. They also won’t consider their testimony or findings as evidence if the case ends up in the courtroom.  There is one limited exception to this rule to, be used only when there is no other choice.  Florida law allows an injured worker to engage in self help, but only after a request for the specific treatment is made to the insurance company, and even then, only if there is a delay and denial of the care–and only if the care is ultimately determined to be necessary and causally related to your injury.  Also, emergency care–true emergency care–requires no prior authorization.  In any event, these issues are tricky and can rarely be navigated without legal guidance. 

It’s recommended that you work with the doctor they’ve provided you with as best you can. Explain the situation and propose accommodations or changes that can improve the experience. If they remain uncooperative, then you should inform your provider directly and consider speaking with a legal expert.

Can I Request a Different Doctor?

Under Florida law, you can request a one-time change, but it doesn’t give you the automatic ability to select the new doctor. Once again, the insurance provider makes the decision, and they may select a doctor that’s just as problematic, if not more so.

If you are seriously considering one, remember that the move may not work in your favor. It’s called a “one” time change for a reason: you get only one for the life of your case. Another change is likely off the table. Explain your concerns to a legal expert and weigh their opinion into your decision-making process, keeping the entire situation documented throughout.

How Should I Handle It?

You might not be able to choose your workers’ compensation doctor, but you can choose the lawyer you work with to overcome the common hurdles imposed by the insurance company selecting your doctor. . If you’re unable to work with the provided workers’ compensation doctor, the best way to handle the road ahead is to speak with a workers’ compensation lawyer early on in the process. Your situation likely has unique details, and it’s best to speak with someone about them and hear their legal opinion as you make your next steps. 

Morgan and Morgan has advocated for the rights of those in complicated workers’ compensation scenarios for more than 35 years. To speak with our team, complete our free, no-risk case evaluation.