Your Ability to Change Your Workers’ Compensation Treatment Provider
After suffering an injury at work, you may be surprised to learn that you do not choose your workers’ compensation treatment providers. You may be entitled to the benefits of workers’ compensation after being injured at your workplace during the scope of your employment, and this compensation usually includes medical care that is necessary to helping you recover. But additionally, you should understand that it is generally the authorized medical professionals chosen by the workers’ compensation insurance company who will subsequently decide on the treatment you need and that includes the specialized providers that you would like to see.
However, this does not mean that you are completely stuck with a doctor who is not a good fit for one reason or another, and it also doesn’t mean that you will never be able to see a specialist who you, in contrast with your workers’ compensation doctor, think is beneficial to your recovery.
Under certain circumstances, you actually CAN choose your own provider.
How Can You Change Providers?
Under Florida Statute Section 440.13(2)(f), every injured worker who is receiving workers’ compensation benefits is allowed a one-time change of physician during the life of the case. This process is initiated by the injured worker’s written request which the insurance carrier is required to provide notice of approval of to the worker within five days of receiving. Even if the carrier fails to provide the worker’s requested change of physician, the new physician chosen by the worker is still considered authorized so long as the provided treatment is compensable and medically necessary.
Fortunately, you are not stuck with a provider you feel does not have your best interest at heart which is especially important because there are dangers of returning to work too soon.
What is the Recent Case That Came Out of the 1st District Court of Appeals in Florida?
The case of Myers v. Pasco County School Board, No. 1D17-5457 (Fla. 1st DCA 2018) involved a situation in which an injured worker was attempting to obtain a one-time change from her orthopedic surgeon to a new orthopedist. Instead, the insurance carrier provided the injured worker with a neurosurgeon. The lower court judge found that this was substantial compliance with the injured worker‘s request. However, the injured worker appealed this decision and the 1st District Court of Appeals disagreed with the decision of the lower court because it found that the neurosurgeon was not the “same specialty” as the originally authorized orthopedic surgeon that the injured worker had requested to replace.
This case solidifies to employers and insurance carriers that they are required to comply with the statute and cannot substitute a different kind of specialist than the kind requested by the injured worker simply because it is more favorable to do so from its viewpoint.
Do You Have Questions About Your Workers’ Compensation Claim?
With the care of experienced attorneys, you can focus on ensuring that you recover from your workplace injuries while we focus on ensuring that you obtain all of the benefits that you are entitled to. The Miami workers’ compensation attorneys at Payer & Associates have significant experience helping people like you. Begin by contacting us today to schedule a free consultation.
Resource:
1dca.org/content/download/214940/1915564/file/175457_1287_06042018_10594362_i.pdf
https://www.payerandassociates.com/how-video-surveillance-can-affect-a-workers-compensation-claim/
