Changing Doctors

What if you have done everything that your doctor has recommended, and you still haven’t fully recovered after a workplace injury? What if you and your doctor disagree over the next steps in your medical treatment? What if you and your doctor simply do not get along, and you are not confident in their continued medical care and treatment. Can you change your attending doctor? Yes. If you are dissatisfied with the medical treatment being provided by your attending doctor after a workplace injury, you can make a change.

Changing Your Doctor

There are three ways to switch your attending physician:

1. Get a referral from your present attending physician. Sometimes, even good medical treatment may not gain you the desired result. For instance, you might have undergone knee surgery, but the movement in your knee may not have fully returned, even with months of follow-up care and physical therapy. In situations where you have followed your doctor’s instructions, listened to their recommendations, cooperated and attended your scheduled appointments, and you have still not achieved your treatment goals, you are well within your right to seek another physician’s opinion. Your attending doctor may agree to refer you to another physician for a second opinion in the hope that you fully recover from your workplace injuries or illness. If your attending doctor refers you to another physician for further medical care and treatment, you will be permitted to change your doctor so long as you follow the treatment referral.
2. Obtain approval to change doctors from your employer’s workers’ compensation insurance carrier. Your employer’s representative may be equally dissatisfied with your attending physician’s treatment plan or results. They may have already paid for years of workers’ compensation benefits – including both wage replacement benefits and medical bills – without achieving your return to work. They may have questioned your attending physician’s recommendations but were overruled and forced to cooperate. If you can present a legitimate reason for changing your attending physician, and your new choice is someone respected within the medical field, your employer’s insurance carrier might agree with you and might be willing to authorize you to change physicians. Your employer’s insurance carrier’s goal is to fully resolve your claim for benefits as efficiently as possible. If a change in your physician will help both of you achieve your goal of a successful and healthy return to work, your employer’s insurance carrier may agree with your choice to change attending doctors.
3. Finally, where you and your employer’s insurance carrier cannot reach an agreement as to your request to change treating physicians, you can seek an administrative recommendation from the Administrative Law Judge assigned to your case. In situations where you cannot reach an agreement, you can petition for an Informal Hearing before the Administrative Law Judge. You have to file a written request for an Informal Hearing, and you will need to give written notice of your hearing request to your employer’s attorney or insurance carrier. Assuming you have valid reasons to request a change in your attending physician, the Administrative Law Judge may grant your request. You will need to specify a particular “new” physician, and you will need to provide specific detailed answers as to why your request should be granted. Poor treatment results alone may not be sufficient.

Drawbacks of Changing Your Doctor

Your employer’s attorney or insurance carrier will likely object to your request. They may claim that you are “doctor shopping” or “malingering” to continue receiving workers’ compensation benefits rather than return to work. They may object to the new doctor that you have selected. Treating with a new physician could delay the resolution of your case. Sometimes, you can’t be fully restored from your injuries. Sometimes, you are not able to return to work. In those situations, it may be better – for you and for your employer – for you to negotiate a final resolution to your case (and your employment).

Keep in mind that if you simply switch doctors without obtaining either a referral, an agreement, or authorization from an Administrative Law Judge, you will be considered to have engaged in unauthorized medical treatment. If this is the case, you will be held responsible for the payment of your treatment bills, and you may jeopardize your eligibility for additional benefits.

It can be difficult to change your attending physician. You may not get a helpful referral from your attending physician, who might be upset over your decision to change. Your request to switch your attending doctor may be challenged by your employer’s attorney or insurance carrier. In these circumstances, you need solid legal representation to support your request for treatment by a new doctor. Contact our workers’ compensation attorneys for additional help.