If I am injured at work, can I choose my own doctor?

This is a good, and well argued question. The short answer is that it depends.

First, if you are injured at work and you make a claim for Workers’ Compensation benefits, and that claim is denied, then you may seek treatment from any doctor you wish. The caveat is, in such a case, that you will be responsible for paying for that treatment, at least if and until you settle or win your Workers’ Compensation claim.

In the event you are injured at work and you make a claim for Workers’ Compensation benefits and your claim is accepted by the employer/carrier, then the employer/carrier will usually have the right to select a treating physician. This is not always the end of your opportunity to select your own treating physician. In some emergency situations, treatment may have begun before the employer/carrier has a chance to select a doctor of their own. In these cases, if treatment has already begun and is proceeding with a doctor you have selected, then a change may be only available if the employer/carrier makes a motion to change treating physician in front of the Industrial Commission, which is the court system for Workers’ Compensation claims in North Carolina.

Also, you may have an opportunity to make a motion to the Industrial Commission to change your treating physician if the employer/carrier had selected one for you and the treatment is not progressing properly. Your legislators in Raleigh have decided that in order to have your treating physician changed to a doctor of your own choosing, then you must prove beyond a preponderance of the evidence (more than halfway) that the change is reasonably necessary to effect a cure, provide relief, or lessen the period of disability. Your North Carolina legislators have also decided that when you are seeking to choose the doctor who will treat you, the Commission may disregard or give less weight to the opinion of a health care provider from whom the employee sought evaluation, diagnosis, or treatment before the employee first requested authorization in writing from the employer, insurer, or Commission. (N.C.G.S Section 97-25) You can find more information on the North Carolina Industrial Commission website at www.ic.nc.gov.

So, while it is not easy to change your treating physician in an accepted claim, the law provides for a process in which to do this. It has been the experience in our office that most carriers want injured employees to return to work as soon as possible, and this usually means providing the best and most efficient medical care. Of course, insurance carriers have a natural interest in paying less for medical care and not paying for excessive tests and procedures.

Carriers appear to seek a balance struck between the expense of medical treatment and the quick return of a worker to gainful employment. This is not always something that feels like it is in the best interest of the injured worker.

When you have been injured at work and you face these issues, look for the help of an attorney who practices in this field and has dealt with these questions before.