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Steps to Take if You Don’t Like Your Workers’ Comp Doctor

  • Published: July 27, 2023

If you have been injured on the job, dealing with your recovery can be a complicated and lengthy process. One of the most critical parts of this ordeal is finding a capable physician who can properly diagnose and treat your injuries or illness. Unfortunately, finding the right doctor to treat you through this challenging time is not always easy, and many individuals often feel stuck with their initial workers’ compensation doctor, no matter how unhappy they are. 

However, the good news is that if you are going through this challenging situation, you may have options, including finding a new workers’ compensation doctor that works better for you. 

The Tips You Should Try First With Your Current Doctor

If your workers’ compensation doctor appointments are not going how you were expecting them to, to cover your basis, you may want to try the following tips:

  • Bring a loved one with you. These individuals can act as “witnesses” and help keep the doctor from behaving non-professionally.
  • Keep calm, even if the doctor is being rude or insulting. This will be important if your case goes to court. 
  • Take detailed notes to help document what is happening. This documentation will not only help show how the doctor is acting inappropriately, but it will also show the healthcare professional that you are paying attention. 
  • Ask for a nurse to be present in the room. This can help keep the doctor accountable for what they say and do and give you another chance to seek clarification if needed.
  • Seek another opinion. If all else fails, you may be able to request another opinion with a different insurance-approved doctor. 

A workers’ compensation doctor is just like any other physician. Their primary purpose is to treat their patients, diagnose their issues, and get them the care they need. In addition, as a patient, you should expect your workers’ compensation doctor to act in a professional way, be courteous, and listen to your concerns. If they do not provide you with this care, you should be able to seek care from another doctor. 

Should You Ask for a Second Opinion? 

If you have been injured on the job, you have a right to obtain the best possible treatment. If you believe you are not getting this type of treatment, you have a right to seek a second opinion. Some of the more common scenarios where individuals want to explore their options of seeking a second opinion include the following: 

  • The treatment does not feel right or is unresponsive to the issues 
  • Before going for a serious surgery, such as an amputation, an individual wants another doctor’s advice 
  • The individual continues to be in pain, and the doctor has said that nothing more can be done
  • The physician refuses to listen to the individual’s complaints or opinions regarding the treatment
  • They do not trust the opinion of the physician and have a valid reason for this feeling

Regardless of your reasons, if you believe that the diagnosis, the treatment, or the treating doctor is inadequate and you are not getting the treatment you require, you have options, including getting a second opinion from another healthcare provider. However, the next physician you visit must be part of the Medical Provider Network or MPN. If you seek a second opinion from a doctor outside the network, the insurance company may refuse to pay bills related to the second opinion and any subsequent treatment and rehabilitation costs. 

The Steps You Should Take To Get a Second Opinion

If you are being treated by a workers’ compensation doctor and you want to challenge the medical treatment that is prescribed or are looking to obtain a second opinion regarding your injuries, there are certain steps you will need to follow. According to California’s laws, these steps include the following: 

  • Inform the claim’s adjuster and let them know you want a second opinion. This notification can be through writing or oral communication. Just be clear that you are requesting a second opinion. 
  • Choose a new doctor by checking reviews and the available MPN providers.
  • Make an appointment with the new doctor within 60 days. Otherwise, failing to schedule within this time can mean you have waived the second opinion process. 
  • Once the appointment is set, inform the claim’s adjuster of the new date.

Note that the insurance company or your employer will have the following responsibilities:

  • They must provide a regional area listing of all the MPN specialists and providers. This can help you find a physician that works best for you. 
  • They need to notify the second-opinion doctor that they have been selected for this matter and explain the nature of the dispute. In addition, because this communication needs to be in writing, they should also provide you with a copy.
  • They must provide the second-opinion doctor with a copy of all your medical records before the appointment. 
  • They need to acknowledge your right to a copy of your medical records. This means that if you request your records, they must offer them to you. 

After reviewing your medical records and information, if the second-opinion doctor determines that your injury is outside their scope of expertise, the medical professional will need to notify the claims adjuster. In these circumstances, your employer or the insurance company should offer you a new list of MPN providers or specialists so that you can try choosing again. 

Contact the Experienced Workers’ Compensation Attorneys at KCNS Law Group for the Legal Help You Need

While seeking a second opinion is within your rights as an injured worker, obtaining the right second opinion is not always easy and can become a draining process. In some instances, it can even risk you obtaining the compensation you deserve.

Fortunately, you do not have to take on this process alone. If you are considering filing a workers’ compensation claim or want to know more about second opinions, contact KCNS Law Group today. Call us at (818) 937-9255 or fill out our contact form for a free consultation.

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