When you’re hurt in a workplace accident, you must seek medical treatment in order to qualify for workers’ compensation. Depending on state law, injured workers have full say or none when choosing a doctor. However, choosing which doctor treats you may make you more likely to qualify for workers’ comp. A doctor who knows both you and your medical history will better estimate your recovery time. And you may qualify for workers’ comp faster, since they can vouch for chronic illnesses or older injuries. But who treats your workplace injury or illness really depends on your location — unless you’re a federal employee.
State Laws Govern Which Doctors Can Treat Injured Workers After an Accident
Every state has its own workers’ compensation laws and regulations. Some favor injured workers, while others favor the employer. For this reason, your workers’ comp protections and claims process will vary based on:
- How big your employer’s company is as well as where it operates
- Your Human Resources department’s guidelines for injured workers
- Whether you’re a contractor, seasonal/part-time worker or full-time employee
Knowing what protections your state’s WC laws provide can help when you’re hurt in a workplace accident.
Many Insurance Companies & Employers Control Which Doctors Treat Workplace Injuries
Employers and insurers alike are gaining more power over which doctors can treat workers hurt while doing their jobs. Currently, only half the states let workers decide which doctor treats their injuries. But in others, injured workers must choose an insurance-approved doctor from an employer-provided list. Each state has specific guidelines for how and when an employee can choose a doctor to treat workplace injuries. (For even more details, see USlaw.org’s state-by-state breakdown here. Sometimes an employer gets first pick, but injured workers may have the right to choose their ongoing care provider.)
States That Let Injured Workers Pick Which Doctor To See After An Accident
States that let injured workers pick their own doctor after a workplace accident include:
- New Hampshire
- New York
- North Dakota
- Rhode Island
- South Dakota
- West Virginia
- Washington D.C.
States Where Employers Choose Doctors to Treat Injured Workers
These states don’t let injured workers select their own physician after a workplace accident:
- New Jersey
- New Mexico
- North Carolina
- South Carolina
States With Employer-Specific Rules for Treating Injured Workers
The following states have employer-specific WC laws on who chooses the injured worker’s doctor:
- Arizona — Injured workers can choose which doctor to see, unless their employer’s self-insured. Then, the employer picks a doctor to treat their injuries.
- Florida — If an employer’s insurer uses a managed care network, then workers must select a doctor from that list. If either no list exists or the employer doesn’t use a managed care network, the worker may choose.
- Georgia — Workers select a doctor from an employer-provided panel. If none are available when the injury occurs, the worker can see any doctor they like.
- Kentucky — Injured employees must pick a doctor in their employer’s managed healthcare plan network. If none exists, then workers can see any doctor they choose.
- Texas — Since Texas is the only state where WC insurance is 100% optional, it has some confusing rules about doctors. Visit the state’s website to see which rules may apply to your case.
- Virginia — Employers maintain a physician panel for workers to choose from. If that’s not available, workers can then see any doctor at their employer’s expense.
For better insight into each state’s specific WC laws, visit the National Federation of Independent Business website. It’s important to remember that employee choice states give injured workers the right to choose the first doctor they see. Some states require injured workers to seek ongoing care from the employer’s preferred healthcare provider after that first visit. Other injured workers may choose a doctor from an employer-supplied panel of in-network providers. And still others may choose which doctor treats their injury long-term after an initial assessment.
You May Qualify for Legal Assistance
Whenever you don’t have a clear-cut workers’ comp case, you’re better off talking to a lawyer. Workers’ compensation attorneys can give confidential answers to all your claim questions for free. What’s more, these lawyers always work on contingency. That means you’ll owe $0 for legal assistance if your lawyer doesn’t win you a cash settlement. And if you do win, then you’ll only pay a small, one-time fee.
Ready to see if you may qualify? Click the button below to start your free benefits evaluation now!