Can I Change Doctors if I’m Not Satisfied with the Medical Care Provided Under Workers' Compensation?

Florida job injury victims have a limited right to see their own doctors.

Not exactly, and not in Florida. Initially, most job injury victims must see company doctors, or at least doctors that insurance companies designate. Because they essentially serve two masters, these doctors are in difficult positions.

The late, great Bill Walton is a good example. When the free-spirited Walton joined the Portland Trail Blazers in 1974, it seemed like a match made in heaven. But Walton struggled with foot injuries. According to him, the team doctors kept telling him he could play. Then, when he played, his foot injury got worse. After missing the entire 1978-79 season, Walton left the team.

Although the law requires Florida job injury victims to see team doctors, mostly to prevent another tragic outcome like Walton’s, this law is full of exceptions and loopholes. So, in most cases, a Tampa workers’ compensation lawyer can ensure that victims get the medical treatment they need, not the medical treatment an insurance company or employer is willing to pay for.

Initial Doctor Choice

The lack of choice is usually most prominent in hearing loss, toxic exposure illness, repetitive stress injuries, and other occupational disease claims. The first time these victims see doctors, they must see employer-designated doctors. Otherwise, their claims may be summarily denied.

Insurance companies/employers retain control beyond the initial doctor visit. The law also limits referrals to specialists and other such care.

Fall and other trauma injury victims have it a little better. These victims may seek treatment at the closest available trauma clinic or other facility, which is what they would probably do anyway. Although the employer controls subsequent treatment, at least trauma injury victims get to see an undesignated doctor without jumping through hoops.

Florida law does give all job injury victims one chance to change their treating physicians. A Tampa workers’ compensation lawyer must submit a written request to the insurance carrier.

But this process does not offer true freedom of choice, at least in most cases. The insurance company designates another treating physician. However, if insurance companies fail to respond to change requests within five days, injured workers can truly choose their own doctors.

Major Exceptions

Most Claims Examiners deny most workers’ compensation claims. These denials give injured workers the right to seek independent medical examinations (IMEs) from doctors who are not affiliated with employers or insurance companies.

The managed care exception often comes into play even earlier. Most workers have HMOs, PPOs, or other managed care plans. These victims may choose any in-network provider. These providers are loosely affiliated with insurance companies, but since most doctors accept patients from multiple plans, they are not financially bound to a particular employer.

The final major exemption is insurance company inactivity. It is similar to the exception discussed above. If the insurance company refuses to let an injury or illness victim see a doctor, the worker may have freedom of choice in this area.

One final note. Even if injured workers are initially assigned doctors by insurance companies, they can still seek a second opinion from another physician of their choice, if that second opinion is a consulting opinion that does not disrupt any ongoing treatment with the designated doctor.

Work With an Expert Hillsborough County Lawyer

Victims need and deserve compensation for their serious injuries. For a confidential consultation with an experienced workers’ compensation lawyer in Tampa, contact the Rooth Law Firm. Mr. Rooth is a Board-Certified attorney in workers' compensation law by the Florida Bar Association, a distinction that fewer than 1% of all Florida lawyers have.