Workers' Compensation Medical Treatment Frequently Asked Questions
Workers’ Compensation Medical Treatment
North Carolina’s Workers’ Compensation law restricts an injured worker’s ability to select a doctor. Generally speaking, the employer, or the employer’s insurance company that administers workers’ compensation claims, chooses the doctor and directs the medical care dealing with work-related injuries. If you are injured on the job, you should ask your human resource’s office or the worker’s compensation administrator where to go for medical care after an on-the-job injury. Some large employers may have a doctor on site.
In other instances, the employer or insurance provider may have a list of doctors from which to choose an approved physician to treat your workplace injury. It is important that you follow your doctor’s orders. If you disregard the doctor’s orders or miss follow-up appointments, you may jeopardize your workers’ compensation benefits.
Your employer can request information from the treating doctor regarding the course of treatment of your work-related injury and the estimated time out of work, work restrictions and anticipated time of work restrictions.
If you require emergency medical care, you may seek the necessary treatment from a doctor or hospital of your own choosing. But you must promptly notify your employer of your injury and ask for approval of the emergency treatment. If the employer disputes the treatment, you may file a petition with the N.C. Industrial Commission seeking authorization of the emergency medical care. The industrial Commission is the state agency that administers the Workers’ Compensation Act.
You also have a right to choose your own doctor to give you a second opinion on your level of disability. If you have received a permanent disability rating after recovering from a work-related injury and you disagree with the rating, you can select a doctor to re-examine you and provide a disability rating.
An employee who has been injured may petition the Industrial Commission for permission to change doctors or approve a doctor chosen by the employee when there is a valid reason to do so.
Requesting a change of doctors to treat your work-related injury can lead to a dispute with your employer or the insurance company overseeing the workers’ compensation claim. You may need the help of a knowledgeable workers’ compensation lawyer to advocate on your behalf and help you present a persuasive case to the Industrial Commission to order a change of physicians. Younce, Vtipil, Baznik & Banks, P.A., has attorneys who are Board-Certified Specialists in North Carolina workers’ compensation law, a distinction held by only a small portion of attorneys in the state.
An injured employee who has claimed workers’ compensation after an injury is required by law to submit to an independent medical exam if requested to do so by the employer or the employer’s insurance company. Independent medical exams are authorized by the North Carolina Workers’ Compensation Act. An injured employee who refuses to submit to an IME if requested may lose his or her workers’ compensation benefits or have them suspended.
If the insurance company requests an IME, it may be a signal that the insurer is preparing to dispute some issue in your workers’ compensation case, such as the need for surgery, for example. If your employer or the workers’ compensation insurance administrator has asked you to have an IME, you may want to speak with a workers’ compensation attorney about your rights. An experienced North Carolina workers’ compensation lawyer can discuss how best to respond to a request for an independent medical exam.
The independent exam must be conducted at a reasonable time and place by a doctor licensed to practice in North Carolina. As an injured employee, you have a right to have present during the IME your own doctor, chosen and paid for by you.
If a doctor conducts a physical examination of the injured worker as part of the independent exam, the employer is required to provide a copy of the doctor’s report to the injured worker within 10 business days of the employer receiving the report. The report should be provided along with all documents and written communications pertaining to the employee.
North Carolina law provides the employee some rights regarding IMEs. If you have been released from medical treatment and are still experiencing pain, you may seek an independent medical exam to determine whether other treatment is needed. You should not have to live in chronic pain due to a work-related injury. But the insurance company may resist your request for additional medical treatment. You may need the assistance of a knowledgeable workers’ compensation lawyer to apply to the Industrial Commission for approval of your request for an independent medical examination.
If the treating doctor determines that you have reached maximum improvement and releases you from treatment to return to work, you can request a second opinion about treatment recommendations. You have a right to propose a doctor to conduct an independent medical exam. If you and the workers’ comp insurance administrator cannot agree on a doctor to give a second opinion, you can file a request with the Industrial Commission to agree to a second opinion with a doctor that you have chosen.
If the insurance adjuster disputes your request for a second opinion, it is helpful to have an experienced workers’ compensation attorney arguing on your behalf to justify your request for a second opinion. Your company’s workers’ compensation adjuster will have a lawyer or experienced representatives making arguments as to why your request should be denied. You should have legal representation too, or you will be at a disadvantage.
Under the North Carolina Workers’ Compensation Act, you also have a right to get a second opinion if you disagree with your permanent disability rating assigned by the doctor who treated your work-related injury. You are entitled to have another examination focused on your disability rating by a doctor of your own selection. The doctor shall be paid for by the employer.
If you sustain an injury on the job, you should ask your employer’s personnel office or the worker’s compensation administrator where to go for medical treatment. Your employer or the insurance company is in charge of your medical care for a work-related injury and may send you to a specific doctor.
Our experienced attorneys have worked with many doctors who treated injured workers in North Carolina. If we represent you, we can help you get a referral to a doctor to provide a second opinion about your work-related injury. Our attorneys are dedicated to helping our clients receive the full medical care they need and the full benefits they are entitled to by law. Our consultations are free and without obligation. A consultation with a knowledgeable attorney can help you educate yourself about your rights.