When an insurance company admits liability for your North Carolina workers’ compensation claim, they have the right to direct your medical care. This means they get to tell you which doctors to see and when to see them. If you treat with your own doctor, you may end up getting stuck with the bill. As you’ve probably guessed, this part of our law can lead to major problems for injured workers.
What happens if I don’t like the doctor they selected for me?
So, you’ve been injured on the job. The insurance company finally accepts your claim and schedules an appointment for you with a doctor. On the day of your appointment, you spend 30 minutes in the waiting room, followed by a grand total of 30 seconds with the doctor. No one asks you how you’re feeling. No one asks whether you can safely return to work. The very next day, the insurance company calls to tell you that you’ve been released from treatment and are expected to report to work immediately. All the while, the pain from your injury has gotten even worse. Is this really happening? Believe me, you’re not alone.
While I’ve seen cases where this can and does happen, fortunately it’s not the norm.
Some insurance companies may want to get you back to work as quickly as possible (even if you’re not ready). This is one of the many reasons insurance companies want to direct your medical care and send you to doctors they select.
They have been choosing doctors in North Carolina long enough to know which ones are more likely to give them the benefit of the doubt – without compromising the patient’s condition, of course.
You have the right to a second opinion
The insurance company has the option of sending you to a doctor of your choosing for your second opinion, but they rarely do. I’ve seen situations where they have sent my clients a list of doctors, telling them they have to pick one (they’re lying). Other times, they’ve told my clients that they are not entitled to a second opinion in North Carolina at all (they’re at it again).
Here’s the truth
You have the right to request a second opinion. Does that mean it’s going to be easy? Probably not. A workers’ compensation lawyer can make the process easier for you, while minimizing the risks of trying to handle this cumbersome and confusing process on your own.
When you request a second opinion, the insurance company has 14 days to respond. North Carolina law encourages the parties to try to agree on a particular doctor during that time. At the end of 14 days, if you still haven’t reached an agreement, you have the option of taking your request to the Industrial Commission where an administrative judge will make the final call.
After your second opinion, you may be able to switch over to the new doctor for the remainder of your treatment, but that process typically involves approval from the Industrial Commission.
What’s the bottom line?
Don’t believe everything you hear from an insurance company. Many of these issues can get pretty complicated and there’s often more than one right answer.
If you have questions about your rights, contact one of our experienced workers’ compensation attorneys at the Law Offices of James Scott Farrin. We’re here to help you determine the best option for your unique circumstance.