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How medical treatment works under workers' compensation

After suffering a workplace injury, getting the right treatment can make a great difference in your recovery and general wellbeing. Thus, many people are unhappy to learn that North Carolina workers' compensation law limits their ability to research and choose a provider.

When you file for workers' comp, you receive a list of approved providers to select from. You must see someone from that list or else risk your chance to receive the benefits you need.

Disadvantages of limited choice

Of course, the fact that a provider is on the employer's approved list does not always mean he or she does not have the qualifications or even that he or she does not intend to provide the best possible care. However, this affiliation with the insurer does make it more likely that a doctor will, to some degree, incline toward prioritizing the insurer's interests. This can mean assigning a lower disability rating, favoring low-cost treatments over more expensive ones that may be more effective, or being in an undue hurry to lift work restrictions.

Asking for a second opinion

The law does provide injured workers with some measure of recourse. First, you may submit a written request for a second opinion from a doctor you select. The employer must bear the expense of this examination. The employer and the insurer will receive the reports from the examination. The regular treating doctor may be present at the examination. If the employer denies this request or does not agree with your choice of doctor, you can go further and submit an appeal to the Industrial Commission.

Changing providers

If you are able to obtain a second opinion that shows your current treatment is not optimal, you can request the Industrial Commission's approval to change providers. In such a case, you can ask to switch to a specific doctor, but the Industrial Commission has to approve that new provider.

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Vincent Law Firm, P.C. | 8 Juniper Trail | Southern Shores, NC 27949 | Map & Directions

Local: 252-489-2200 | Toll Free: 866-840-1389 | Fax: 866-535-0201

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