You’ve been injured on the job and filed a workers’ compensation claim. You go to the doctor chosen by your employer or its workers’ compensation insurance carrier, just like you’re supposed to. But you have concerns about the medical treatment the doctor recommends. So you wonder if you can get a second opinion and still get the workers’ compensation benefits you need and deserve.
The short answer is “most likely,” but you need to be careful. The workers’ compensation system involves insurance companies and a bureaucracy, meaning there are certain procedures that must be followed. While patients always have the right to competent medical care and can ask for another doctor if they don’t think they are getting it, working with a workers’ compensation attorney will make the process easier.
The South Carolina Workers’ Compensation Commission’s FAQ page offers this answer to that question: “You can talk to the insurance carrier and see if he or she will allow you to go to another doctor, or you can request a hearing by completing a Form 50 and have a Commissioner make a determination on the case.”
It’s crucial that you work with an experienced workers’ compensation lawyer when pursuing a claim. An attorney can help guide you through the process, in particular if you need a second medical opinion. It’s also important that you continue treatment. Refusing treatment from the approved doctor could jeopardize your claim.
A good attorney will probably advise you to start by trying to talk with the doctor treating you. Tell the doctor your concerns and see if you can agree on a treatment plan that works for you.
If that doesn’t resolve the issue, you have the right to ask for a second opinion, especially if the doctor refuses a reasonable request. Your attorney can work the workers’ compensation insurance company to get another doctor or a second opinion. Changing treatments might even save the insurance company money if you can get better faster.
Your lawyer can also help you file a Form 50 to get a hearing with the Workers’ Compensation Commission. At the hearing, you will need to present evidence to persuade the commission to approve a second opinion. Your lawyer can present your information to meet the legal standards and help you get the treatment you need.
There may come a point when you might need to consider getting – and paying out of pocket for – an independent second opinion. This is especially important if the care is invasive, such as surgery. While doctors usually won’t perform surgery on a reluctant patient, refusing surgery could potentially have consequences for your claim.
The bottom line is that consulting with a lawyer can help you get the medical care you need while safeguarding your workers’ compensation claim.