Can I Get a Second Medical Opinion for Workers’ Compensation?

If you were hurt on the job in Summerville, then you know how challenging the situation can be. Unfortunately, your situation will grow more complicated if you suspect that a doctor failed to properly conduct your initial medical examination or misdiagnosed your condition.

As an injured worker in South Carolina, you do not have an absolute right to get a second medical opinion on your work injury. However, in most instances, a workers’ compensation insurance company will agree to set up a second opinion, especially if you have a surgical injury.  If your employer refuses to let you get this opinion, you should speak with an experienced Summerville, S.C., workers’ compensation attorney as soon as possible. The attorney can take immediate steps to protect your rights and help you to pursue all South Carolina workers’ compensation benefits you are due, including scheduling a medical examination with an independent doctor.

Here, we discuss important aspects of the process that goes into seeking a second medical opinion.

Initial Examinations

Unless it is an emergency, you must initially get a medical exam from a doctor that your employer or its workers’ compensation insurer has approved. An employer typically will ask you to see a doctor who regularly examines the company’s injured workers and who is already included under the company’s workers’ compensation plan. The choice of doctor is important. This is because the doctor’s opinion could decide a worker’s course of treatment and level of disability.

For example, the treating physician must determine whether the worker’s injury is, in fact, job-related. (To be eligible for workers’ compensation benefits in South Carolina, your injury must have occurred within the scope and course of your employment). The doctor may also:

  • Diagnose your medical condition
  • Create a treatment plan for you
  • Determine when your condition allows you to return to work
  • Decide what types of job duties your condition allows you to do
  • Possibly give you an impairment rating.

If you are dissatisfied with the authorized doctor and you would like a second opinion, you should speak with your employer or its insurance carrier. If the employer or insurer refuses to allow you to get a second medical opinion, an experienced South Carolina workers’ compensation attorney can help you get the same.

When Should I Ask for a Second Opinion?

In two situations, an injured worker in Summerville may want to seek a second medical opinion:

  • During the Initial Examination

This is when the doctor chosen by the employer or its  workers’ compensation insurer attempts to diagnose a worker’s condition.  The worker may feel uneasy about the doctor’s diagnosis and treatment plan, or the worker may feel that the doctor performed only a cursory examination.

  • During the Impairment Rating Determination

An employer’s insurer may require an injured worker to undergo an examination to determine whether he or she has reached Maximum Medical Improvement (MMI). If a doctor decides that the worker is unlikely to continue improvement even with further treatment, the doctor will try to determine an impairment rating. This rating will help to determine how much an injured worker receives in permanent disability payments.

For instance, if a doctor determines that a worker is temporarily and totally disabled, the worker could receive benefits payments for up to 500 weeks in an amount equal to two-thirds of his or her average weekly wage (or up to the statutory limit).

So, if you are an injured worker who suspects that the insurance company-selected physician failed to perform an adequate examination or failed to properly address the extent of your permanent impairment, you may consider seeking a second opinion.

Obtaining a Second Opinion

If your employer or its insurer allows you to get a second opinion, all information that a doctor discovers during the second exam must be disclosed to the insurer, original treating doctor and the employer.

Even though employers can choose an injured worker’s doctor, they are not permitted to speak with the doctor about the worker’s case without the worker’s permission. However, the employer can request medical reports and send the doctor written questions, as long as a copy of the written questions is provided to the injured worker, or the worker’s lawyer.  As an injured worker, you have the option to be present whenever a case manager speaks with a doctor or other medical personnel handling your case.

An Experienced Summerville Workers’ Compensation Lawyer Can Help You

If you are an injured worker who disagrees with any aspect of the examination and/or treatment you received from the insurance company-selected doctor, you should contact a Summerville workers’ compensation lawyer as soon as possible. An attorney can help you to go through the proper process for getting a second medical opinion.

Contact Joye Law Firm today to learn more. You can speak with an experienced workers’ compensation attorney who will advise you of your rights and options in a free and confidential consultation.