Second Medical Opinion for Workers’ Compensation: Should I Get One?

doctor giving medical advice about workers comp to a couple

If you were injured at work in Summerville, then you know how difficult the situation can be.

Unfortunately, this situation can become even more complicated if your doctor initially misdiagnosed your health condition or made a mistake at your medical examination.

South Carolina does not give those that were injured on the job the absolute right to get a second medical opinion on your work injury. However, especially in cases such as those where someone has a surgical injury, there are many instances where a worker’s compensation insurance company will agree to set up a second opinion. In the case that your employer denies you a second opinion, you should speak with a knowledgeable Summerville, S.C. workers’ compensation attorney as soon as possible. The attorney will immediately begin the process to ensure that your rights are protected and aid you in pursuing all of the South Carolina workers’ compensation benefits you are entitled to, including setting up a second opinion medical examination with an independent doctor.

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

Initial Medical Examinations

In all cases other than medical emergencies, you initially are required to get a medical exam from a doctor that your employer or its workers’ compensation insurer has approved.

An employer will usually request that you see a doctor who typically sees the company’s injured workers and who is already included under the company’s workers’ compensation plan. The doctor who performs this initial examination could decide a worker’s course of treatment and disability level. Thus, the doctor who is chosen for your initial examination is very important .

One of the doctor’s main roles is to decide whether or not the employee’s injury was, in fact, caused by their job activities. In order to receive workers’ compensation benefits in South Carolina, your injury must have occurred within the scope and course of your job.

The doctor might also:

  • Diagnose your injury or condition
  • Determine a treatment plan for you
  • Make an assessment as to when your condition allows you to resume work
  • Decide what duties you are able to fulfill with your condition
  • Give you an impairment rating.

If you are not happy with the doctor that you are assigned for your initial examination and you wish to receive a second opinion, you need to discuss this with your employer or its insurance carrier. If your employer or their insurer denies your request to receive a second physician’s opinion, a knowledgeable South Carolina workers’ compensation attorney can help you navigate this issue.

When Should I Ask For A Second Medical Opinion?

There are two situations in which an injured worker in Summerville may wish to receive a second medical opinion:

During the Initial Examination

During an initial examination, the doctor assigned by the employer or its workers’ compensation insurer will try to diagnose a worker’s condition or injury. In some cases, the worker may not feel comfortable with the physician’s diagnosis or treatment plan, or the injured worker may feel that the physician performed an insufficient examination.

During the Impairment Rating Determination

An employer’s insurer may also require that an injured worker receives an examination to decide whether or not he or she has reached Maximum Medical Improvement (MMI). If the assigned doctor determines that the injured worker is not likely to keep improving their health condition with continued treatment, the doctor may give the worker an impairment rating. An impairment rating is a major factor in determining how much an injured worker will receive in permanent disability payments.

For example, if a doctor’s opinion would support an employee’s claim that he is totally disabled, the injured party may receive benefits payments for up to 500 weeks of an amount that is equal to two-thirds of his or her average weekly wage (or up to the statutory maximum weekly benefit).

So, if you are an injured worker who believes that the insurance company or employer-selected physician did not perform a satisfactory examination or failed to fully address the extent of your permanent impairment, you may need to seek a second opinion.

Obtaining A Second Opinion

If your employer or its insurer agrees to your obtaining a second opinion, anything that the second physician discovers during your second exam must be shared with the insurance company, the original doctor, and your employer. Despite the fact that employer is able to choose your initial doctor, they do not have the right to speak with that doctor about the worker’s case unless they obtain permission from the worker. However, the employer does have the right to ask for medical reports and to send the doctor written questions, as long as the written questions are copied and provided to either the injured worker, or the worker’s lawyer. Injured workers also have the right to be present whenever a case manager speaks with either the doctor or other medical personnel who are involved in their case.

An Experienced Summerville Workers’ Compensation Lawyer Can Help You

If you were hurt on the job and you are not happy with any aspect of the initial examination and/or treatment you were given by the insurance company-selected physician, you should contact a Summerville workers’ compensation lawyer immediately. An experienced lawyer will help you navigate the proper process of obtaining a second medical opinion.

Contact Joye Law Firm today to learn more. At Joye Law Firm, you will find experienced workers’ compensation attorneys who will give you advice about your rights and options in a confidential consultation, free of charge.

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