If you were injured on the job in South Carolina, your employer’s workers’ compensation insurance company usually chooses the first doctor you’ll see. That doctor’s medical opinion is important, but it is not the only opinion that counts. Many clients ask, “Can I get a second medical opinion for workers’ compensation?” In many cases, the answer is yes, especially when your health or your workers’ compensation claim is at stake.
Joye Law Firm Injury Lawyers is one of South Carolina’s largest and most respected team of workers’ compensation lawyers. Since 1968, we’ve guided thousands of injured workers and know when a second medical opinion is necessary for your workers’ compensation case. Head of Workers’ Compensation Department, Attorney Matt Jackson has been selected for inclusion in Best Lawyers in America for Workers’ Compensation in Charleston since 2017 and was selected as the 2024 “Lawyer of the Year” in the category. Managing Partner, Ken Harrell, earned “Workers’ Compensation Lawyer of the Year” inclusion multiple times over the last decade. Just Call Joye to talk to a workers’ comp attorney for free legal advice.
Why a Second Medical Opinion Can Change Your Workers’ Compensation Claim
Getting a second medical opinion clarifies your actual condition, confirms the need for surgery, or opens the door to additional treatment that the first doctor may have never mentioned. For many injured workers, that fresh look makes the difference between short-term relief and lasting recovery. It can also:
- Challenge an insurance company’s doctor who says you have reached maximum medical improvement (MMI) too soon.
- Support a request for further treatment or specialized care such as physical therapy, pain management, or additional different surgery.
- Increase the value of any final settlement because permanent restrictions are documented by an independent physician.
- Protect your right to workers’ comp benefits if the first doctor downplays your limitations.
In short, a second opinion can align your medical needs with the legal goals of your workers’ comp claim.
Real Case Example:
After a serious on-the-job neck injury, a forklift driver turned to Joye Law Firm to help when the workers’ comp system failed to provide proper care. The employer-provided doctor dismissed his pain and delayed effective treatment, but Attorney Sarah Khouri recognized the urgency of the situation and quickly arranged for a second opinion with a trusted spine specialist. That independent exam revealed major injuries requiring immediate surgery, a sharp contrast to the conservative treatment plan initially recommended. The surgeon confirmed the physical therapy may have worsened the condition and warned that further delay could lead to paralysis. This second opinion, along with an Independent Medical Evaluation later in the process, was critical in obtaining surgery approval, weekly wage benefits, and ultimately a $175,000 settlement.
Signs You Need a Different Doctor’s Opinion
Second opinion requests are strongest when:
- The first doctor recommends a high-risk procedure, and you want confirmation.
- You are still hurt, but the doctor says you are ready to return to your job full duty.
- Your condition and treatment options were not fully explained in plain language.
- You suspect a different diagnosis because symptoms have spread or worsened.
- You feel the doctor rushed the visit or relied only on old imaging.
Trust your instincts. You have the right to request a second opinion if your recovery isn’t progressing or your doctor’s assessment seems lacking.
What South Carolina Workers’ Compensation Law Says About Second Opinions
South Carolina law lets your employer’s insurance company direct your medical care, but it does not give them the last word. You may ask the adjuster for another evaluation, and if the request is denied, you can file Form 50 with the South Carolina Workers’ Compensation Commission to have a commissioner order a second opinion.
Some important points to consider:
- You cannot pick a different doctor and bill the carrier without permission.
- A commissioner may order the carrier to pay for a qualified physician.
- Most workers receive only one approved second opinion per injury, so timing matters.
- An experienced workers’ compensation attorney can present medical records and testimony to show why another opinion is reasonable.
How to Request a Second Medical Opinion Without Losing Benefits
Requesting a second medical opinion in a workers’ comp case can be tricky, but with the right steps, it’s possible to get another evaluation without risking your benefits. Here’s how to do it correctly:
- Talk to the adjuster. Explain specific concerns such as ongoing pain or conflicting test results.
- Put the request in writing. List the claim number, treating doctor, and reasons for another review.
- Follow up. Ask for the appointment date and keep copies of every email or letter.
- File Form 50 if needed. A hearing may be the fastest way to move forward.
- Attend all scheduled visits with the first doctor until a decision is made. Missing appointments can threaten weekly pay and medical coverage.
Independent Medical Examination vs. Second Medical Opinion
An independent medical examination (IME) is arranged either by the insurance carrier or your attorney to obtain an impartial opinion on your disability rating, future medical care, or work restrictions. On the other hand, a second opinion focuses on diagnosis and medical care. Before you go, ask whether the appointment is an IME or a second opinion, so you understand its purpose.
Real Case Example of a Second Opinion Making All the Difference:
A construction worker was struck by an axe that fell 10-15 feet, hitting his head near his neck at a job site in Awendaw, S.C. Thankfully, he escaped major fractures and was sewn up at MUSC, but his family noticed something was amiss with his behavior. Attorney Matt Jackson, recognizing the inconsistency between the client’s symptoms and the doctor’s assessment, arranged for a second opinion through an Independent Medical Examination. The new physician revealed the presence of post-concussion syndrome, PTSD, and severe depression. This second opinion played a critical role in challenging the initial MMI determination, strengthening the client’s case, and ultimately securing a $165,000 settlement.
See the results we’ve obtained for injured South Carolinians.
Please note: Results our law firm has achieved on behalf of clients in one matter does not necessarily indicate similar results can be obtained for other clients. Each case is unique.
Choosing the Right Physician for Your Second Opinion
While the insurance company still influences the choice, you may suggest a physician who:
- Holds board certification in the correct field, such as orthopedics, neurology, or pain medicine.
- Has no ongoing contract with the insurance company.
- Is known for thorough exams and balanced reports.
At Joye Law Firm, we’ve spent more than 50 years building trusted relationships with experienced medical professionals across South Carolina. If you’re unsure where to turn, we can help connect you with a physician who will take your concerns seriously and work with you to ensure proper care and documentation of your injuries.
What to Bring to Your Second-Opinion Appointment
Preparation ensures the doctor sees the full picture and documents findings that support your workers’ compensation case.
- A concise timeline of your workplace injury and all treatments to date.
- Current imaging (X-rays, MRI, CT) on disc plus reports.
- List of medications and side effects.
- Daily symptom log that shows pain levels and activity limits.
- Questions about the treatment plan: surgery, therapy, injections, or additional treatment such as nerve stimulators.
How a Second Opinion May Affect Treatment, Benefits, and Settlement
A second opinion can do more than offer peace of mind; it may directly impact your treatment plan, benefit eligibility, and final settlement. Here are a few ways it could change the outcome of your case:
- A new specialist may order updated scans or refer you to a different surgeon for a less invasive procedure.
- If the second doctor sets lighter work restrictions, your workers’ comp benefits (temporary total, temporary partial, or permanent disability) may keep flowing.
- A later MMI date often raises the compensation you receive for permanent impairment.
- Credible support for lasting limitations increases wage-loss calculations and may cover future medical care.
FAQs About Second Medical Opinions in South Carolina Workers’ Compensation Cases
WC Second Opinion
Do I have to pay out of pocket for a second opinion?
No, not if it’s approved. If the insurance company or the Workers’ Compensation Commission allows the second opinion, the insurance company must pay for it. If you go outside the system without approval, you may have to cover the cost yourself.
What if my pain gets worse after the first doctor says I’m healed?
You should notify both your doctor and the adjuster immediately. If your symptoms return or get worse, you may be able to reopen your claim or request a new evaluation.
How long does it take to get a second opinion approved?
It varies. If the adjuster agrees, it can be scheduled quickly. If they deny it and you need a hearing, it could take weeks. A lawyer can help expedite the process by filing the correct documents and advocating for a hearing date.
Should I get a second opinion before settling my case?
Absolutely. Before you agree to any settlement, you should know your full medical picture. A second opinion may uncover long-term needs or restrictions that should be factored into any payout.
Does a second opinion affect how long I get workers’ comp benefits?
Yes. If the second doctor gives a different opinion about your ability to work or your recovery timeline, it can extend or increase your benefits.
Can I use my health insurance instead?
You can, but workers’ comp may later deny reimbursement, leaving you on the hook if your private insurance seeks repayment from your settlement.
What if the second doctor agrees with the first?
Consistency can still help. It shows you respected the process and may speed approval for the treatment recommended.
Is a third opinion possible?
Yes, in rare cases. You must show significant new symptoms or objective test results to justify another review.
Will requesting a second opinion anger my employer?
Employers usually rely on the insurance company’s advice. A polite, documented request keeps emotions low and focuses on facts.
Talk to Joye Law Firm Injury Lawyers Today
If the workers’ comp doctor’s diagnosis doesn’t feel right, getting a second opinion is a smart choice. South Carolina law sets some limits on how your medical care is handled, but it’s still possible to ask for another medical review if you go through the correct channels.
At Joye Law Firm, our workers’ comp lawyers have helped thousands of injured employees get the care and benefits they need, even when insurers push back. We’re leaders in the field and respected by our peers. Attorneys Matt Jackson and Ken Harrell are both Past Presidents of Injured Workers’ Advocates (IWA), Davis Rice serves on the group’s Executive Committee, and several of our attorneys are also members.
Contact us for a free consultation. We’ll deal with the insurance company, handle the paperwork, and fight for every benefit you’re owed. Don’t settle for just one medical opinion. Your health and future matter.
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