In many Washington, DC workers’ compensation cases, injured workers are allowed to choose their own attending physician. The law is clear that you generally have the right to select a qualified doctor to treat your work-related injury or illness. This doctor must have the appropriate training, licensing, and expertise to treat your specific occupational health problem.
Injured at work in Washington, D.C.? Call our experienced workers’ compensation attorney in Washington, D.C. for a free case evaluation.
Does Your Regular Doctor Have to Accept Workers’ Compensation?
Not every primary care doctor is willing to handle workers’ compensation cases. Some doctors may choose not to do so because they prefer their standard billing routines or want to avoid the paperwork, specific documentation, or regulations required in Washington, DC work injury cases.
Your physician will need to bill the workers’ compensation insurance carrier, not your regular health insurance and satisfy reporting requirements demanded by DC workers’ comp law and insurers. For this reason, it’s important to check with your regular doctor, or any provider, before assuming they’ll accept you as a workers’ comp patient or send required reports.
Can the Insurance Company Make You See Its Doctor?
Yes, in many workers’ comp claims, the insurance provider or your employer has the right to require you to attend a separate exam with their chosen medical provider. This process is called an Independent Medical Examination (IME).
The purpose of this evaluation is to get another opinion on your injury and whether your treatment is medically necessary. It is not about your routine care or personal treatment plan. An examination conducted by the insurance company’s preferred doctor does not replace your right to visit and be cared for by the physician you’ve chosen.
What If the Insurance Company’s Doctor Disagrees With Your Regular Doctor?
Disagreements between your chosen physician and the insurance company’s IME provider are common in DC workers’ compensation cases. Conflicts might involve whether the accident was actually caused by work, which treatments are justified, questions about work restrictions, whether you’ve reached maximum medical improvement, or your ability to go back to work (with or without restrictions).
The opinion of the insurance company’s doctor is not automatically the deciding factor in your case. While the insurer may rely on its doctor’s report to limit or challenge your benefits, their opinion must still be weighed alongside the medical records, treatment notes, and recommendations of your own attending physician.
When Should You Speak With a Washington, DC Workers’ Compensation Lawyer?
Consider speaking with a workers’ compensation attorney if you encounter any of the following situations:
- You are told you cannot use your own doctor to treat your work injury
- The insurance company refuses to authorize or pay for your treatment
- The insurance company’s doctor disagrees with your regular physician about whether your condition is work-related or if your treatment is necessary
- You are being pressured to return to work before your doctor approves
- Your benefits have been denied, suspended, or reduced after an IME
- You aren’t sure if your doctor is providing the right reporting or paperwork for your workers’ comp claim
Getting early legal advice can make a difference in navigating disputes, protecting your benefits, and ensuring you get the medical care you need. If you’re facing these issues or simply want to clarify your rights, contact a DC workers’ compensation lawyer for guidance.