Can You Choose Your Own Workers’ Comp Doctor in Virginia?

You dedicate countless hours of your life to your job. When you suffer an on-the-job injury, it’s only right that your employer covers the cost of medical care. Most employers do this through the workers' comp system.

Other workers may have told you that when you’re injured at work, you can choose any doctor to treat you. In Virginia, this isn’t true. The workers’ comp system does give you some level of choice, but if you seek treatment from a non-approved doctor, you could put your benefits in jeopardy.

In this post, we’ll take a closer look at how to choose your doctor for workers’ compensation treatment.

How the Virginia Workers’ Comp System Handles Post-Injury Treatment

If your work injury is severe enough that you must be transported to an emergency room, you probably had no say in which hospital you went to. Your workers’ compensation benefits should cover emergency care, but if at all possible, you should tell the hospital the injury was work-related so they can properly bill your employer.

However, follow-up and non-emergency care generally must be with a doctor approved by the Workers’ Compensation Commission. If you go to an ER for non-emergency care or schedule follow-ups with doctors who aren’t approved, your medical care might not be covered.

Your Employer Must Provide a List of Physicians

Many people don’t think about the logistics of filing a workers’ compensation claim until they have already been injured. Following any necessary emergency treatment, you’ll need to know which workers’ comp physicians to choose from.

The Virginia Workers’ Compensation Act requires your employer to provide you with a “panel of physicians.” This is a list of at least three doctors you may choose from.

Here’s what you need to know about this important list:

• Your employer may choose the doctors on the list (as long as they meet other criteria)
• Doctors must be within a 50-mile radius of your home or your workplace
• Each doctor on the list must practice independently of the others
• At least one doctor on the list must specialize in the area of your injury

Your treating physician may have a major impact on your claim. For instance, if your injury results in some level of disability, this doctor will likely be the one determining your disability rating. If possible, take a bit of time to look into each doctor on the list.

What Happens if You Refuse Treatment From the Doctor Panel?

If you refuse to be seen by one of the doctors on the list or refuse treatment altogether, your workers’ compensation benefits may be suspended or revoked entirely.

Exceptions to the Rule: When You May Choose Your Own Doctor

If your employer-provided panel of physicians doesn’t meet the criteria set by the Workers’ Compensation Commission (or your employer will not give you a panel of physicians at all), you might be permitted to choose your own doctor.

However, you should never assume you’re allowed to choose your own doctor without talking to a workers' comp lawyer first. Workers’ compensation insurance companies often look for any reason to deny claims, and they might argue that you didn’t give your employer enough time to supply (or correct) a panel of physicians.

Why Seeing an Unapproved Doctor Puts Your Benefits in Jeopardy

Workers’ compensation insurance covers most expenses related to your injury. However, insurance companies want to be able to control costs, so they limit your choice of doctor.

If you choose to see an unapproved doctor, you will likely be responsible for treatment costs on your own. However, workers’ compensation insurance companies typically require you to cooperate with the treatment process to receive benefits. Seeing an unapproved doctor might be construed as not cooperating. You may lose access to your medical benefits, and in some cases, your entire workers’ comp claim may be denied.

How a Workers’ Compensation Attorney Can Help With Medical Care Disputes

Disputes over medical care can be stressful, and they may delay your healing. If you’re having trouble getting workers’ comp to pay for your medical care, you should contact a workers’ compensation attorney as soon as possible.

These are some of the ways your lawyer might be able to help:

• Handling communication with the insurance company
• Reviewing the panel of physicians and offering guidance on who to select
• Filing appeals if your claim is denied
• Representing you at court hearings if needed

Going through the workers’ compensation system for the first time can be overwhelming and disorienting. The right workers’ comp lawyer can serve as your guide.

FAQ

How Long Do You Have to Report an Injury to Your Employer?

It’s generally good practice to report your injury as soon as possible. However, the official workers’ compensation deadline is 30 days after your injury.

Will Workers’ Comp Benefits Replace All of Your Wages?

No. Wage replacement benefits are usually two-thirds of your weekly wage.

Can You Switch Doctors Under the Workers’ Compensation System?

You usually can’t switch doctors. However, if you think you’re receiving subpar care, you can request a change with the Virginia Workers’ Compensation Commission.

Need Help Navigating the Workers’ Compensation System?

Figuring out Virginia’s workers’ comp system can be difficult, especially when you’re also trying to heal from a serious injury. Although the system is designed to streamline the process of recovering compensation, disputes and delays can (and do) arise.

In this situation, the best thing you can do is to retain a workers' comp attorney. At Commonwealth Law Group, we center our practice on workers’ compensation, civil rights, and personal injury cases.

If you’re experiencing problems with your workers’ compensation claim or just need some guidance, contact us today to set up your free consultation.