Can I Choose My Own Doctor for a Workers’ Comp Injury in NC?

Your employer or their insurance company usually picks the doctor you will see for injuries related to your workers’ compensation claim in North Carolina. However, if you feel the treatment you are receiving is inadequate or want a second opinion, you can ask to see a different doctor. 

To do this, you must file a petition with the North Carolina Industrial Commission (NCIC). In your petition, you must explain why you need to see another doctor and provide any necessary information to support your request. If the NCIC grants permission, you can see a doctor of your choice for your workplace injury, and your employer will be responsible for footing the bill.

Are There Situations Where I Can Choose My Own Doctor?

Under North Carolina law, employers generally can direct the medical care they cover under workers’ comp. Still, you can seek greater control over your care in some situations. Specifically, you can petition the NCIC for the right to choose your own doctor. You can start this process by writing to your employer requesting a change of doctor or a second opinion examination before receiving treatment. If your employer does not respond favorably within 14 days or if you and your employer cannot agree on a new provider, you can ask the NCIC to intervene.

Your request to the NCIC must clearly show that your current medical treatment is inadequate and that a change in health care provider is reasonably necessary. This could involve submitting detailed medical records, expert opinions, or evidence of insufficient care under your current provider. The burden is on you to make a compelling case that a new doctor will significantly improve your recovery process. The NCIC will then review the evidence to determine whether to approve the requested change.

Importantly, in an emergency, you do not need prior authorization from your employer or insurance to seek immediate medical attention. You can visit the nearest emergency department or healthcare provider directly to receive urgent care for injuries you sustain at work.

Is the Employer’s Chosen Doctor on My Side?

Since your employer or insurance company chooses the doctor you see in North Carolina, it’s normal to wonder if this doctor is looking out for your best interests.

Remember that the doctor your employer chooses receives payment from them and often works with them on many cases. This doesn’t mean the doctor will treat you unfairly, but their connection with your employer could influence their decisions. The doctor must follow medical ethics and provide you with proper care, but they will also communicate with your employer about your treatment and progress. This means they might focus more on getting you back to work quickly than other doctors.

If you feel the care you’re receiving isn’t adequate or they’re rushing you back to work before you’re ready, you can request a change of doctor through the NCIC. Being open with your doctor about your symptoms and concerns is essential to ensure your health and recovery remain the top priorities.

Can I Request a Second Opinion from a Doctor I Choose?

If you’re dealing with a workers’ compensation case and are dissatisfied with the medical care you’re receiving, you have the right to request a second opinion. You can choose the doctor for this second opinion, but there are specific steps you must follow to ensure your employer will cover it.

First, you must write to your employer explaining why you want a second opinion. Your employer might agree to this and help you arrange it. However, if they don’t respond positively or disagree with your choice of a new doctor, you can take your request to the NCIC.

When you file your petition with the NCIC, you must provide a good reason for needing a second opinion. This could be due to doubts about the accuracy of your diagnosis or if you believe another treatment might be more effective. If the NCIC approves your request, your employer will pay for this second opinion under the same terms as your original medical care.

What Is an Independent Medical Exam?

An independent medical exam (IME) is a particular type of doctor’s appointment that plays a role in many North Carolina workers’ compensation cases. If a disagreement arises about your injury or treatment, your employer or the insurance company might ask you to sit for an IME. The doctor conducting the IME is not the one treating you. Instead, this independent doctor will evaluate your injury to give an unbiased opinion about your medical condition.

An IME is meant to clarify the extent of your injury and the kind of treatment you need. IMEs are sometimes necessary to resolve disputes between you and your employer or their insurance company about your health status. After the exam, the IME doctor will write a report that your employer or insurance provider will use to decide on your workers’ compensation claim.

What Can I Do If the Doctor Says I Am Healed, But I Don’t Feel Better?

If a doctor your employer chooses for your North Carolina workers’ compensation case says you have recovered but you still feel unwell, you have options. First, communicate clearly with your doctor. Explain your symptoms and concerns in detail.

If you still believe they are not taking your concerns seriously, you can request a second opinion from another doctor. You must write to your employer asking them to cover the doctor’s visit necessary for this second opinion. If they disagree, you can take your request to the NCIC and show them why you need a different doctor. Remember, you know your body best and have the right to seek further medical evaluation to ensure you get the care you need.

Contact a North Carolina Workers’ Compensation Lawyer

If you’re facing challenges with your workers’ compensation claim in North Carolina and need guidance, contact The Law Offices of John Drew Warlick, P.A. today. We offer a free initial consultation to discuss your case and help you understand your options. Don’t struggle alone – let us help you get the medical care and benefits you are due.

Visit Our North Carolina Workers’ Compensation Law Offices