If you were injured on the job and your injuries did not heal properly after treatment, if surgery is recommended, or you’re dissatisfied with your diagnosis, it is wise to seek a second opinion.
When the injury falls under workers’ compensation, the process for obtaining a second medical opinion in a Florida workers’ compensation claim is more complicated than simply looking for another doctor. Under Florida workers’ compensation regulations, you only have one opportunity to change your physician.
A Florida workers’ compensation attorney at Berlin Law Firm can help you navigate the process necessary to seek another doctor to oversee your care. We handle workers’ compensation cases exclusively and will work tirelessly on your behalf.
You Get a One-Time Change in Physicians
In Florida, all injured workers are entitled to request a one-time change in their authorized treating physician if dissatisfied with the initial treatment. You do not have a right to a “second medical opinion,” although the one-time change often serves that purpose. The new doctor must practice in the same specialty as your initial treatment physician.
Steps to Obtaining a One-Time Change in Physicians
To receive your one-time change in physicians, you must follow all the necessary steps. These include:
1. Request Employer Permission
Before obtaining a second medical opinion, you must request permission to do so from your employer. It’s important to make all requests in writing.
If the employer does not respond to your written request for a new physician within five days, you can pick your new doctor. This is the only exception for not using a provider approved by the insurance company outside of initial emergency treatment.
2. Choose an Authorized Physician
Under the workers’ compensation system, injured workers cannot choose physicians outside of the doctors authorized by the employers’ insurance carrier.
This is important to understand—the insurance company will only approve doctors that they approve of. This means that the medical professionals available to you work for the insurers, therefore, they will attempt to diagnose you in a way that reduces your disability rating and minimizes treatment to keep money in the insurance company’s pockets.
Even if you did want to choose your own doctor out of desperation with the quality of care you are receiving, your personal health insurance policy may not cover any job-related injuries. You may have to foot the entire bill yourself if seeing an outside doctor.
3. Attend Appointments Regularly
With the first physician assigned to you, and with the physician whom you have received a second opinion from, it is imperative to attend all appointments with healthcare providers and adhere to your treatment protocol. Failure to do so not only jeopardizes your workers’ compensation coverage but can mean you are considered well enough to return to work.
Treatments Covered by Workers’ Compensation
The treatments covered by workers’ compensation include:
- Prescription medications
- Medical tests
- Hospitalization
- Doctor’s visits
- Physical therapy
- Prostheses
- Attendant care
Note that injured workers do not have the right to choose their physicians. That choice lies within the purview of the employer’s insurance company. You can change your doctor, which is permitted once by written request.
Additionally, it’s important not miss any medical appointments or treatments. Failure to attend these appointments can indicate your injury has been resolved, as far as the insurance carrier is concerned. If you cannot attend an appointment, notify the healthcare provider and schedule a new one. Notify the insurer and explain the situation as well. Otherwise, you are in danger of losing your benefits.
Discuss Your Work Injury Claim for Free
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Using an Independent Medical Examiner
If you opt for a one-time change of doctor but are still not satisfied with your care, there is another avenue to pursue, that of the independent medical examiner. According to Florida law, “Independent medical examiner refers to a physician selected by either an employee or a carrier to render one or more independent medical examinations in connection with a dispute.”
An independent medical examination (IME) means an “objective evaluation of the injured employee’s medical condition.” That may include impairment or work status. IMEs are performed by a physician or an expert medical advisor at the request of the injured worker, the insurer, or a judge of compensation. When the worker makes the request, they must pay for the IME themselves.
Unlike an authorized physician, an independent medical examiner cannot provide treatment. Their role is determining if more or different treatment is needed, and/or your ability to work status.
Second Opinions Don’t Negate Return to Work Orders
As per the Florida Department of Financial Services, seeking a second opinion, a one-time change of doctor or an IME does not negate a return-to-work order. Failing to comply to a return to work order can result in forfeiture of your lost wages benefits during the non-return period.
If you feel you cannot return to work until receiving a second opinion, change of doctor, or IME, it’s important for your new healthcare provider to address your ability to work as of the original return-to-work date established by your first doctor. This documentation can help support your eligibility for lost wage benefits during that time. However, the new doctor has discretion over the information they include in their report. Be sure to discuss your situation with them to ensure they understand the importance of addressing the work status for benefits purposes.
Contact Our Florida Workers’ Compensation Lawyers Today
It is critical that you make an informed decision when exercising your sole opportunity to change doctors under workers’ compensation. To learn more about benefits in Florida workers’ compensation and how a lawyer can maximize your compensation, contact a workers’ compensation lawyer at the Berlin Law Firm today. Schedule a free, no-obligation consultation.
Our legal team is paid either a portion of your settlement or directly by the court—meaning you pay nothing out of pocket.
Discuss Your Work Injury Claim for Free
Learn the types of compensation you may be eligible for and have your questions answered. Call today.
