Can I change doctors if I don’t like the one the insurance carrier is sending me to for my work injury?



Not if you want to keep your benefits. Generally speaking, disliking a doctor is not a valid reason for not going to the insurance carrier’s doctor.

workers compensation

Refusing to accept the medical services that the worker’s compensation insurance carrier provides to you could lead to your worker’s compensation benefits being suspended. In most cases, you must continue treating with their doctor(s) if you want all of your medical treatment paid for, until you are released at a maximum medical improvement. There are only a few exceptions to this rule:

1. In an emergency situation

It must be a true emergency, such as complications after a surgery which arise when the doctor’s office is closed. Thereafter, the injured worker will have to return to the insurance carrier’s doctor.

2. If the injured worker is not provided with medical care by the employer or the employer’s worker’s compensation insurance carrier in accordance with the Act

For instance, two specialists selected by the worker’s compensation insurance carrier advise that an injured employee needs surgery promptly, but the insurance carrier refuses to authorize it.

3. “Because of any other good reason” [cited from IC § 223-3-4 (d)].

Please note that this is not clearly defined, so it is left to the Board’s discretion to determine what qualifies for this exception.

For example, you have a surgical procedure performed at your own expense, and result of which is significant improvement to your work injury. For instance, you could only do sit down work before the surgery, but after the surgery you can stand and work up to six hours a day. In this scenario, the Board may find such treatment to have been “reasonable and necessary,” thus falling under this exception.

In any of these situations, if possible, you should seek prior medical approval from the insurance carrier before obtaining treatment on your own.

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