Choosing Your Own Doctor Under Workers Compensation
- 11 years ago
Veteran attorneys, Wade Coye and Dan Smith from the Coye Law Firm, discuss your right to choose your own doctor while receiving a claim in workers compensation.
Transcript:
Wade:
Let's talk a little bit about when after the claim is either accepted or denied. Let's talk a little bit about going to the doctor. Under different years when the law has changed you used to have different types of rights under workers compensation. For instance, we used to be able to make a pick under the managed care system. Now the carrier gets to pick which doctor you'll get to go see. Can you talk a little bit about how that process of the carrier selecting the doctor and let's talk about some of the exceptions to that rule.
Dan:
In the normal long way in which the thing should work is that you report the claim and the carrier should than immediately contact you and tell you who you should go see or in fact, your employer may have a designated doctor. You know, you're going to go to Centra Care. You show up and they send you there. The advantage of that is it's supposed to be a quick medical treatment. The disadvantaged is you don't get to see the doctor you're used to going to see. So the normal rule is, you do not get to pick the doctor you want to see. There are some exceptions. For instance, in some denied claim situations, in other words, by denying me, the insurance company is not providing, or is denying the case for one reason or another. In some circumstances we're able to then ultimately pick the doctor.
Wade:
Let's talk about that a little bit, about the types of situations where we actually get to help our clients pick a doctor for themselves. I think that's something that folks really like to hear about is, what is some of the good opportunities that they get to do.
Dan:
Absolutely. We've been very successful in some past cases in which the cases come to us and they've been denied and they've been treating with their own doctor for some amount time or we got them into a doctor that we like or they like and then we go to the judge and we ask them for what's called an "After the Fact Termination" that that doctor has authorized. So they way it would work is someone would treat with the doctor of their choice while the claim is being denied then we go to the judge and say, "Judge, this case should not have been denied." They knew about the case. It wasn't this isn't a failure to report the case or whatever the defense were fighting up against. And when we win, the judge then will authorize that doctor that they've been treating all along with. Some other situations are in which you have the right to ask for a one-time change of doctor. And if the carrier fails to do that in a timely manner then we get to pick who that second doctor is. And we have been successful in getting our clients doctors that we just think are better picks for them.
Visit us at www.coyelaw.com
Transcript:
Wade:
Let's talk a little bit about when after the claim is either accepted or denied. Let's talk a little bit about going to the doctor. Under different years when the law has changed you used to have different types of rights under workers compensation. For instance, we used to be able to make a pick under the managed care system. Now the carrier gets to pick which doctor you'll get to go see. Can you talk a little bit about how that process of the carrier selecting the doctor and let's talk about some of the exceptions to that rule.
Dan:
In the normal long way in which the thing should work is that you report the claim and the carrier should than immediately contact you and tell you who you should go see or in fact, your employer may have a designated doctor. You know, you're going to go to Centra Care. You show up and they send you there. The advantage of that is it's supposed to be a quick medical treatment. The disadvantaged is you don't get to see the doctor you're used to going to see. So the normal rule is, you do not get to pick the doctor you want to see. There are some exceptions. For instance, in some denied claim situations, in other words, by denying me, the insurance company is not providing, or is denying the case for one reason or another. In some circumstances we're able to then ultimately pick the doctor.
Wade:
Let's talk about that a little bit, about the types of situations where we actually get to help our clients pick a doctor for themselves. I think that's something that folks really like to hear about is, what is some of the good opportunities that they get to do.
Dan:
Absolutely. We've been very successful in some past cases in which the cases come to us and they've been denied and they've been treating with their own doctor for some amount time or we got them into a doctor that we like or they like and then we go to the judge and we ask them for what's called an "After the Fact Termination" that that doctor has authorized. So they way it would work is someone would treat with the doctor of their choice while the claim is being denied then we go to the judge and say, "Judge, this case should not have been denied." They knew about the case. It wasn't this isn't a failure to report the case or whatever the defense were fighting up against. And when we win, the judge then will authorize that doctor that they've been treating all along with. Some other situations are in which you have the right to ask for a one-time change of doctor. And if the carrier fails to do that in a timely manner then we get to pick who that second doctor is. And we have been successful in getting our clients doctors that we just think are better picks for them.
Visit us at www.coyelaw.com