Sometimes you are ready to change the doctor treating your work-related injuries. Maybe you don’t like the quality of care, the office is too far away, or the practice is closing. Or you might be adding a new medical provider – you get referred to physical therapy or a specialist. Many employees are not sure how to start the process of changing doctors and who to notify.
- New Primary Treating Physician
A primary treating physician is the doctor who is providing the majority of your care for your work injury. This may be a surgeon, a specialist, an internist, or many other kinds of doctors. Often people visit their general medicine doctor’s office first. Before you visit a doctor twice, you should be aware that if you change primary treating physicians, you may need to follow a specific process required by the workers’ compensation laws.
If you visit a doctor twice and do not already have a primary treating physician, then the doctor you visited will be your primary. Within the first 60 days of beginning treatment, you can change primaries once without any prior notice or authorization. After 60 days pass, you must get approval for the change from either the insurance company or a judge.
The insurer may not approve the change when you ask. In that case, you need to show a judge that you have a reasonable basis for changing doctors, such as losing faith in the doctor’s skill or lack of medical improvement. The judge will not approve the change if he or she believes that:
- You are attempting to block reasonable treatment or to avoid acting on the provider’s opinion
- The change is to develop litigation strategy, not treatment
- The new provider lacks the expertise to treat you for the injury
- The same care is available at a closer, more reasonable location
- No further treatment is needed
- The request is not in the best interest of the employee and the employer.
(Minn. Rules § 5221.0430.) Again, make sure that you have a reasonable basis for the change, and talk to your lawyer about showing this to the judge.
- Referrals and Specialists
After you start seeing a primary treating physician, he or she may refer you to other medical providers. You do not need approval to start going to physical therapy or seeing a specialist if you are referred. But before you receive any new procedures such as surgeries, it is a good idea to talk to the insurance company and make sure it will cover the costs.
Need help getting workers’ compensation for your injury? Joe Osterbauer, Esq. and the Osterbauer Law Firm stand up for injured Minnesota workers’ rights. Joe’s 27 years of workers’ compensation experience and his team’s speedy service combine to get clients the results they need. To schedule a free consultation, visit Osterbauer Law Firm online or call Joe’s office at (612) 334-3434.
