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Workers’ Comp: Can I Choose My Own Doctor?

Picture this; you were having a relatively non-eventful day at work. Everything was as it should have been. That is, your day was routine until you encountered an accident.

The accident has left you with severe injuries. Most of them were debilitating enough for you to miss work and a chance to make income. The resulting impairments have led your employer to arrange for workers’ comp as per Minnesota labor laws.

Workmans’ comp Minnesota laws include everything from the assessment of your injuries to the restoration of your abilities. All of these services are under the watchful eye of a physician who is selected by your employer’s insurance provider.

That said, you may be wondering: “Can I choose my own doctor in Minnesota?”

The answer is “yes”. In this article, we explain the details behind physician selection that worker’s comp Minnesota allows. Keep reading to learn more!

Why You Would Want to Choose Your Physician

In most states, workers’ compensation is part of an employer’s business liability insurance coverage. Business liability insurance covers employers from liabilities and medical expenses associated with injuries sustained by people within their premises.

Covered parties include not only customers or visitors but also, most importantly, employees. Employees, following the submission of certain incident-related reports, are entitled to reparations and compensation in the form of workers’ compensation.

Worker’s compensation covers the assessment of the employee’s injuries. In particular, the assessment guides when an employee can return to work and the amount of compensation they will receive. Treatment is planned by a qualified rehabilitation consultant, and medical care required for recovery is rendered by a physician.

What to Expect from a Workers’ Comp Doctor?

Of the concerned professionals in an employee’s recovery, the physician plays a pivotal role. The physician is responsible for more than diagnosis and treatment. In Minnesota, physicians need to issue several reports that will form the basis of your compensation amount if you are injured.

Physicians along with QRCs are the ones responsible for worker restriction requests. In addition, they also issue permanency ratings. These ratings indicate whether or not you recovered after rehabilitation.

These reports greatly determine the amount of compensation you are entitled to. While this sounds good on paper, here is something you may want to think of.

By and large, insurance providers tend to select physicians with whom they have working ties. At times, these physicians may be selected not solely on the basis of their abilities. Rather, insurance providers can associate themselves with physicians who have a history of acting in the provider’s best interests.

For this reason, if your physician is selected by your employer, there may be a conflict of interest. In particular, the physician may act in the interests of the insurance provider and your employer instead of you.

While this is not necessarily the status quo in Minnesota, it is something worth considering. This is why your decision to choose your physician may be a wise one.

Does Workers’ Comp Minnesota Law Allow Me to Choose My Physician?

Whether or not employees can select their doctors can vary from state to state. For example, while choosing a doctor in Missouri and New Jersey is reserved for employers, this is not the case for states like Alabama, California, and Hawaii.

In some states, the right to select a physician is an employer and insurance provider prerogative. In other states, an employee needs to predesignate one.

States like Alaska allow employees to choose doctors. The condition is that these physicians must be part of a list of eligible physicians for workers’ comp.

Luckily, in Minnesota, employees on workers’ compensation have the right to select their physicians. Hence, should you be injured at work in the state, you can call your physician. As a bonus, you can have your expenses covered by your workers’ compensation.

While you may have free rein when choosing your attending physician, the state mentions three special circumstances wherein your employer can choose on your behalf.

When an Employer in Minnesota Chooses Your Physician

Three special circumstances will permit your employer to choose your physician. These circumstances are related to:

  • Your location
  • A collective bargaining agreement
  • Whether your employer has a certified managed care plan

Let’s look at each in greater detail.

Your Location

If you choose a physician who lives far from you, you may still be able to opt for this doctor. However, your employer may require you to get your prescription medication (if you require any) from a pharmacy or physician that is within 15 miles.

As Part of a Collective Bargaining Agreement

Your employer may also choose your physician if they are part of a collective bargaining agreement. As part of any collective bargaining agreement, your employer can specify certain provider-approved physicians to attend to you. In this situation, your employer can select from a list of physicians their insurance provider compiled.

If Your Employer Had a Managed Care Plan Certified

Your employer may have a managed care plan in place. A managed care plan allows your employer to select health care providers on behalf of employees when they have accidents.

Before your employer can implement a managed care plan, a commissioner from the Minnesota state labor office needs to certify it. Certification has several requirements, most of which seem to favor workers.

On the other hand, you can still choose your doctor if:

  • Your employer has no managed care plan at the time of your accident
  • Your employer is in the process of getting a managed care plan certified at the time of your accident

Can I Change My Workers’ Comp Doctor?

When selecting the doctor to treat you after a work injury, choose carefully because even though you can switch to a new doctor during treatment, the process of switching is not always easy.

Under workers’ compensation law in Minnesota, if a doctor has treated you on at least two occasions, that doctor is automatically recognized as your primary treating physician. You can change your primary physician during the first 60 days of treatment without prior authorization or notice. But after the 60-day mark, you are required to obtain approval for the switch. The approval must come from the insurance company or a judge. If the insurance company does not provide approval for the change in doctors, you will need to provide a reasonable basis for the switch to a judge for his or her approval.

A reasonable basis for changing doctors may not be that disagree with the injury rating or work restrictions imposed upon you. On the other hand, a reasonable basis may include the fact that communication with your doctor has broken down or that you have lost confidence in the doctor’s ability to treat you because your condition has not improved under his or her care.

If you change primary treating physicians after the first 60 days of treatment without getting prior approval from the workers’ comp insurance company, the insurer will not be liable for the costs of the treatment you receive from your new doctor. It is best to contact a workers’ compensation attorney if you want to change to different physician mid-treatment to ensure you get proper approval and avoid any surprise medical bills in the future.

Final Thoughts: You Can Choose Your Doctor in Minnesota for Workers’ Comp

Minnesota laws allow employees to receive coverage for medical care rendered by the physician of their choosing. If your employer bars you from choosing your doctor, check for:

  • Your physician’s proximity to you
  • A managed care plan
  • A resolution of a collective bargaining agreement

Otherwise, your employer should not prohibit you from choosing a doctor. If met with resistance, you need an injury lawyer. Call us at Osterbauer Law if you experience such unlawful prohibitions from your employer.