Who will my doctor be?
If you suffer a job-related injury (an injury that was caused by an accident arising out of and in the course of your employment), your employer has the right to select the doctor you will see — given that it will pay for the treatment. The approved doctor is known as an authorized treating physician. The law further requires that the injured employee must submit himself for examination by the employer’s physician at all reasonable times if requested to do so by the employer. If an employee’s refusal is deemed unreasonable, rights to compensation may be suspended by the employer. If the initial doctor refers the injured to a specialist, the specialist is also deemed to be an authorized treating physician, and the employer must pay for that specialist’s treatment, as well. There are no co-pays, deductibles, or caps on what must be paid to authorized doctors for reasonable and necessary treatment over the course of the injured worker’s life, so long as the treatment relates to the work injury. Only rarely do circumstances arise where the injured worker is able to select with complete freedom what doctor he may wish to see.
Often, workers are dissatisfied with the initial authorized physician. If you are dissatisfied with the initial physician selected by your employer, you may be entitled to select another physician from a panel of four different physicians – selected by the employer. If surgery is required and you are not content with the selected surgeon, you may also elect to select another surgeon from a panel of four different surgeons – also selected by the employer.
What is my employer required to pay?
The law in Alabama requires that an employer pay the actual cost of necessary medical and surgical treatment; physical rehabilitation; medicine; medical and surgical supplies; crutches; and artificial members and other apparatus. Employers often utilize an “independent medical review” tor “peer review” to determine if a proposed procedure, surgery, or course of treatment is “reasonably necessary” and likely to improve the employee’s condition. In doing this, when the injured worker’s doctor says he needs a particular course of treatment, the insurer will get another doctor — never seen by the worker — to look over the records and see if he agrees with the treatment recommended by the authorized doctor; this often results in the treatment being denied. This is how penny-pinching insurers dispute the necessity of prescribed treatment and limit their expenses in providing medical treatment. We fight these reviews for our clients very frequently, so that our clients get the treatment the authorized doctors say they need.
If your employer or their workers’ compensation insurance carrier are dragging their feet or preventing you from treatment you need, consider contacting an experienced workers’ compensation attorney at our office so that we can help.