Can North Carolina Injured Workers Switch Doctors?
When an employer accepts liability for a work-related injury or condition, the employer gets the right to direct the medical care. This includes the selection of doctors, hospitals and other healthcare providers. Sometimes workers are dissatisfied with the doctors chosen by the employer. The question therefore often arises as to whether the employee can change doctors at will.
The answer is no.
Our Raleigh workers' comp lawyers want to make it clear to injured workers that there is an alternative: The injured employee may ask the Industrial Commission for permission to change doctors.
The controlling statute in North Carolina provides that if an employee desires, “an injured employee may select a physician of his own choosing to attend, prescribe and assume the care in charge of his case, subject to the approval of the Industrial Commission."
The “subject to the approval of the Industrial Commission” is a big hurdle. Unless the Industrial Commission has a very good reason to allow the employee to change physicians, the requested change of doctor is usually denied.
Of course, an employee may always consult and be treated by a doctor of his/her choice. However, the risk of doing so is that the Industrial Commission may not require the employer to pay for this medical care.
If a case is being defended by an aggressive workers' compensation insurance company, it will try to direct employees to physicians who it thinks are more likely to render opinions favorable to the insurance company.
As mentioned in our North Carolina workers' compensation book, there are some doctors who, for whatever reason, are totally unsympathetic to the plight of the injured worker and consistently render opinions adverse to the employee. If you end up with one of these doctor’s you should try hard to change doctors and start treatment by an objective fair-minded doctor.
If the situation with the employer’s doctor is bad enough, it may be wise to go to another doctor, even without the approval of the Industrial Commission, so that you can present the opinions of the new doctor to the Industrial Commission to support your claim. It is not necessary that a doctor be approved in order to give testimony to the Industrial Commission. It is necessary however for a doctor to be approved by the Industrial Commission before the employer will be required to pay for the services of those doctors.
If the employer is not required to pay the doctors fees it may be possible to recover payment for those fees from a health or hospitalization insurance policy issued either to the employee or the employee spouse.
Theoretically, there is no limit on the number of physicians the employee may choose. However, it is unlikely that the Industrial Commission will approve and require the employer to pay for multiple doctors chosen at the will of the employee.
It is a safer practice to obtain permission from the Industrial Commission before a new doctor is consulted. The risk is the Industrial Commission may not approve this doctor and the employee will thereby be stuck with the bills. The law requires that application for approval of a change of physician occur within a reasonable time after procuring the services of the physicians.
In order to support an approval by the Industrial Commission for medical treatment rendered by the employees own physician there must be a finding based upon competent evidence that the treatment was “required to affect a cure or give relief” or that it has “tended to lessen the time of disability”. There must also be finding that the condition treated is or was caused by, or was otherwise traceable to a work related injury or condition.
See Brent Adams' North Carolina workers' compensation book for a discussion as to when and under what circumstances an employer may switch doctors after a treating physician has been established.