Workers compensation claim: your right to choose your doctor

Lodging a workers compensation claim can be a very complicated process for the ordinary person; endless paperwork and demands being made by the insurer, all whilst trying to seek treatment to improve your injury and manage your pain.

One issue that arises often is that insurers arrange for an injured worker to see a doctor for the purpose of issuing a Certificate of Capacity. This is despite the worker already having their own doctor who they trust and want to continue providing treatment.

So, can the insurer tell you which doctor to see for treatment?

The simple answer is ‘no’.

Under the law, the worker has a right to nominate a treating doctor (GP) for the purposes of managing their injury. This doctor is referred to as the “Nominated Treating Doctor”.

You also have the right to be referred to a treating specialist of your choosing, or as suggested by your Nominated Treating Doctor.

The insurer and/or your employer cannot, and should not, arrange for you to be seen by a doctor for the purpose of treatment. This includes for the purpose of arranging an Injury Manageme.nt Plan or to obtain a Certificate of Capacity.

However, the insurer can arrange for an Independent Medical Examination if they want to review the appropriateness of your treatment or work capacity. Failure to attend a legitimate or reasonably requested independent examination can result in the insurer ceasing your benefits.

If you are asked to see a doctor by the insurer or your employer, you should specifically ask for what purpose the assessment will be conducted. You should also ask that they confirm this in writing.

Approved Legal Service Providers in workers compensation cases, such as the lawyers at Kells, can provide you with advice free of charge. We can access funding from the Independent Review Office to ensure that your legal fees are covered, and you are not out-of-pocket for seeking help.

If you have concerns about requests being made by an insurer, we encourage you to contact us today. We provide a free consultation and our legal services are on given on a “no win, no fee” basis.

ID 1062948 © Byron Moore | Dreamstime.com