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Can I Go to My Own Doctor for Workers’ Comp?

If you’re injured at work, you might wonder whether you can see your own doctor for your care. We get it; workers' compensation can get complicated, especially when it comes to choosing your medical provider.

 

Our New York workers’ compensation lawyers explain your rights to choose a doctor, how Preferred Provider Organizations (PPOs) affect your options, and how Independent Medical Examinations (IMEs) could affect your claim below.

How Do I Check If My Doctor Is Authorized by the New York Workers’ Compensation Board?

Before choosing a doctor, you’ll want to make sure they’re authorized by the New York Workers’ Compensation Board (WCB). Only WCB-approved providers can bill workers’ compensation insurance for your treatment. You can verify this by checking the WCB’s online database, calling the doctor’s office directly, or asking your employer, especially if they use a Preferred Provider Organization (PPO).

Can I Change My Workers' Comp Doctor?

Yes, you can change your workers' compensation doctor at any time. You can request a new provider if you're unhappy with your care or feel your needs aren't being met.

 

When Can You Request a New Doctor?

 

  • Within the First 30 Days: As mentioned above, if your employer is part of a PPO, you must start treatment with a doctor from that network. After 30 days, you can switch to any WCB-authorized provider.
  • After 30 Days: If you’re beyond the initial 30-day period or if your employer doesn’t use PPO, you can change doctors without restrictions.

 

To make the switch, you’ll need to notify your insurance carrier or employer in writing to ensure your medical records are transferred and your new doctor has your treatment history.

What Happens If You Refuse to See the Approved Doctor?

If your employer is part of a PPO or an Alternative Dispute Resolution (ADR) program, not seeing a doctor from their approved list for your initial treatment could create problems with your claim, including delays or even denials of benefits.

Can I Go to My Own Doctor for Workers’ Comp?

In New York, if you’re injured at work, you generally have the right to choose your doctor
under workers’ compensation. There are rules you need to follow, though, to make sure your benefits aren’t affected:

Emergency Care

In an emergency, you can seek treatment from any available medical provider.

Authorized Providers

For non-emergency care, your doctor must be authorized by the New York Workers’ Compensation Board.

Preferred Provider Organization (PPO)

If your employer uses a PPO, you must see a provider within that network for the first 30 days after your injury. After 30 days, you can switch to any authorized provider by notifying your employer or insurer in writing.

Medical Reports

Your doctor must submit a Doctor’s Initial Report (Form C-4) within 48 hours of your first treatment.

What Happens If Workers' Comp Orders an IME?

An Independent Medical Examination (IME) is a medical evaluation requested by your employer’s insurance company. Its purpose is to provide an independent opinion about your condition and the extent of your injuries.

 

If your insurer orders an IME, you are generally required to attend. Refusing to go or missing the appointment can put your benefits at risk, since the exam helps the insurance company decide how serious your injuries are and what treatment may be necessary.

How Long Do I Have to See a Doctor After a Work Injury?

In New York, you generally have 30 days to report your injury to your employer, but it’s best to seek medical attention right away, ideally within 24 hours. Getting care quickly not only helps your recovery but also strengthens your workers’ compensation claim by ensuring your injuries are properly documented.

 

Your doctor must also file an initial report with your employer and the WCB within the first 48 hours of your visit, followed by a more detailed report within 15 days. Delaying treatment can create problems since it might suggest your injuries aren’t serious, which could hurt your claim.

Do I Need Referrals to Specialists?

In most cases, you don’t need a referral to see a specialist for a work-related injury. If you’re seeing a WCB-authorized primary care doctor, they can refer you to a specialist when it’s needed.

Key Takeaways

In New York, you can choose your own workers’ compensation doctor if they’re authorized by the Workers’ Compensation Board.

If your employer has a PPO, you must see one of their doctors for the first 30 days of treatment.

You can change doctors anytime, but you need to notify your insurance company or employer in writing.

Contact Our New York Workers’ Compensation Lawyers!

Workers’ compensation can be complicated, especially when it comes to choosing a doctor and understanding your rights. Field Law Group is here to make the process easier and ensure you get the benefits you deserve.

 

Whether you have questions about your claim or need help finding an authorized doctor, Contact us today or call 212-739-7278 to schedule a FREE consultation with our firm.

 

About the Firm: With over a decade of experience, Field Law Group has been helping personal injury victims across New York since 2013. We’re dedicated to protecting the rights of accident victims and fighting to get them the compensation they deserve.

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