Working With Your Own Doctor – Connecticut Injury Lawyers
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Working With Your Own Doctor

Many people that we work with have long-standing relationships with their own primary care doctors. When these clients are injured on the job, or if they experience an occupational illness or disease, their first instinct is to see their primary care physician for their medical treatment. It makes sense. This doctor knows them, knows their medical history, and they are comfortable getting treatment from this doctor. For some, the idea of having to treat with a different doctor is highly upsetting. You might be someone who does not want to receive care from a new doctor.

Medical Care

The workers’ compensation system understands your situation. When you are first injured, you are entitled to receive all necessary and appropriate medical care and treatment. This is one of your primary workers’ compensation benefits. Your employer is responsible for furnishing your initial medical treatment at a hospital or at a designated office or facility. After your initial medical care and treatment, you may choose your attending physician. If appropriate, your primary care physician can be your attending physician. Depending on your specific workplace injury or illness, you may need specialty medical care and treatment. In such a case, you must receive your treatment from a specialist. For example, if you severely injure your knee in a workplace accident, you might require surgery. Your primary care doctor, no matter how qualified, is not an orthopedic surgeon. In this instance, you will need to receive your surgery and post-surgical care and treatment from a surgeon.

Designated Medical Practitioners and Your Physician

Generally, after your initial visit with your employer’s designated medical practitioner, you may select your own attending physician for the remainder of your case. If your employer does not participate in an approved Medical Care Plan, you are able to choose a licensed medical practitioner within the State of Connecticut, including practitioners who practice medicine, chiropractic, naturopathy, osteopathy, and podiatry.

If your employer does participate in an approved Medical Care Plan, then you are entitled to choose any physician from the list of doctors included within the approved plan. Even if your medical treatment is covered by your employer’s approved plan, you, not your employer, have the right to choose your physician from within the plan.

Your medical care and treatment must be provided by physicians and practitioners licensed to practice within the State of Connecticut. This normally isn’t a problem because most clients live within Connecticut, and they generally want to receive their medical care from a doctor near them. Usually, these doctors are also located within Connecticut.

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Options Outside of Connecticut

If for some reason, you require care and treatment from a doctor who practices outside of Connecticut, you may have some options. First, your employer’s workers’ compensation insurance carrier might agree to have the out-of-state physician provide you with treatment. Consider the case of a highly specialized doctor or nationally recognized specialist located out of state. If your particular medical situation requires a degree of specialization that is not available within Connecticut, then your employer’s insurance carrier might agree and authorize the out-of-state treatment. And, of course, if your employer’s insurance carrier refuses to authorize the out-of-state doctor, you can bring your request to the Administrative Law Judge, who may or may not authorize the out-of-state treatment. The greater your need for the out of state medical care – for instance, in the situation where you require specialty care that isn’t available in-state – the greater likelihood that the Administrative Law Judge will approve your request.

Be aware that if you receive medical care and treatment from a physician or practitioner other than the approved attending physician, or a specialist to who you have been referred, your treatment will be considered unauthorized. By receiving unauthorized medical treatment, you may jeopardize your eligibility to receive further workers’ compensation benefits. Also, the bills for any unauthorized medical care and treatment are your responsibility, not your employer’s.

Getting Help

If you find yourself in a situation where you are being denied your right to select your attending physician, or if you require medical care and treatment from a doctor or practice group that is located out of state, you should contact our workers’ compensation attorneys for assistance. Your employer’s insurance carrier may contest your choice of attending doctor. It is highly likely that they will contest your ability to receive treatment from an out-of-state doctor, no matter how qualified or necessary. Do not chance your important medical care and treatment. Get the legal representation that you need.

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