You can see your own doctor while on workers’ comp if you are willing to cover the costs and need a second opinion. However, while on workers’ comp, generally, you are expected to see the treating physician of your employer’s choosing. In this way, when clients ask us, “Can workers’ comp force you to see their doctor?” we find it necessary to explain how South Carolina workers’ compensation laws work so they better understand what to expect from the process.
Your dedicated North Charleston workers’ compensation lawyer from Shelly Leeke Law Firm has in-depth knowledge and experience of the South Carolina Workers’ Compensation Act. We can help you assert your right to be seen by the doctor you feel most comfortable with. Contact our office for a free consultation to learn more about how you can work within the state’s laws to protect your rights.
You Have the Right to Coverage of Your Medical Treatment in Your Workers’ Compensation Claim
You are entitled to coverage of your medical expenses when you are involved in a work-related accident. Immediately after the incident, inform your human resources department, supervisor, or upper management professionals as soon as possible. They will need to direct you to the nearest health clinic or employer-approved physician so you can get the treatment and care you need.
When you arrive at the healthcare facility, notify medical professionals that you were involved in a work-related injury. Make sure you provide them with the name of the company you work for and your manager. If you are involved in an accident that requires emergency medical attention, you should be taken to the nearest hospital for treatment.
When you arrive at the hospital, notify them of your work-related injury. Then, as soon as you are stable, notify your employer of your catastrophic injury. Otherwise, your employer may attempt to claim that you failed to report the work accident in a timely manner.
What Workers’ Comp Covers in South Carolina
South Carolina requires any company with four or more employees to have workers’ compensation coverage, according to the South Carolina Workers’ Compensation Commission (SCWCC). As part of this coverage, your employer’s insurance provider is obligated to cover specific types of costs and offer certain benefits. These benefits include:
- Full coverage of your medical expenses, including future medical treatment related to your work injuries
- The cost of your hospital stay and ambulance bills
- Cost of medical devices, including prosthetic limbs, wheelchairs, braces, and other necessary equipment
- Ongoing mental health counseling or rehabilitative therapy expenses
In addition to medical expenses, the insurance company will also provide you with wage replacement benefits amounting to approximately 2/3 of your average weekly salary, according to the SCWCC. If your injuries prevent you from being able to return to work, the insurance company may cover the cost of vocational rehabilitation or training so you can begin to support yourself more. Additionally, if you succumb to catastrophic work injuries, your surviving family members may be entitled to death benefits, including disability benefits and coverage of your funeral and burial costs, according to SC Code §42-9-30.
Can I See My Own Doctor for Workers’ Comp Benefits?
It is not unusual for our clients to ask, “Can you see your own doctor on workers’ comp?” According to the SCWCC, employers have the authority to choose the doctor who will treat you. You may not be entitled to coverage of your medical expenses if you go to a physician that your employer has not approved. This is one of the most common ways companies attempt to avoid paying out on workers’ compensation claims.
You will generally be expected to follow the treating physician’s healthcare plan so as to continue collecting medical benefits. If your doctor imposes or lifts work restrictions, you will need to adhere to these guidelines. If your physician gives the go-ahead for you to return to work on light duty, if you refuse to do so, your workers’ compensation benefits may be terminated per South Carolina Code §42-9-30.
This also applies to occupational illnesses. For example, if you regularly work with toxic substances or chemicals, you might develop a respiratory condition. To ensure your medical expenses are covered, you will need to be diagnosed and treated by the physician your employer has pre-approved.
What Do I Do if I Want a Different Doctor to Treat Me During My Workers’ Comp Case?
If you are unhappy with your treatment or care with your employer-approved doctor, you may be able to see a physician of your choosing. However, you will need to request a second opinion from your employer’s insurance representative. Do not be surprised if they deny your request.
If this happens, your workers’ compensation attorney in South Carolina will be prepared to help you with a formal appeal before the SCWCC. We will need to fill out the necessary appeal forms, submit them, and present this evidence and documentation during a hearing before the Workers’ Compensation Commission Board. We will need to explain to the SCWCC why you would like to see your own doctor to get your request approved.
You Can Pay Out of Pocket for a Second Opinion
If you find that your request for a second opinion or to see your own physician is denied, you may still be able to get your personal health insurance to cover the costs. If your insurance company refuses to pay, you have the right to see your own doctor by covering costs out of your own pocket. If your healthcare provider’s medical records differ from that of your employer-approved physician, you may be able to get the insurance company to cover your medical expenses with help from your legal advocate.
Turn to a Trial-Proven South Carolina Workers’ Compensation Law Firm for Help Today
You may be required to use your employer’s selected healthcare provider, but that does not mean you cannot see your doctor if you are unhappy with the medical attention and care you receive from the provider of your employer’s choosing. However, expect the insurance company and your employer to push back when you attempt to assert your rights. Working with a reputable South Carolina workers’ compensation lawyer from Shelly Leeke Law Firm may be the best way to show the insurance company you are taking your workers’ comp benefits seriously.
If the insurance company is delaying the processing of your claim or you have received a denial based on the assigned treating physician’s diagnosis, you may require the legal support of a trusted advocate. Turn to our law firm to request a free consultation and get the second medical opinion you are entitled to. Complete our convenient contact form or call our office to schedule yours as soon as today.
