Can Injured Workers Choose Their Own Doctors?

If you have suffered a work-related injury or illness in Massachusetts, you may be entitled to benefits under the Massachusetts workers’ compensation system. Along with wage replacement while you are recuperating, the system also provides medical treatment for your injury or illness if you qualify.

Understandably, injured workers are often confused about their right to choose a doctor. Although each claim is unique, the following general guidelines may help you understand your rights if you have suffered a work-related injury or illness in Massachusetts.

Filing Your Claim

Before you do anything else, you need to report your injury to your supervisor. In the normal course of events, your employer will then file the necessary paperwork to report your injury and get your benefits approved through its workers’ compensation carrier. Your employer must file the required documents within seven calendar days after the fifth calendar day of your injury or illness. This makes it very important that you notify your employer in writing immediately after your injury.

Initial Evaluation

Once your claim has been filed, you may be required to be seen for an initial evaluation by what is referred to as a “preferred provider.” Essentially, this is a type of workers’ compensation insurance plan that calls for all claimants to have an initial evaluation by a physician who is part of the “preferred provider” plan. Many people have preferred provider health insurance plans that operate in much the same way. Although this initial evaluation may be required, you are not obligated to continue treatment with the physician who completes your initial evaluation.

Choice of Doctor

After you have had an initial evaluation with the preferred provider, if applicable, you then have the right to be seen by a doctor of your choosing. Furthermore, your employer is legally required to provide you with a list of all physicians or specialists in the area who are on the preferred provider list. You may also have the right to seek a second or even a third opinion if you are not satisfied with the initial doctor’s evaluation.

Treatment Disputes

Along with your right to choose your doctor, you have a say so in the treatment you receive. Sometimes, your doctor will recommend a course of treatment that the workers’ compensation system does not agree with or does not wish to pay for initially. You have a right to dispute this refusal to pay for treatment. You also have a right to negotiate the amount that the system is willing to pay for services, such as a surgery.