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Can I See My Own Doctor If I’m Receiving Workers’ Compensation Benefits?

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As a general rule, when you receive medical care for a job-related injury under workers’ compensation, your employer has the right to choose your doctors. There are, however, several exceptions to this rule. For instance, if you require emergency medical care and cannot immediately reach your employer, you are free to go to the doctor of your choice without waiting for approval.

Outside of an emergency situation, you can also select your own healthcare provider if your employer consents to such an arrangement. But if your employer does not consent and you are dissatisfied with the doctor chosen for you, then your only option is to ask the Iowa workers’ compensation commissioner for permission to seek “alternative care” at the employer’s expense.

Iowa Supreme Court Holds Employer Not Liable for “Unauthorized” Surgery

So what happens if your employer initially denies your claim for workers’ compensation benefits altogether? In that case, you are free to seek whatever medical care you think is necessary and appropriate, albeit at your own expense. If you then successfully challenge the decision to deny workers’ compensation coverage, the commissioner may then order your employer to pay for these “unauthorized” medical services if you can prove they were “reasonable and necessary” under the circumstances.

Recently, the Iowa Supreme Court addressed a situation where an employer initially denied an employee’s injury was covered by workers’ compensation but later changed its position. In the interim, the employee opted to undergo surgery from a physician who was not authorized by the employer. A dispute then arose as to whether or not the employer had to pay for the employee’s time off from work to recover from the surgery.

Here are some more details. The plaintiff injured her left shoulder as the result of repetitive work moving large bolts of fabric and equipment. The employer authorized workers’ compensation benefits. While receiving treatment for this injury, the employer-authorized medical provider later diagnosed the plaintiff with carpal tunnel syndrome.

The provider said the carpal tunnel was a work-related injury. The employer disagreed. It subsequently denied the plaintiff’s request for additional workers’ compensation benefits related to her carpal tunnel. The plaintiff appealed this decision, but was turned down by the workers’ compensation commissioner.

This was not the end of the matter. The employer continued to “investigate” the plaintiff’s carpal tunnel. It directed her to see another doctor, who concluded the plaintiff’s condition was in fact “aggravated” by her work. The employer subsequently told the commissioner it now admitted liability.

The plaintiff then decided to undergo surgery to treat her condition. She did not receive authorization from the employer. The employer later denied the plaintiff’s request for “healing period benefits” for the time she needed off from work to recover from surgery, arguing it was not legally responsible for any “unauthorized” treatments.

Following multiple rounds of administrative and judicial review, the Iowa Supreme Court sided with the employer. The justices said healing period benefits are subject to the same rules as other workers’ compensation benefits. And once the employer reversed its initial decision to deny compensation for the plaintiff’s carpal tunnel, it “regained” the right to direct her medical care.

Speak with an Iowa Workers’ Compensation Attorney Today

Workers’ compensation often frustrates employees, who struggle to reconcile the need for immediate medical care with their obligation to follow a complex web of rules and regulations. Hiring an experienced Iowa workers’ compensation lawyer can help. Call the Noyes Law Office, P.C. today if you have suffered a work-related injury and need legal advice on what steps to take next.

Source:

iowacourts.gov/courtcases/283/embed/SupremeCourtOpinion

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