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Choice of Doctor.

The general rule is that an injured employee is always allowed to choose the health care provider from whom they wish to receive treatment. This right may be limited in two situations.

If the employer has a certified managed care plan in place on the date of injury, or opts to purchase one after the date of injury, the employee may be required to treat with a participating provider on the managed care plan’s list. The employee is always able to treat with any provider with whom he/she has a prior history of care. That history does not have to include at least two treatments in the two years immediately preceding the date of injury as many insurers will tell you. Any prior history of treatment, for any condition, will suffice so long as the history reasonably supports the employee’s claim that they trust the provider and want to treat with them.

If the employee belongs to a union, the collective bargaining agreement may contractually obligate the employee to treat with specified providers. Usually these contracts only require an evaluation with the company doctor before the employee will be allowed to return to work after an extended absence.

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