If you’ve been injured at work, getting the right medical care is an important part of your recovery. But you may be wondering whether you have to see a doctor chosen by your employer or the workers’ compensation insurance company, or whether you can choose your own doctor.
In Wisconsin, injured workers generally have the right to choose their own treating medical provider for a work-related injury. However, there are rules about choosing a doctor, switching providers, and getting treatment covered by workers’ compensation.
Understanding these rules can help you protect your health and avoid unnecessary disputes over medical expenses.
Can You Choose Your Own Doctor After a Workplace Injury?
Yes. Under Wisconsin workers’ compensation law, an injured employee generally has the right to select a qualified medical provider licensed and practicing in Wisconsin to treat a work-related injury. Eligible providers include physicians, chiropractors, psychologists, dentists, physician assistants, advanced practice registered nurses, and podiatrists.
Your employer should offer you the opportunity to choose your treating provider when it has notice of your injury and its connection to your employment. You do not automatically have to accept a doctor simply because your employer or its insurance company recommends one.
There is an important distinction, however, between choosing your treating doctor and attending an examination requested by the employer or insurance company. An insurer may have the right to require a reasonable medical examination under applicable workers’ compensation rules.
How Many Times Can You Change Your Doctor?
Wisconsin law generally allows injured workers two choices of treating provider.
Your first choice: You can select a qualified provider to evaluate and treat your workplace injury.
Your second choice: If you are dissatisfied with your first provider or want another medical opinion, you generally have the right to choose a second provider. You must notify your employer or its workers’ compensation insurance carrier of this second choice.
Additional changes: If you want to switch providers again, you generally need mutual agreement from the appropriate parties.
There are also important exceptions to these rules. For example, a referral from your treating provider to a specialist generally does not count as a new choice. Providers within the same partnership or clinic are also generally treated as one provider for this purpose.
Because these rules can affect whether treatment expenses are covered, it is important to understand your rights before making a change.
What If Your Employer Tells You Which Doctor to See?
Your employer may provide information about medical providers, but Wisconsin law generally protects your right to choose your treating provider.
If your employer directs you to a particular doctor, it is worth clarifying whether the appointment is intended to provide treatment or is an examination requested by the employer or insurer. These are not necessarily the same thing.
If you feel pressured to use a particular provider or are unsure whether you can select someone else, consider reviewing the situation with a workers’ compensation attorney before making decisions that could affect your claim.
What If You Need Emergency Medical Treatment?
Your health and safety come first.
In an emergency, your employer may arrange immediate medical treatment without first offering you a choice of provider. Once the emergency has passed, you generally must be given the opportunity to select your treating provider as soon as reasonably possible.
Do not delay emergency medical care because you are uncertain about workers’ compensation procedures. Notify your employer about the injury as soon as you can and keep records of the treatment you receive.
Will Workers’ Compensation Pay for Your Medical Treatment?
Wisconsin workers’ compensation generally covers reasonable and necessary medical treatment related to a compensable workplace injury. Covered expenses may include doctor visits, hospital care, medication, diagnostic testing, physical therapy, and other appropriate treatment.
However, not every medical expense is automatically covered. Disputes can arise over whether treatment is related to the workplace injury, whether it is medically necessary, or whether the applicable provider-selection rules have been followed.
To help prevent problems:
- Tell your medical provider that your injury happened at work.
- Report the injury to your employer promptly.
- Keep copies of medical records, prescriptions, referrals, and bills.
- Notify your employer or insurance carrier when selecting a second treating provider.
- Keep copies of any correspondence about your claim or medical care.
If you receive a medical bill that you believe should be covered, do not simply ignore it. Contact the workers’ compensation insurance carrier or claims administrator to clarify the issue.
What If You Disagree With Your Doctor’s Opinion?
A disagreement with your doctor can be stressful, particularly if the doctor believes you can return to work while you are still experiencing pain or limitations.
If you are concerned about your diagnosis, treatment plan, or work restrictions, you may have options for seeking further medical advice. Wisconsin law generally allows a second choice of treating provider, subject to the applicable notice requirements.
You should also keep copies of any medical restrictions and provide them to your employer when appropriate. These records may be important if you cannot perform your regular duties or need temporary workplace accommodations.
Keep in mind that a second medical opinion does not automatically mean the insurance company must accept every recommended treatment or pay every related expense. Coverage can depend on the circumstances and applicable law.
What If the Insurance Company Disputes Your Medical Treatment?
A workers’ compensation insurer may dispute whether an injury is work-related, whether a particular treatment is necessary, or whether medical expenses should be paid.
If your treatment is denied or payment is delayed, ask for an explanation in writing and keep a record of your communications. Review the reason for the dispute and consider getting legal advice about your options.
An attorney familiar with Wisconsin workers’ compensation law can help you understand the dispute, identify relevant documentation, and determine whether further action may be appropriate.
Speak With a Wisconsin Workers’ Compensation Attorney
After a workplace injury, you should be able to focus on your health and recovery rather than worry about whether your medical treatment will jeopardize your claim.
If you have questions about choosing a doctor, changing providers, disputed medical bills, or a workers’ compensation denial, understanding your legal rights can help you decide what to do next.
At Bykhovsky Law, we help injured people understand their options and navigate the challenges that can follow a workplace injury.
Contact Bykhovsky Law for a free consultation. We can discuss your situation and help you understand your legal options. You pay no attorney fees upfront.
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This article is for general informational purposes only and does not constitute legal advice. Workers’ compensation rights and coverage depend on the facts of each case and applicable Wisconsin law.
