Who Can I Choose As My Doctor Under the Workers' Compensation System - The Defense Base Act

This article is made available for educationalthat if you do not like your doctor or what he is
purposes only, to give you general informationtelling you, the insurance company probably loves
and a general understanding of the law, not tohim.
provide specific legal advice. This should not beOne situation we have run into recently, is where
used as a substitute for competent legal advicethe insurance company actually recommends a
from a licensed professional attorney.doctor to the injured employee. Sometimes this is
Who can I choose as my doctor under thedone by the insurance company's "Nurse Case
Defense Base Act?Manager." A Nurse Case Manager often just ends
This is a question I am not asked frequentlyup being a spy for the insurance company. He or
enough. The answer is simple - you can chooseshe will be assigned to your case and theoretically
any qualified physician under the sun to treat yourtheir job is to facilitate your medical treatment.
injuries. That is a flexibility not offered under mostThey may even convince you to allow them to
state workers' compensation systems. Forcome to your doctor's visits and speak privately
instance, in the State of Georgia, where ourwith your doctor. However, no matter how
office is located, you would only have a choicepleasant a human being they appear to be, they
from a list of doctors your employer posts atare first and foremost an employee of the
your work place. Under the Defense Base Act,insurance company. Their paycheck comes from
depending on the type of injury you suffered, ifthe same place as your weekly check and your
the doctor you choose is a licensed surgeon,medical expenses. Their interests are not
podiatrist, dentist, clinical psychologist, optometrist,necessarily in line with yours.
osteopath, or chiropractor, then you have made aIn a recent case, the Nurse Case Manager
valid initial choice of physician.mentioned this "great" doctor they knew whose
The reason why I am not asked this questionoffice was nearby to our client. Little did he know
very often, is that most injured contractors onlythat this doctor is one of the "go-to" doctors one
contact an attorney AFTER something has gonemajor insurer sends claimants to for "independent"
wrong with their case, like that their benefits aremedical evaluations when they seek to challenge a
stopped or reduced or a medical procedure isclaimant's case. To our industry, this conversation
denied or delayed. One reason why this isis the equivalent of offering to sell you some
unfortunate is that while you have amazingbeachfront property in Nevada.
flexibility in choosing an initial physician, those sameThey managed to fool the unsuspecting injured
rules limit your ability to change doctors.contractor into picking this doctor as his one free
If your first choice of physician refers you tochoice of doctors. You can guess how well that
some other specialist, for instance a family doctorhas worked out for him. He had no clue of this
who refers you to a orthopedic specialist for adoctor's reputation and had no clue he likely could
back problem, the insurance company must honornot change doctors without the insurance
that referral. Also, if your doctor retires, you cancompany agreeing. While you have a wealth of
choose a new one.options available to you upon your return to the
However, outside of those situations, you areUnited States or your home country, when you
pretty much stuck with your first choice. Once apick your doctor please do some research, talk to
claimant has made his initial, "free choice" of afriends, or make some calls. Don't just pick them
physicians, he may change physicians only uponout of the phone book and double check anyone
obtaining prior written approval of the employer,the insurance company recommends.
insurer, or the Department of Labor. It is likely