Workers Compensation Doctor List in Virginia

 

In Virginia you can choose which doctor treats your workers compensation injury to a limited extent. To know your choices, you need to get the employer’s workers compensation doctor list.

 

Virginia workers compensation requires your employer or its insurance carrier to offer a workers compensation doctor list. This list is called the “panel of physicians.” So you’ll often hear the terms “panel of physicians” and “doctor list” used interchangeably during the workers compensation claims process.

 

Many injured employees in Virginia have questions about the list of doctors:

 

  • What are the employer’s responsibilities when it comes to the panel of physicians?
  • Does my employer have to give me a copy of the workers compensation doctor list?
  • Where is the workers compensation doctor list posted?
  • How do I know that the workers compensation doctor list is approved by the Virginia Workers’ Compensation Commission?
  • Can I choose any doctor on the list?
  • What if the employer offers me a list of doctors after I’ve started treating with someone else?
  • What if I need to see a specialist for my injury and the doctor list only contains primary care providers?
  • What if I don’t want to see a doctor on the list?
  • What happens if I treat with a doctor who is not on the list?

 

This article discusses common questions about the workers compensation doctor list and gives you guidance on how to pick the best physician for your work injury. If you have questions about your case or specific situation, contact Virginia workers’ comp lawyer Corey Pollard for a free consultation. We have helped hundreds of injured workers in Virginia navigate workers comp and negotiate top-dollar workers compensation settlements.

 

What Does the Workers Compensation Doctor List Look Like?

 

In Virginia the workers compensation doctor list can take many forms. The Workers Compensation Act does not require the employer or its insurance carrier to use a specific format for the doctor list.

 

Your employer may write or type the contact information for three or more physicians on a sheet of paper. Or it may give you a document from its insurance carrier that lists contact information for several doctors.

 

Where is the Workers Compensation Doctor List Posted?

 

Many employers put a copy of the doctor list in a prominent place at headquarters. This is usually on a bulletin board in the break room or near the time clock.

 

The Workers’ Compensation Act does not, however, require the employer to post the list of doctors in a specific place. If the list is not posted in a common area, ask your supervisor, HR, or the company’s owner for a list of workers compensation doctors.

 

Does My Employer Have to Tell Me About the List of Doctors?

 

Yes. Virginia law states that an employer must advise an injured employee of the identity of panel physicians. Posting a notice that contains the list of doctors or telling employees about the company panel during safety meetings is insufficient.

 

In representing hundreds of injured workers, I’ve found that many were never offered a list of doctors by their employer. Rather, their employer told them to treat with a specific doctor or medical facility following the work injury. Or worse, the employer refused to offer any help at all when medical treatment was needed.

 

Employers are required to do more under the Workers’ Compensation Act. Your employer should give you a list of doctors to choose from and explain that you may pick a doctor from the panel. Contact an attorney immediately if your employer refuses to give you a panel of physicians for your work injury.

 

Can I Keep a Copy of the Workers Compensation Doctor List?

 

Yes. Your employer or its insurance carrier should give you a copy of the workers compensation doctor list.

 

It’s important that you keep a copy of the list for several reasons:

 

1. You need the contact information for the physicians so that you can schedule a workers compensation doctor’s appointment.

 

2. You need the doctor list so that you can follow up with your second or third choice if the first doctor is no longer accepting workers compensation patients. This happens more often than you would think – and it is grounds for a new panel.

 

3. You need the list in case the employer or its insurance carrier later argue that treatment was unauthorized.

 

We recommend making copies of the workers compensation doctor list and taking a picture of the list using the camera on your cell phone. Send a copy of the list of doctors to your attorney so that he or she can help you choose the best one.

 

How Do I Know that My Employer’s List of Doctors is Valid under the Workers Compensation Act?

 

Many workers compensation doctor lists offered by employers and insurers are invalid. But you will need to speak with an attorney to determine if your panel is proper under law.

 

Here are common reasons that the workers compensation doctor list is improper:

 

1. It lists physicians who are affiliated with one another. For example, we’ve seen many doctor lists that give three options but two of the physicians are affiliated with one another and work for the same hospital. Unless we have a favorable opinion of one of the doctors and have found him or her helpful in the past, we will ask for a new list of doctors.

 

2. The doctor list contains medical providers who are too far from your residence. There is no bright-line rule for the distance that you may be required to travel to see a doctor on the list, but the Commission will review your limitations, the physician’s specialty, and the availability of physicians in your area when determining whether the panel is valid.

 

You may still want to choose a doctor from the list even if the panel is invalid. For example, we have received invalid panels that contain at least one doctor who we know will be a strong advocate for our client is disability or the reasonableness of medical treatment is disputed in the future. In that situation we would not ask for a new panel.

 

Can I Choose Any Doctor on the Workers Comp List?

 

Yes. You can pick any doctor from the panel of physicians. The doctor you pick becomes your authorized treating physician.

 

The authorized treating physician plays a critical role in your case, so it’s important that you pick the best doctor from the list. Choosing the right treating physician is often the difference between getting the medical treatment you need to recover physically and maximizing the value of your wage loss and permanent partial disability benefits, and having to fight the insurance company for approval of medical treatment at multiple workers compensation hearings.

 

We spend a lot of time developing relationships with workers compensation doctors across the state. We can point you in the direction of the best doctor for your case – someone who can provide top-notch medical treatment and who will help us during litigation with supportive statements and opinions.

 

Do I Have to Choose a Doctor from the List if I’ve Already Established Care with Another Doctor?

 

As we discussed above, some employers will tell an injured employee to see a specific doctor after an injury.

 

Let’s say you followed your employer’s direction and started treating with that doctor. After a few visits to that doctor the workers compensation insurance adjuster calls and tells you that you can no longer see that doctor. The adjuster offers you a new panel of physicians. What can you do? You like that doctor and seem to be getting better.

 

Depending on the facts of your case, you may be able to continue treating with the initial doctor.

 

In Flanegin v. Hechingers Corp., 75 O.W.C. 275 (1996), the injured employee reported the accident on the day after it happened. He then treated with his physician eight times.

 

Three weeks later the employer offered a list of doctors from which to choose. The Commission found that the offer of a panel was untimely and that the employee had already established care. The employer did not have to treat with someone on the list of doctors.

 

Time and time again the Commission has stated that once an employee selects an initial treating physician the employer may not thereafter offer a panel of physicians. But as an injured employee you should consult with an attorney to evaluate whether you have established care with a treating physician as that term is defined by the Workers’ Compensation Commission. The Commission may require you to have attended multiple appointments before it will state that you established care with a particular physician.

 

Do I Have to Choose a Physician from the Workers Compensation Doctor List if the Employer and Insurer Denied My Claim?

 

No.

 

When the insurance company denies liability for a claim you can choose your own treating physician. The carrier cannot turn around and force you to choose from a panel of physicians if the claim is found compensable. It is stuck with the doctor you chose when the claim was denied.

 

What Happens if I Treat with A Doctor Who is Not on the Panel of Physicians?

 

If the employer offers you a panel of physicians but you decide to treat with someone who is not on the panel, then you may have to pay for treatment with the unauthorized physician. This can get expensive.

 

What if I Get Referred to a Specialist Who is Not on the List?

 

Most workers compensation doctor lists, especially those from employers, do not contain specialists. Instead the panel lists numerous primary care providers.

 

Many of you will require a specialist for your work injury. Most of our clients see an orthopedic doctor for their neck, back, shoulder, knee, or ankle injuries.

 

You should still seek treatment with a physician on the panel, even if you think you need to see a specialist. The panel physician has the power to refer you to an orthopedic doctor, and the insurance company is responsible for the payment of medical treatment rendered by or at the direction of your authorized treating physician.

 

Have Questions About Your Workers’ Compensation Case?

 

You deserve the best medical care possible after your work injury. And to receive it, you must understand how to navigate workers’ compensation medical issues.

 

If you have any questions or concerns, contact attorney Corey Pollard for a free consultation. We’ll answer your questions about workers compensation and give you a free consultation. All you have to do is call, text, or email us today.

Corey Pollard
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