Can the Workers Comp Insurance Company Have a Say in My Treatment?

Neither the insurance company nor the employer can choose how you are being treated or what’s done in order to help you get better.

When you file a workers comp claim, you are essentially asking for your medical costs caused by a work injury or illness to be covered in addition to other compensation you may be entitled to. In Missouri, the employer has the legal right to choose the doctor who will administer said treatment, which can often bring forward a set of issues.

What Does the Law Say?

Legally, your employer has the right to choose the doctor who will be treating you if you file a workers compensation claim. They usually transfer this right to the insurance company that will ultimately make the reimbursements because the company frequently collaborates with doctors.

As a result, if you seek treatment for your work injuries from a different doctor, you risk missing out on workers compensation benefits. However, if you went to your own doctor to get diagnosed, it is possible to get the costs reimbursed if you argue you were not aware of your work-illness at the time – you were just visiting your doctor for a routine check-up.

You may ask your employer to allow you to continue seeing your doctor, and if they agree, the insurance company must comply, unless the employer has legally transferred their right to choose the doctor to the company (some may ask for it in writing, while others may not). The insurance company will most likely not be very keen to allow you to seek a doctor of your choice, because they’d prefer you go to the one they have a relationship with.

Why Is That Important?

Because the insurance company knows the doctor who is treating you, it can be much easier for them to get information about your medical improvements, either directly from the doctor, or “spies” like nurses or other hospital staff. As a result, they can be one step ahead, and move to stop your benefits when you’re showing improvement.

However, neither the insurance company nor the employer can choose how you are being treated or what’s done in order to help you get better. That remains the decision of the doctor, who must choose the best course of action for you regardless of the insurance company’s wishes.

I Suspect I’m Not Getting the Best Treatment

If you think the insurance company may have too much of a say in your treatment, you have some options for fighting back. One possible solution is requesting the help of the Dispute Management Unit, which will act as a mediator and try to make sure each party is heard.

Another option is to sue the insurance company, though this is really only an option if you have proof they are overstepping their bounds and deciding your treatment.

Speak With a St. Louis Work Injury Lawyer

If you think your insurance company if influencing your treatment, you can fight back. Get in touch with a St. Louis workers comp lawyer to see what your options are. Give us a call 24/7 at (314) 361-4300.