Can I Choose My Own Doctor for Workers’ Comp?

The three broad models

States fall into roughly three groups:

• Employee choice You select your own treating physician, sometimes with a requirement to notify the employer or carrier
• Employer or carrier directed The employer or its carrier designates the treating provider, often from a network or a posted panel, at least for an initial period
• Hybrid The employer directs care initially and you gain the right to change after a set period, a set number of visits, or by following a formal request process

Within those models there are usually additional rules on emergency treatment, on second opinions, on how many times you can change provider, and on what happens if you see someone outside the permitted arrangement.

How to change your treating physician

Most states allow a change at some point, and most require you to follow a defined process rather than simply switching. That usually means notifying the carrier or filing a specific form, and sometimes needing approval. Do it formally, because treatment from an unapproved provider may not be paid.

Your pharmacy is a separate question

This is worth knowing, because people conflate the two. Rules about choosing your treating physician are not the same as rules about which pharmacy fills your prescription, and in many states pharmacy choice is treated differently and less restrictively than provider choice. If you have been told you must use a particular pharmacy, it is worth checking, because your options may be wider than you were led to believe.

If you would like your workers’ comp prescriptions handled by a pharmacy that does only this, call us at (317) 676-5752 and we will tell you whether we can serve your claim in your state.