Can you select your own doctor after a workplace injury?

When you get hurt on the job, it’s a painful reminder of how quickly your life could change. Now, you need to seek medical care and to go through a potentially long recovery.

Who can help with that recovery? That depends on the doctor you choose.

Short of the Texas Workers’ Compensation Commission stating otherwise, you do have the right to select which doctor you see for your medical treatment. As a patient, you deserve to have a medical provider who is there for you throughout your recovery. You also deserve to have that doctor be someone you trust.

The Texas Department of Insurance does certify workers’ compensation networks, so if your employer uses a network as a part of a managed care plan, then you may need to select a doctor from that list. There are exceptions, such as if you were injured before your employer signed up with a workers’ compensation network of providers or if you have an emergency that cannot wait for an approved provider’s care. Some employees may also seek approval to work with a doctor who is out of the network if they need to see them due to the doctor’s specialty or another reason.

How do you know if you can select your own provider or if you need to choose from the network?

To start with, you should report your injury to your employer. Then, they will ask you to select a doctor from the network list. If you have a health plan through a health maintenance organization, or HMO, then you can ask the network to allow your primary care provider to become your doctor.

Keep in mind that your PCP has the right to deny that request in some instances and must agree to the terms of being a part of the network. The network also has to approve your doctor before you begin treatment if you’d like that treatment to be covered.

What happens if you don’t choose a doctor?

In the case that you don’t choose your own doctor, you will be assigned one. You can change that doctor if you wish. Also, remember that you will need to seek a referral if you’d like to be seen by a specialist for your future care.a