Can I change the doctor when I have an Oregon Workers' Compensation Claim?

Yes you can, but there are limits.

The doctor that is primarily responsible for your medical care is known as the "attending physician." You can only have one attending physician at a time. All of the medical treatment that you get must be authorized by the attending physician, except for emergency medical services.

Switching doctors is different than getting a referral to a specialist. Attending physicians may refer you to another doctor, like a specialist. However, those referrals have to be in writing. When the attending physician makes a referral, he or she has to be specific about the nature of the referral. For example, if the referrals only for a consultation, that must be included in the documentation. If the referral does not include a request for a consultation, then the specialist can provide medical services and treatment here she determines is appropriate.

An injured worker can change their attending physician two times after the initial choice of a doctor. If you ask your physician to refer you to another physician, that will count as one selection. However, certain changes of medical providers does not count, including:

1. When the insurance company asks you to see a doctor;

2. When your physician refers you to another doctor as a consultation only;

3. When your doctor refers you to a radiologist or a pathologist for diagnostic studies;

4. When you have to change your physician because the rules require that you see a different kind of doctor. In other words, only certain kinds of doctors can act as an attending physician for a certain period of time, and if you have to make a change for this reason, it does not count.

5.  When the change of your physician is for some reason beyond your control.  This can happen when the physician leaves the practice, the physician no longer wants to treat you, you move away from the area, or when the rules do not allow the physician to provide treatment. Sometimes, the insurance company will enroll you in a Managed Care Organization, which will result in a change of physician.

Even if you have used your choices, you can still change your physician if the insurance company agrees.

If you are in the middle of a workers' compensation claim, and wonder about changing physicians, contact us at 503-325-8600. We can help you decide how to go forward with the claim.

 

Joe Di Bartolomeo
Connect with me
Joe Di Bartolomeo is a top rated personal injury lawyer helping Oregon and Washington families