By Joseph M. Wilson, Jr., Attorney at Law
If you have been injured on the job in North Carolina and are covered under workers’ compensation (as most employees are), your employer and its insurance company will likely have a specific doctor or medical facility that they will send you to for treatment of your injury. Workers’ comp insurance is different from your regular healthcare coverage and claims for any work-related injuries are paid by your employer’s workers’ comp insurance provider. You will not have a copayment or deductible; your employer’s insurer should cover all medical bills.
What happens if you do not agree with the treatment plan the doctor has designed, or do not believe you are improving under this plan? The North Carolina Industrial Commission does allow injured workers the option to get a second opinion, however you cannot simply go to another doctor on your own. The first step you must take is to ask your employer in writing to approve a second opinion. You should include the name and address of the physician you would like to have review your case. If your employer agrees (get this in writing), you may then schedule the appointment. If your employer denies your request, you are unable to agree on an acceptable doctor to review your case, or the employer fails to respond within 14 days, you may petition the Commission to order a second opinion. If the Commission orders the second opinion, the employer is obligated to pay for the exam.
The injured worker may also have the option to change doctors by petitioning the Commission. The injured employee must show good grounds for the change by explaining how he or she will benefit (i.e., faster medical improvement) from the change. The change must be approved in writing before the injured employee sees the new physician or the costs may not be covered.
The ultimate goal of the workers’ compensation system is to return employees to work as quickly as possible. Sometimes, however, the path through the system is not clear cut. If you have been injured on the job and have questions, you may wish to consult with a North Carolina workers’ compensation attorney.