Injured workers in Indiana are often confused by the question of “who gets to choose the doctor?” The answer varies depending on the specific situation, but the general rule is that the employer (or more likely, the worker’s compensation insurance company) gets to select the medical providers. This creates a large advantage for the insurance companies and a significant disadvantage for Indiana workers.
The reality is that relationships often develop between worker’s compensation insurance companies and the medical providers they choose. The adjusters have the ability to learn which doctors prescribe inexpensive treatment options (rather than more elaborate and costly treatment options), and which doctors give lower PPI ratings (which is one of the factors considered when evaluating settlement value). It is not surprising that the more “conservative” doctors end up getting a lot of repeat business and the more “patient-friendly” doctors get a lot less.
This dynamic can be particularly troubling when it comes to an injured worker’s “pain management”. Because this area of medicine involves not only science, but also a degree of art, different doctors use different approaches to it. While certain medical providers are open to using many different tools (such as injections, TENS units, spinal cord stimulators, and a variety of medications), other doctors have preconceived philosophies against some of these types of treatments, and simply won’t ever recommend them. This can leave injured workers wondering whether they are truly getting the best care possible or whether they are getting quickly pushed through a low-cost course of treatment.
The good news is that, in certain circumstances, injured workers can acquire, free of charge, an independent medical exam (IME) from a doctor chosen by the Worker’s Compensation Board (rather than one chosen by the insurance company) to challenge the findings of the insurance company’s doctor. Additionally, injured workers always have the right to seek a second opinion from a doctor of their choosing. Although this may cost claimants some money, a second opinion from a patient-friendly doctor can be a valuable tool to challenge the findings of the insurance company’s doctor.
For more answers to worker's comp questions, check out our Indiana worker's comp FAQs.