When you’ve had an on-the-job injury or illness in Florida, your employer’s insurance company must provide you with any medical care that’s needed to treat your condition. However, you have very limited options for choosing the doctors who will actually treat you and make important decisions that will affect the other workers’ comp benefits you may receive. Those decisions include:

• when you need time off from work to recover
• when you’ve recovered as much as can be expected, and
• to what extent you have any permanent disability.

Read on to learn about the basic rules and exceptions for choosing a doctor in your workers’ comp case.

How Is a Treating Physician Selected?

Under Florida law, your employer’s insurance company will send you for treatment to a doctor it has chosen, unless:

• you require emergency treatment for your work injury
• the insurer doesn't send you to a doctor within a reasonable time after you’ve requested it in writing
• the insurance company has a managed care arrangement for workers’ comp injuries, in which case you should be able to choose a doctor within that provider network; or
• your workers' comp claim is initially denied.

Changing Your Treating Doctor

If you’re unhappy with your treating doctor, you may ask to switch to another physician. However, you can do this only once during your workers’ comp case. The insurance company will choose the replacement unless it hasn’t assigned you to a new doctor within five days after your written request. If you’re getting treatment from a managed care network, you may select a new in-network provider.

Seeing a Specialist

As with all other medical care for your work injury, your treating doctor must get authorization from the insurance company before referring you to a specialist (like an orthopedic surgeon or chronic pain doctor), a diagnostic facility, or a physical therapy center. It will be assumed that the referral is authorized if the insurer doesn’t respond to the doctor’s request within a certain period of time.

When There Are Disputes Over Medical Care

When you and the insurance company have a dispute about your medical care, either or both of you may request an independent medical examination (IME). However, you’re entitled to only one IME during your workers' comp case. You can choose the examining doctor if you’ve requested the IME, but you must pay for the exam unless:

• the examiner is from the managed care provider network
• the insurance company decides to pay for the medical treatment based on the IME doctor’s report, or
• you win the dispute as a result of an order from a workers’ comp judge.

If you’re having trouble getting the medical care you need, it would be a good idea to speak a lawyer who can help you navigate the system and protect your right to appropriate treatment. An experienced workers’ comp attorney might also be able to recommend a good physician to conduct an IME.