Can you choose your own doctor/hospital?

This depends. If your employer posts the names of at least six providers—three of which must be physicians—in your workplace and has you sign a Panel Acknowledgement stating that you will treat with these doctors, you must do so for 90 days.

The Panel Acknowledgment must have been signed when you were hired, when any changes were made and immediately following your injury. Absent these circumstances, you are free to treat with a doctor of your choice. No matter what, you are always allowed to treat with the doctors of your choosing beyond 90 days. Aside from the panel doctors, your employer may require you to attend a physical by a company-designated doctor up to two times per year.

What’s the selection of healthcare providers like?

During the 90 days, you may select any of the choices provided by your employer. The list of healthcare providers must have no more than four coordinated care organizations and no fewer than three physicians, and if there are no chiropractors on the list, the employee can see a chiropractor of their choosing.

Following your first visit, you must continue treatment with a doctor or a combination of doctors on the employer provided list for 90 days. Once that time is up, you can see whichever doctor you’d like.

Are there any special circumstances?

There is one special circumstance during the 90-day period. If you are seeing one of the employer-listed doctors and he or she recommends invasive surgery, you have the right to obtain a second opinion by a physician of your choice. However, any treatment recommended as a result of a second opinion that falls within the 90-day window must be with one of the providers in the list provided by your employer.

Do I have to go back to work if the doctor says I’m able to work?

You do have to listen to the doctor, but you most likely won’t be thrown back into work full-time, as you’ll normally be told you’re able to perform “light-duty work.”

Partial disability benefits are payable up to 500 weeks (9.6 years) when your partial disability status is determined from an IRE or if an insurance carrier’s doctor feels that you are able to perform light-duty work. This means that you have the ability to earn some wages, but you have not completely recovered from your work injury. Before, you were receiving total disability benefits because you weren’t capable of working at all.

If the new job pays less than the pre-injury job, you are entitled to be paid two-thirds of the difference between average weekly wage of your old job and your new job up to the maximum rate for the year of your injury.

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