Being injured on the job is a common occurrence for many workers throughout California. Regardless of how you were injured, the most important thing is to report your accident right away and take the necessary steps to file a workers’ compensation claim. You go ahead and submit your claim, and the insurance company assigns you a doctor to treat your injuries.
Unfortunately, you are not happy with the doctor that’s been assigned to you. Maybe you have concerns about the course of treatment they’ve recommended or how long you should be out of work in order to for your injuries to fully heal. You are not alone in these concerns, as we can attest from the countless injured workers we’ve represented over the years. At this point, you have one question on your mind: Do I have a right to a 2nd opinion from a doctor outside of my workers’ compensation network?
Yes, it is your right under California law to obtain a second opinion if you suffered a workplace accident. In this article, we will go over the procedures you must follow, as well as your legal options if you’re being denied the right to seek a second opinion on your workplace injury case.
When Should I get a Second Opinion from a Doctor outside of my Workers’ Comp Network?
California rights for injured workers include the option to seek a second opinion on any course of treatment that’s being advised for a workplace injury. A second opinion can be very helpful in the following circumstances:
- Your injuries are unresponsive to the treatment advised by your in-network doctor.
- You feel like your doctor isn’t listening to your concerns regarding your symptoms or your doubts about the treatment you’re receiving.
- You’ve been advised that a high-risk procedure such as amputation or total knee replacement is the only option. Before you agree to such a life-altering procedure, you want to consult another medical expert.
- You are in more pain than what is expected for your injury, but your doctor insists that there’s nothing more they can do.
- You and your doctor do not agree on your disability rating (the severity of your injuries and their impact on your earning capacity).
- You have reason to believe that the insurance company has influenced your treating physician to change their opinion about your injuries.
That last statement is particularly relevant in workers’ compensation cases where the insurer is giving you a hard time about seeing an out of network doctor. The truth is, these companies are in the business of saving money, and the best way to do that is by paying you as little as possible. That’s a big part of why they refer workers to the same doctors again and again. The unfortunate result is that you are denied essential medical treatment, as well as compensation for the level of injury you’ve suffered. If this is the situation you’ve found yourself in, please seek help from the workplace injury lawyers of Normandie.
What Steps do I need to take if I want a Second Opinion?
As we’ve previously stated, it’s your right as an injured worker in the state of California to seek a second opinion if you disagree with your physician’s diagnosis or treatment plan. However, there are certain steps you will need to take to ensure that you are in compliance with the laws set forth by California’s Department of Industrial Relations. The basic procedures are as follows:
- Inform your claim adjuster that you want a second opinion, either in writing or through a phone call. Make sure to clearly state that you are asking for a second opinion, which is different than the process of changing your treating physician. Not stating your request clearly enough may cause problems with other aspects of your claim.
- Carefully research your options for a new doctor / specialist who can evaluate your injuries.
- Schedule your second opinion within 60 days of notifying the insurance company that’s handling your claim. If you wait any longer, it will be the same as waiving your right to a second opinion.
- Once you’ve scheduled the appointment, make sure to convey that information to your claim adjuster.
It’s likely that you will face resistance from the insurance company during this process. In fact, don’t be surprised if they try to force your hand by refusing to pay for any treatment or rehabilitative services that are based on the new doctor’s findings. However, it is your right to seek another expert’s opinion as an injured worker, whether it’s from a doctor within or outside of your network. Challenging the insurance company may seem overwhelming, but our lawyers are here to protect your rights. If you need a seasoned workers’ comp lawyer to fight for you, contact us today for a free consultation.
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Can I get a Third Opinion on my Injuries?
Sadly, there’s no guarantee that the doctor you see for a second opinion will be different than the first one. It’s also a possibility that the second physician will review the available evidence and decide that your condition is out of their scope of knowledge. When this happens, you may be afraid to bring up the option of seeking a third opinion on your case. However, you have the right to ask for a third opinion and make sure that you are completely confident in the course of treatment you are about to enter. The process of asking for a third opinion is the same as the one you followed for a second opinion. If you have any questions or run into issues that you’re unsure about, don’t hesitate to call us.
What can I do if the Insurance Company won’t let me see a Doctor Outside of their Network?
First and foremost, we want to assure you that seeking a second opinion is your right under the WC state law of California. Your employer’s insurance company cannot deny you this right by forcing you to see a doctor within their own network. If you feel that you are being pressured into seeing a network doctor for a second opinion, contact our office without delay. We are more than ready for the challenge of representing you and fighting for your rights as an injured worker. Our attorneys will see your case through from beginning to end and ensure that you receive all the benefits you are entitled to.
Second Opinion on Your Workers’ Compensation Claim
So far, we’ve talked about seeking a second opinion on your medical issues, but have you ever considered a second opinion on your workers’ compensation claim? If you have an active WC case that you have questions or concerns about, we’re here to assist you with a free second opinion. That’s right – this is a completely free consultation with one of our labor law attorneys. You will receive a free case review, along with recommendations on your available legal options. However, our main priority is to educate you on the legal process, so there is no pressure to act on any of our advice. Just give us a call to schedule a second opinion at our office.
Contact the Workers’ Rights Attorneys of Normandie
Taking advantage of the rights you are entitled to should be a straightforward process when it comes to a workers’ compensation claim. Unfortunately, many workers are unaware of their right to a second opinion on their injuries from a doctor of their own choosing. They may also feel pressured by their employer or the insurance company in charge of their claim to see a physician within their own network. This puts the employee at a disadvantage that’s unacceptable to us, which is why are so driven to fight for the rights of our clients.
Here at Normandie, you can expect skilled and aggressive representation from day one. We will not rest until you receive every penny of the compensation you deserve, no matter how long it takes. Furthermore, we will put up the entire cost of litigating your case under the terms of our Zero fee guarantee. With this policy, the only way we get paid is if you get paid. That means if we don’t win your case, you won’t be billed for any legal fees.
As you can see, there’s no reason to hold off on contacting us and taking some time to learn about your rights. Call us today and schedule a free case evaluation.
Other Pages on Our Website Related to This Topic
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