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Pain management doctor is decreasing medication/treatment due to DEA inquiry, what rights do I have? How can I file action?

Los Angeles, CA |

The pain management doctor I see has decreased medication/treatment due to a DEA inquiry made on me. I have been suffering with chronic pain for years. I am not worried about the inquiry itself, since I did nothing wrong, but now it's affecting my pain management. I now see this doctor because I had no choice but to change doctors since my insurance group dropped my previous pain mgmt doctor from their network of providers. I tried changing the doctor I see now but found out the dr. is now the only pain mgmt doctor in the network under my insurance. I can attest to the fact that due to his treatment and demeanor my pain management is not his priority. I am in more pain now because of this and it's doing me more harm. What rights do I have in the matter? How do I file action?

Attorney Answers 6

Posted

A doctor is not required to prescribe you narcotics, nor treat you. Retain a new doctor to get the treatment you require. Try to find a doctor to treat the underlying problem, as opposed to prescribing more narcotics which will take a toll on your body.

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Posted

Review the plan terms. Should be a procedure for you to get a second opinion. If there is no other pain mgmt doc in the plan, then you may be able to make them pay for a consult with a non plan doc in the area. You can also contact the calif dept of managed healthcare for possible addl info.

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Posted

There should be more than one pain management doctor in your area that is covered under your insurance. From the facts presented you should find another doctor. If necessary you may need to drive to another town for treatment, but call your network back again and find out where there are other pain management doctors. If you stay with this doctor, yes, he can make your treatment decisions.

Merry Fountain is licensed to practice law in Indiana. She can be contacted at 1-888-242-HURT. This is not legal advice and it does not create an attorney/client relationship. It is legal education intended to provide general information about the matter within the question. If the question does not include important timeframes and facts the answer could change. Merry Fountain strongly advises the questioner to confer with an attorney in your state.

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Posted

A patient has no legal rights or procedure by which to compel a physician to act contrary to the physician's professional judgment and prescribe any medication that the physician does not believe appropriate to the patient's medical situation. What's more, the patient has no legal rights or procedure to compel the physician to maintain or let stand any judgment or medical decision that the physician has previously made.

Your doctor's medical judgment is not tied to your insurance coverage in any way. It may be that you will need to change physicians and rely on another physician who sees your medical needs differently.

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Posted

You should inquire within your health care plan first and exhaust all of your contractual rights before you sue. Also, you have a duty to mitigate your damages as well.

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Posted

Contact your health insurance and request authorization for an out of network doctor.

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