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Can I change to another doctor who is within the same group of approved doctors I was sent to by my company?

Gainesville, GA |

I was sent by the company adjuster to a specific orthopedic group that I had chosen from a list.I had an appointment set for me with a certain doctor there. I went to that doctor and do not think he looked at me thorough enough.Can I now change to a doctor who is with the same group?

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Attorney answers 6

Best Answer
Posted

I know this is not what you want to hear, but it depends. If the group was listed instead of a specific doctor on the panel of physicians, or if the entire group was approved for treatment (rarely happens), then you can arguably make the switch. Otherwise, you will need to speak with the Adjuster and she if she will agree to it. I would do this before obtaining representation, as the adjuster will likely not be as cooperative after an attorney is involved. However, I do recommend obtaining representation before settling your claim as the insurance company is not your friend and will try to get out of your claim as cheaply as possible. You can exercise a one-time right to a change in panel physicians but I recommend saving that if you can get the adjuster to agree to let you seen by the other doctor. If the adjuster does not agree, I recommend hiring an attorney. If you have any questions, please feel free to give me a call.

Sincerely,

B. Shawn Rhodes
Powers and Rhodes, LLP
478-227-5997

Asker

Posted

This is exactly what I needed to hear. Thank you for your time !

Posted

You are allowed one switch to another doctor on the Panel of Physicians. I believe that this change will count as your one switch. I would recommend against this, however. I would be wary of switching to another doctor in the same group. If you want to switch to another Panel Physician, I would recommend that you go to a different medical group altogether. Good luck.

Tom Holder
404-523-6100

Asker

Posted

Thank you for your time and help. Good advice.

Posted

Assuming your employer had a correctly posted panel of physicians or some other form of controlling the medical such as s managed care plan (MCO), you can always make a second choice to someone else who is listed. If they failed to have a panel or MCO you are free to select any physician you want as your second choice. If you like the orthopedic group and know of the specific doctor there that you want to see, you can ask the claims adjuster to approve it. If they refuse, or if you just need guidance on which doctor to select, you really should hire an experienced workers compensation lawyer. I spend most of my time each day just getting my clients to the right doctor.

Asker

Posted

If I could have marked two answers as the most helpful, I would have marked yours too! I feel that asking the claims adjuster first is the best route to take. Thank you.

Posted

It depends on whether the group is on the panel or another specific doctor on the group is on the posted panel of physicians. Either way, why would you want to go to another doctor within the same group who is not likely to go against his partner. You are better off getting an attorney to see if the panel is valid and then switching to a Claimant friendly attorney

Asker

Posted

Thank you so much. I so happen to be a non workers comp patient with a surgeon with this group. We are on excellent terms, and he knows pretty much everything about me already.Good advice, thanks.

Posted

I agree with what Tom said below about not switching to another ortho within the same group. Unfortunately most doctors are very busy and alot less than 5 minutes per patient, no matter who you go see. You are entitle to a one time change to another panel doctor, but this ortho may have already counted as your one time change if you originally were seen by a different doctor.

Asker

Posted

Thank you Lisa. I was seen by a company approved doctor who then referred me on to be seen further by an orthopedist. Thanks again for your time!

Posted

You can switch to another panel physician once without additional approval, however, I would suggest switching to a panel MD in a different group.

Disclaimer: This response is provided to you by attorney Robert G. Rothstein (404) 216-1422 for educational and informational purposes only.No attorney-client relationship has been created hereby. Other attorneys may have different opinions or responses. If you found this response helpful, please indicate Best Answer to Avvo. Thank you.

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