Insurance Company’s Rejection of Claim Allows Employee’s Rejection of Panel Doctor
to this rule.
For example, an injured claimant is under no duty to seek treatment with a panel doctor for treatment which employer disclaimed responsibility. Even assuming arguendo that the alleged panel was timely provided, the denial of the claim frees the injured worker to make his or her own choices as to what doctor s they will see. The employer’s denial of any injury to claimant, even if it accepts some of the body parts, may preclude its defense that treatment with the worker’s chosen doctor was unauthorized. Likewise, where the employer defends a claim on the alternative ground that the medical treatment rendered was not causally related to the compensable accident, the employer cannot compel the claimant to seek treatment from its alleged panel doctor. To hold otherwise would place the claimant in the untenable position of having to accept the treatment form the employer’s hand-picked physician and then become personally responsible for that treatment should the Workers Compensation Commission find that the treatment was not causally related to the accident. A Claimant faced with the prospect of paying for medical care due to the employers disclaimer of responsibility is free to choose her own treating physician.
Bottom line, according to top Workers Virginia Comp lawyer Doug Landau “He who pays the piper gets to call the tune.” In other words, if the insurance company is paying for the care, they have some say in what doctors are on the panel. If they deny the claim, then the disabled worker is free to go wherever they like for reasonable, causally related treatment. If the employee prevails at the Hearing, then the insurance company and employer are responsible for paying the bills, even though the doctor was not on their “list.” If you or someone you know or care for has been injured as the result of an accident on the job or while working off site, and there are questions about what laws apply, e-mail or call us at ABRAMS LANDAU, Ltd. (703-796-9555) at once.