The Answer is No! You can always get medical attention on your own!
You are not breaking any laws by going on your own to get a serious medical opinion about the true nature of your work injuries. Remember that the claim for medical and wage benefits under your employer’s work injury insurance plan is separate from your right to file a lawsuit for employer negligence. Because the main goal of these insurance plans is to manage work injury claims, like yours, so that they limit exposure to lawsuits and limit expense to the employer.
Your adjuster will tell you that you are “required to treat with approved doctors” and that you cannot go to a doctor that is “outside of the plan”. What does this really mean? Does it really mean that you can’t go see a doctor on your own? No!! It just means that you have to go see the doctors that they send you to or, that insurance does not pay the bill and, your employer will not follow the restrictions of any other doctor outside of the plan.
As you imagine, this puts all the control of your medical care in the hands of the follow cast of characters:
- Your Employer
- Your Employer’s Attorneys
- Your Employer’s Insurance
- Your Employer’s Insurance doctors
The truth is, by making you think that you have to treat with the doctors under the plan, your employer is already setting up a way to defend your case by using the doctors to claim that your injuries are not related to your work injury. Don’t settle for medical attention under the plan, you have a right to go see a physician that has your best interest in mind.
How Will You Pay for the Treatment you Get Outside of Your Employer’s Insurance?
Just because your employer initially offers you medical and wage benefits does not mean that you do not have a right to sue your employer for negligence. But, if in your case, you are able to establish that you were injured as a result of your employer failing to provide you with a reasonably safe workplace, then, you will have a right to sue your employer for your injuries and, you can claim your past and future medical expense in that lawsuit.
Often times, your employer’s insurance will start you off with treatment while they determine if there is any liability in your case. Once your employer’s team is able to figure out whether or not you could sue them, they will make the decision on whether to continue with your treatment. If they decide that they could be liable in your case, they could continue to provide you with treatment but, be aware that you may not necessarily receive the best medical care you would need to get healed up. For this reason, you should still have an interest in getting your own medical opinion about your work injuries. Do not settle for treatment under “The Plan” and do not let them take advantage of you while you are injured.
The Treatment You Receive from Your Employer’s Insurance Has a very Deliberate Purpose!
As with all insurance, the purpose is to limit what they pay. That said, when you give all the control to your employer and their insurance over your medical treatment, you are handing them all your trust that they will take care of you. Unfortunately, this is not the case in most of these non-subscriber work injury cases. The longer you wait, the more complicated and confusing your treatment will get. There could even be times where the insurance appears to be arguing with the doctors that they chose to send you to. The doctor could be recommending further tests and the insurance company will take it upon themselves to simply deny those tests that could help diagnose your injury. Let that sink in. The insurance sends you to a doctor to treat you and then denies his recommendations? Your employer’s insurance company is deliberately sabotaging your case! Do not wait until it is too late and your left having to go back to work with an undiagnosed injury for which you only received a few weeks of physical therapy! Get informed and know where your case is going.
If your injury resulted from your employer’s failure to provide a safe workplace because of the lack of training, equipment, manpower, or, because they adopted an unsafe work practice, you could have a good negligence case against your employer. Neither your employer, their insurance, nor their doctors are going to do anything to protect your rights! You will need to act promptly.
Even after understanding the intent of your employer’s insurance, you will need to be sure you consult with a Texas non-subscriber work injury attorney that can provide with the best way to approach your case.
Our firm handles work injury cases of all types. We are ready to discuss your work injury case when you are!
Contact Sandoval Law Firm, PLLC at (346) 347-7777 to request an initial consultation to discuss your case.