Medical Provider Networks And Your Right To Choose Your Doctor After An Injury In Volusia County, FL

When you’re injured on the job in Florida, your choice of doctor can significantly impact your recovery and your workers’ compensation claim. This, for many other reasons, makes understanding how choosing a workers’ compensation doctor in Volusia County works and what options you have absolutely vital. In this article, we’ll break down…

• How medical provider networks (MPNs) operate.
• Your right to request a different doctor during a workers’ comp claim.
• How to handle situations where your doctor may not be acting in your best interest.

What Is A Medical Provider Network (MPN), And How Do They Work In Florida?

Florida workers’ compensation law has evolved over time, and at one point, insurance carriers commonly established managed care arrangements, which listed approved doctors and hospitals. Today, however, things are different. While formal networks are less common, insurance companies and employers still have the right to choose the initial treating physician for an injured worker.

In practice, this means:

• Employers and carriers typically select the first doctor
• Doctors are usually chosen from a list of providers who are willing to work with the carrier
• Workers don’t always have a direct say in this initial choice

This system can be frustrating for workers who feel that their treatment options are limited or not ideal.

What Are Some Signs My Workers’ Comp Doctor Is Biased Toward the Insurance Company?

It’s not uncommon for workers’ compensation doctors to be conservative in their approach, meaning they may be less likely to recommend aggressive treatments, like surgery. While this isn’t necessarily a bad thing, some workers may feel that their doctor is more aligned with the insurance company’s interests rather than the patient’s well-being.

Here are some signs that your doctor may be biased:

• The doctor frequently downplays the severity of your injury
• They recommend only minimal treatment or therapy despite your ongoing symptoms
• You sense that the doctor is not fully listening to your concerns or considering the full extent of your injury

In these cases, it’s important to be aware that you have options. If you feel that the doctor isn’t treating you fairly, you can request a one-time change of treating physician or even seek an independent medical examination (IME).

Matthew Romanik, founding attorney of Working For Workers in Florida, has spent his career advocating for injured employees navigating a system where insurance-chosen doctors don’t always prioritize patient care. He has helped countless Volusia County clients push back against biased medical opinions, successfully securing physician changes and independent evaluations that have led to accurate diagnoses and proper treatment. Mr. Romanik knows how to spot when a doctor is more loyal to the insurance carrier than the patient and, more importantly, how to fight back.

If you’re unsure whether your doctor is truly on your side, contact Working For Workers today to protect your health and your claim.

Can I Request A Second Opinion Under Florida Workers’ Compensation Law?

Under Florida law, you do have the right to request a one-time change of treating physician. Additionally, you can seek an independent medical examiner to provide a second opinion on your injury, provided the doctor has not previously treated you for the same injury.

Know that a one-time change allows you to switch to a new doctor, but once you make that choice, you can’t go back to your previous provider. An independent medical examiner can be requested to assess the severity of your injury, and their findings are admissible in court.

While these options provide a second opinion, it’s important to weigh the consequences carefully, especially if it means cutting ties with your current doctor.

What Can I Do If I’m Unhappy With My Assigned Workers’ Comp Doctor?

If you’re dissatisfied with the care you’re receiving, there are a few options available. You can:

• Pay out-of-pocket to see a doctor of your own choosing for a second opinion (though this won’t officially count as part of your workers’ compensation claim)
• Request a one-time change of treating physician, or
• Seek an independent medical examination, where a doctor of your choosing evaluates your case

These steps can help ensure you’re receiving the best possible care, even if the workers’ compensation system feels limited in terms of available doctors.

What Should I Document During Appointments To Protect My Case?

The most important thing you can do during your medical appointments is to be honest and transparent with your doctor about your symptoms. Inconsistent information can damage your credibility and weaken your case. By being upfront and detailed about your condition, you help ensure that the doctor’s report accurately reflects the true extent of your injury.

When documenting your appointments, make sure to clearly explain all of your symptoms, even if they seem minor. Be sure to mention any changes in your condition since your last visit. If your doctor prescribes any treatments or therapies, confirm that these are recorded correctly in your medical records. Thorough and accurate documentation not only supports your recovery but also strengthens your workers’ compensation claim.

How Do You Help Your Clients When A Doctor Is More Loyal To The Insurance Company Than The Patient?

Unfortunately, this is a common issue in workers’ compensation cases. When I encounter a doctor who seems overly biased in favor of the insurance company, I immediately request a one-time change of treating physician or arrange for an independent medical examination to provide a fresh perspective on the case. Challenging these unfair or biased opinions can often correct the course of treatment and better protect our clients’ interests.

When Carriers Argue That A Doctor Was Biased In Favor Of My Client

Some doctors develop a reputation for being more plaintiff-oriented, which can lead to situations where both the insurance carrier and judges are aware of their tendencies. It’s often the case that if you were to take the witness lists of both sides in a case and present them to a judge without names, the judge could immediately identify who is likely representing which side based on the doctors’ reputations.

While this isn’t ideal, it’s part of the reality of the workers’ compensation system. Understanding this dynamic helps us better navigate the legal process and advocate for injured workers.

Still Have Questions? Ready To Get Started?

For more information on choosing a workers’ compensation doctor in Volusia County, an initial consultation is your next best step. Get the information and legal answers you are seeking by calling (631) 359-8016 today.