Can I Choose My Own Doctor for a Workers’ Comp Injury?

Getting hurt on the job is stressful. Add in medical appointments, paperwork, and missed work, and it’s easy to feel overwhelmed. One of the most frustrating parts of the workers’ compensation process is often the lack of control over medical care, especially when you realize you may not be able to choose your own doctor.

Many injured workers assume they can see their family physician or a specialist they trust. Unfortunately, workers’ compensation doesn’t always work that way. Understanding how doctor selection works can help you protect your health, your benefits, and your claim.

If you have questions or concerns, speaking with an experienced Des Moines workers’ comp lawyer can make a difference in how your case unfolds.

Who Chooses the Doctor in a Workers’ Comp Case?

In most workers’ compensation systems, including Iowa’s, the employer or their insurance company controls the initial choice of medical provider. That means after a workplace injury, you’re required to seek treatment from a doctor or clinic chosen by the employer or listed in their approved provider network.

This rule often surprises injured workers, especially those who already have a trusted physician. However, under workers’ compensation law, the employer has the right to manage medical care because they are responsible for paying the medical bills.

In many cases, you may be given:

• A specific doctor to see
• A list or panel of approved providers
• Instructions on where to go for treatment

Failing to follow these directions can create serious problems for your claim.

Authorized vs. Unauthorized Medical Treatment

One of the most important distinctions in workers’ compensation is authorized versus unauthorized treatment.

Here’s what each category means for your claim:

Authorized Treatment	Unauthorized Treatment
●      Provider approved by your employer or their insurer ●      Care is covered under workers’ compensation ●      Medical bills paid by the insurer	●      You chose a provider without approval ●      Visit was not pre-approved ●      Insurer may refuse to pay

Seeing an unauthorized doctor can leave you personally responsible for medical bills, even if the injury happened at work. In some cases, it can also be used to argue that you failed to follow proper workers’ comp procedures.

This is one of the most common mistakes injured workers make, and it’s why consulting Des Moines workers’ comp lawyers can help protect your claim.

When Can You Choose Your Own Doctor?

Although employers usually control the initial provider, there are situations where injured workers may have more flexibility, including:

Emergency Medical Treatment

If your injury requires immediate medical attention, you can seek emergency care at the nearest hospital or urgent care center. In these situations, your health comes first, and prior authorization is not required.

Once the emergency phase ends, however, the employer or insurer may take over decisions about continued treatment.

Requests for a Second Opinion

If you disagree with the diagnosis or treatment plan, you may be allowed to request a second opinion. This typically must be done through proper channels, often requiring approval from the insurance carrier or workers’ compensation commissioner.

Lack of Appropriate Specialists

If the employer’s provider network does not include a specialist qualified to treat your specific injury, such as a neurologist, orthopedic surgeon, or pain management doctor, you may be able to request treatment outside the network.

Proper documentation is essential in these situations.

How to Change Doctors in a Workers’ Comp Case

If you’re unhappy with your assigned provider, you usually can’t just switch doctors. You must follow a formal process, which may include:

• Submitting a written request for a change
• Filing Form 100C (Petition for Alternative Medical Care)
• Explaining why the current provider is inadequate
• Showing that the requested provider is better suited for your injury
• Waiting for approval before scheduling treatment

Failing to follow these steps can result in denied benefits or unpaid medical bills.

This is where qualified Des Moines workers’ comp lawyers can help. An attorney can handle communications with the insurance company, gather supporting documentation, and assist with appeals if your request is unfairly denied.

Why Your Choice of Provider Matters

According to the Bureau of Labor Statistics, Iowa saw over 32,500 nonfatal workplace injuries in 2023. Many of these injuries require long-term care, physical therapy, or surgery. When medical decisions are delayed or mishandled, recovery suffers, and so does your ability to return to work.

Choosing the right doctor impacts:

• Accuracy of diagnosis
• Quality of treatment
• Length of recovery
• Disability ratings
• Eligibility for ongoing and future benefits

That’s why understanding your rights from the start is critical.

Get Qualified Legal Guidance Before Making Changes

If you’re unsure whether you can change doctors, worried about losing benefits, or frustrated with your medical care, seek legal advice before taking action. Workers’ compensation rules are strict, and one misstep can cost you coverage.

Our skilled Des Moines workers’ comp lawyers can review your situation, explain your rights, and help you make changes without jeopardizing your claim.

If you’ve been injured at work and have questions about your medical care options, contact our legal team today to protect both your health and your benefits.