Many times when a person sustains a Vermont work injury, the employer will send an injured worker to a specific doctor’s office for treatment. This is permitted by the Vermont workers’ compensation rules, which state that “[a]n employer may designate the treating health care provider to initially treat an injured employee immediately following a compensable injury.” See WC Rule 12.1100. For example, in Chittenden County, employers often send their injured employees to Concentra; in Franklin County, it’s often Northwestern Occupational Health. What employers, medical providers, and workers’ compensation insurance adjusters often don’t tell you, however, is that you are allowed to switch doctors after that initial visit, and you do not need to keep returning to the provider your employer sent you to. That’s because the workers’ compensation rules also state that “[a]fter the initial treatment, an employee may select another health care provider. . . .” See WC Rule 12.1200.
Why switch doctors from the one your employer sent you to? While it would be nice if you could assume that any doctor you see for a work injury has your best interests in mind, that isn’t necessarily the case. The provider your employer sends you to probably gets a large amount of its business from employers like yours, and counts on businesses in their area to send employees to them after an injury. These referrals presumably result in a substantial amount of income that provider, and in turn, provides a motivation for them to minimize the extent of your injury and/or release you to work sooner than another doctor would. The doctor your employer choose wants to provide your employer with a good result, which will minimize the costs your employer and its insurance company and motivate your employer to send additional employees to that doctor’s office in the future. In contrast, a doctor that you choose — such as your primary care physician or an orthopedist not affiliated with employers — should only be motivated to help you get better, rather than focusing on encouraging additional referrals from your employer in the future.
How do you switch doctors to one that you choose? It’s actually very easy. In order to switch from your employer’s doctor to your own doctor, you simply need to fill out a Form 8 Notice of Intent to Change Health Care Provider, which is available Form 8 and on the Vermont Department of Labor’s website. Once you have filled out that form and submitted it to the insurance adjuster handling your workers’ compensation claim, you can begin treating with the doctor that you choose, and that doctor can submit its bills directly to the workers’ comp insurance company for payment. From that point on, you no longer need to treat with your employer’s doctor, although the insurance company may still occasionally require you to attend an independent medical examination with a doctor of their choosing. In addition, you are not required to file any additional forms if you decide to switch to a different doctor after that.