Who can I choose as my doctor under the Defense Base Act? March 15, 2009Posted by Aaron Walter in Uncategorized.
Tags: choice of physician, medical treatment, nurse case manager
This is a question I am not asked frequently enough. The answer is simple – under the Defense Base Act you can choose any qualified physician under the sun to treat your injuries. That is a flexibility not offered under most state workers’ compensation systems. For instance, in the State of Georgia, where our office is located, you would only have a choice from a list of doctors your employer posts at your work place. Under the Defense Base Act, depending on the type of injury you suffered, if the doctor you choose is a licensed surgeon, podiatrist, dentist, clinical psychologist, optometrist, osteopath, or chiropractor, then you have made a valid initial choice of physician.
The reason why I am not asked this question very often, is that most injured contractors only contact an attorney AFTER something has gone wrong with their case, like that their benefits are stopped or reduced or a medical procedure is denied or delayed. One reason why this is unfortunate is that while you have amazing flexibility in choosing an initial physician, those same rules limit your ability to change doctors.
If your first choice of physician refers you to some other specialist, for instance a family doctor who refers you to a orthopedic specialist for a back problem, the insurance company must honor that referral. Also, if your doctor retires, you can choose a new one.
However, outside of those situations, you are pretty much stuck with your first choice. Once a claimant has made his initial, “free choice” of a physicians, he may change physicians only upon obtaining prior written approval of the employer, insurer, or the Department of Labor. It is likely that if you do not like your doctor or what he is telling you, the insurance company probably loves him.