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What are Connecticut workers' compensation rules for physicians?

Workers' compensation rules in Connecticut might be somewhat confusing for a person after he or she has suffered injuries or illness in a workplace accident. Part of workers' compensation is seeking proper medical treatment. However, some may not realize that there are certain rules and regulations that must be abided by in order for workers' compensation to kick in and cover medical expenses.

For initial medical treatment, a claimant is entitled to receive whatever treatment is necessary and appropriate. Under workers' compensation law, an employer must furnish the initial medical treatment at a facility or office that is employer-designated. Once that is completed, the employee has the right to seek an attending physician of his or her own choosing. Refusing the initial employer-provided medical treatment or not receiving treatment at all can place the benefits in jeopardy.

The claimant can then select a physician. In the event the employer does not take part in an approved medical plan, the employee can select any physician who is licensed to practice in the state. If the employer does take part in a medical plan, the employee must pick a doctor from that network. Choosing a doctor outside the plan might lead to a suspension of workers' compensation. The injured worker is allowed to select a doctor, however, if the employer has a plan, regardless of the plan's specificities

An attending physician can be changed if there is dissatisfaction with the treatment plan. This can be done by getting a referral from the current physician, obtaining approval from the carrier to change physician. Another way to do so is by writing to the district office, providing a doctor to whom the employee would like to switch, and giving a reason for doing so. A worker might have to pay for unauthorized expenses if permission is not given to change to another physician. Also, all treatment must be provided by physicians licensed in Connecticut. Acquiring an out-of-state doctor may be possible, but the state has the right to decide whether or not to authorize out-of-state treatment.

Since workers' compensation benefits are often contingent on following the rules, those who are thinking about changing doctors or going to see a doctor that they are not certain is approved under the workers' compensation program should have a grasp of the law. Speaking to an attorney who is experienced with the various rules of treatment after filing a workers' compensation claim may help with compliance and retaining benefits.

Source: State of Connecticut Workers' Compensation Commission, "State of Connecticut Workers' Compensation Commission Information Packet -- Medical Treatment for Employees with Work-Related Injuries or Illnesses, page 5-6," accessed on July 12, 2016

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Law Offices of Wesley M. Malowitz

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