Being injured at work can be stressful, especially when you are sent to a doctor who quickly examines you and seems to dismiss your concerns. It’s natural to wonder whether you have any control over who treats your injury and whether you can choose a physician you trust.
If you’ve been hurt on the job in St. Peters or elsewhere in Missouri, understanding your rights under workers’ compensation law is important. The answer to whether you can select your own doctor is not always straightforward and depends on several factors, including who pays for your medical treatment and the legal rules established under Missouri law.
Who Actually Controls Your Medical Treatment in Missouri?
When you are injured at work in Missouri, the law clearly defines who controls your medical treatment. Under Section 287.140 RSMo, your employer has the legal right to select the treating physician for your workers’ compensation injury. In most cases, employers delegate this responsibility to their workers’ compensation insurance company, which directs you to doctors within their approved network.
The rationale behind this rule is that employers and their insurers pay for your medical care, so they have the authority to manage those costs. While the law does allow you to see your own physician, you would need to pay for that treatment yourself, and it generally will not be reimbursed under workers’ compensation. Most private health insurance policies also exclude coverage for work-related injuries because workers’ compensation is intended to be the primary source of payment.
What If You’re Unhappy with the Company Doctor?
Sometimes the doctor your employer selects may not meet your needs. You may feel that your concerns are not being fully addressed or that appointments are rushed. While this can be frustrating, it is important to handle the situation carefully and professionally.
You do have options, but approval for a different physician is discretionary. You can request that your employer authorize a change of treating doctor. Submit your request in writing and focus on specific facts rather than emotions. Document your appointments, the treatment you have received, and any concerns that were not addressed. This documentation can be valuable if you need to escalate your request.
Some employers maintain a panel of approved physicians. If yours does, you may be able to select a different doctor from that panel without difficulty. Another option is to seek a second opinion at your own expense. This can provide supporting evidence if you later petition the Division of Workers’ Compensation for a change in your treating physician.
Petitioning for a Change in Physician
If your employer or their insurance company refuses to authorize a different doctor, you may petition the Missouri Division of Workers’ Compensation under Section 287.140.2 RSMo. To succeed, you must show that your current treatment is inadequate, medically inappropriate, or could hinder your recovery.
Key points to keep in mind:
- Medical evidence is essential. Documentation from another healthcare professional can support your claim.
- Approval is not automatic. The Division grants petitions only when there is clear evidence of inadequate care.
- Valid reasons for a change include treatment that is clearly ineffective, ongoing symptoms that are not being addressed and medically supported concerns about the quality of care.
The Division will review your petition and make a decision based on the evidence provided. Keeping detailed records and presenting objective, medically supported concerns will strengthen your case.
Emergency Situations and Initial Treatment
What happens if you’re seriously injured and need immediate care? In an emergency, you can seek treatment at any medical facility. The focus is on stabilizing your condition and addressing urgent medical needs. After the emergency, your employer may direct you to a specific doctor for follow-up care, which is allowed under Missouri law, but getting immediate treatment when you need it is always your right.
For that first doctor visit after your injury, you generally must see the physician your employer designates. However, this initial treatment doesn’t lock you in forever. If problems arise with that doctor, you can pursue the options we’ve discussed above to seek a change.
What Your Workers’ Comp Doctor Must Do
Regardless of who selects your treating physician, Missouri law expects that doctor to communicate clearly with you about your injury and recommended treatment. This is outlined in Section 287.140 RSMo. While failing to communicate is not automatically a disciplinary violation, concerns about inadequate communication or treatment can be raised with the Division of Workers’ Compensation.
If your doctor is not explaining your diagnosis, treatment options, or prognosis in a way you can understand, it can interfere with your recovery. You have the right to ask questions and receive clear answers. Medical care should not be a mystery, and you should be informed about the steps being taken to treat your injury.
Geographic Location and Travel Expenses
If you are required to travel for medical treatment outside your local or metropolitan area, your employer or insurer must advance or reimburse you for necessary and reasonable travel expenses. There are limits to this reimbursement: your employer is not required to cover transportation costs for distances greater than 250 miles each way from the place of treatment.
For injured workers who live outside Missouri but work for a Missouri employer, there is additional flexibility. You may receive treatment within 100 miles of your residence, your place of injury, or where you were hired. While your employer still selects the treating physician, you have some input regarding the general location of your care.
Your Rights Regarding Medical Records
Under Missouri law, every hospital and healthcare provider who treated you must allow their records to be copied and provide full information to the Division of Workers’ Compensation, your employer, and to you. This is outlined in Section 287.140.7 RSMo.
You also have the right to access your own medical records. Healthcare providers may charge copying fees as permitted under Section 191.227.2 RSMo. These fees are adjusted annually based on inflation, so it’s a good idea to check with your provider or the Missouri Department of Health and Senior Services for the current rates.
Obtaining copies of your medical records is important if you are seeking a second opinion, petitioning for a different doctor, or appealing a denial of benefits. Keeping detailed records helps ensure you have the documentation needed to support your workers’ compensation claim.
What You Shouldn’t Have to Pay For
Under Section 287.140.13 RSMo, no hospital, physician, or healthcare provider may bill you or attempt to collect fees for work-related treatment once they have received written notice that the care is part of a workers’ compensation case. This protection applies only to authorized treatment—care that your employer or their workers’ compensation insurance company has approved. Treatment you seek on your own without approval is not covered, and you may be responsible for those costs.
If you receive a bill for treatment that should have been covered under workers’ compensation, contact your employer or insurance company immediately. Keep a copy of the bill and document all communications regarding it. Healthcare providers who knowingly violate this billing prohibition may be committing a class A misdemeanor.
Practical Steps When You Need to Change Doctors
Deciding to request a different treating physician can feel overwhelming, but having a clear plan can help protect your health and your workers’ compensation claim. Missouri law allows you to petition the Division of Workers’ Compensation if your current treatment is inadequate, but approval is discretionary. Following organized steps, documenting everything, and understanding your rights can improve your chances of a successful outcome.
- Document everything. Keep a detailed journal of your appointments, the treatment you received, your reported symptoms, and how your doctor responded. Note any instances where you felt dismissed or where recommended treatment did not help.
- Submit your concerns in writing. Send a clear, factual request to your employer and their insurance carrier explaining why you believe a change is necessary. Avoid emotional language. For example, “Dr. Smith has seen me four times but has not ordered any diagnostic tests despite my ongoing back pain” is more effective than vague complaints.
- Consider a second opinion. You may obtain a second opinion at your own expense. This documentation can support a petition to the Division of Workers’ Compensation but does not automatically guarantee approval.
- Petition the Division if necessary. If your employer and insurer deny your request, you can file a petition with the Division of Workers’ Compensation. Approval is discretionary and based on the evidence you provide.
- Seek legal assistance. An attorney experienced in Missouri workers’ compensation cases can help you present your petition effectively and ensure you provide the Division with the evidence it needs to consider your request.
Why Having Legal Help Matters
Dealing with workers’ compensation issues while you’re trying to recover from an injury is overwhelming. The system is complex, with specific procedures and deadlines. Insurance companies have adjusters and attorneys looking out for their interests.
You deserve to have someone in your corner who’s looking out for you. An attorney experienced in Missouri workers’ compensation cases knows how to work within the system. They can help you request a change in treating physician, gather the medical evidence you need, and present your case effectively to the Division of Workers’ Compensation.
Key Takeaways
- Your employer has the legal right to select your treating physician for workers’ compensation injuries under Missouri law.
- You may choose your own doctor, but you must pay for any treatment you seek without employer or insurer approval.
- Most private health insurance policies do not cover work-related injuries because workers’ compensation is intended to handle those costs.
- You can petition the Division of Workers’ Compensation to request a different physician if your current treatment is inadequate, but approval is discretionary.
- In emergencies, you can seek immediate care at any medical facility, though your employer may direct follow-up treatment once the emergency is addressed.
- Your doctor is expected to communicate fully with you about your injury and treatment, regardless of who selected them.
- You have the right to access your medical records, and reasonable copying fees are permitted under RSMo 191.227.2.
- You should not receive bills for authorized workers’ compensation treatment. Care you seek without approval is not automatically covered.
Frequently Asked Questions
What happens if I see my own doctor without approval?
You will be responsible for paying those medical bills yourself. Treatment you receive without employer or insurer approval may not be considered part of your workers’ compensation claim, and you likely will not be reimbursed. Most private health insurance policies also exclude coverage for work-related injuries since workers’ compensation is designed to cover these costs.
Can my employer fire me for requesting a different doctor?
Missouri law prohibits employers from retaliating against employees for filing a workers’ compensation claim or asserting their rights under workers’ compensation law. However, this protection does not prevent termination for legitimate, unrelated reasons, such as poor job performance or policy violations.
How long does it take to get approval for a different doctor?
There is no set timeline. If your employer agrees to authorize a different physician, approval can happen relatively quickly. If you need to petition the Division of Workers’ Compensation, the process may take longer, depending on the Division’s workload and the evidence you provide.
What if the insurance company’s doctor says I’m fine but I’m still in pain?
This situation is common. Obtaining a second opinion from an independent physician at your own expense can help document ongoing symptoms and support a petition for a change in physician. Having an attorney experienced in Missouri workers’ compensation law can assist in challenging the insurance company doctor’s opinion and seeking additional treatment.
Does workers’ comp cover physical therapy and specialists?
Yes. Workers’ compensation covers all necessary medical treatment to cure or relieve the effects of your injury, including physical therapy, specialist consultations, diagnostic tests, and other appropriate care. Treatment must be authorized by your employer or their workers’ compensation insurance company to be covered.
Contact Us
Dealing with a work injury is stressful enough without fighting battles over medical treatment. If you’re struggling to get appropriate care for your workers’ compensation injury, or if you’re unhappy with the doctor your employer selected, we’re here to help.
At Adams Law, we’ve been standing up for injured workers throughout St. Peters and the surrounding Missouri communities. We know how to work within Missouri’s workers’ compensation system to protect your rights and help you get the medical treatment you need to recover.
Don’t try to handle this alone. The insurance company has lawyers looking out for their interests. You should too. We offer free consultations to discuss your situation and explain your options. There’s no obligation and no upfront cost.
Your health and your future are too important to leave to chance. Reach out to us today and let’s talk about how we can help you get the medical care you deserve.
