Often, the insurance company in a Virginia workers compensation case will tell an injured worker that once they choose a "treating doctor," they cannot change physicians. When an employee enters into a course of treatment with a physician, even in cases where the employer fails to comply with the requirement to provide a proper panel, the employee is not at liberty to change therefrom unless referred by said physician, confronted with an emergency, or given permission by the employer and/or its insurer or the Virginia Workers Compensation Commission.
Under the "course-of-treatment doctrine," an employee may secure the commission’s approval of a change in treating physician only upon showing some reasonable justification for the change, such as:
1. inadequate treatment is being rendered;
2. it appears that treatment is needed by a specialist in a particular field and is not being provided;
3. no progress being made in improvement of the employee’s health condition without any adequate explanation;
4. conventional modalities of treatment are not being used;
5. no plan of treatment for long-term disability cases; or
6. failure to cooperate with discovery proceedings ordered by the Virginia Workers Compensation Commission (i.e., the doctor will not answer written or oral questions pursuant to Interrogatories or Deposition).
Nearly every expression of the "course-of-treatment doctrine" has added the qualification that the employee may change treating physicians when given permission by the employer to do so. When the employer agrees with the requested change in treating physician, the employee need not demonstrate any further justification for the change. The employer’s consent, whether viewed as a reasonable justification in and of itself or viewed as a circumstance mooting the need to prove a reasonable justification, gives the employee an enforceable expectation that he may change his treating physician if he does so consistent with the scope of the employer’s consent. So, when the employer’s insurance company claims adjuster agreed in advance to accept a change of physician if a claimant or became dissatisfied with the attending physician’s care, they may do so without having to satisfy the 6 previously listed exceptions. If you want to change treating doctors, treatment or get a second opinion in a permanent injury or workplace disability case, you should consult with an experienced workers compensation lawyer, as delay and failure to take appropriate steps can forever prejudice your case