Workers’ compensation claims are different than other medical situations. Patients have less control due to the involvement of a complex regulatory system. The doctor overseeing the patient’s care determines the treatment plan for their injury or illness. They may recommend physical therapy or medication. Other times, they may decide that surgery is the best option for improving the worker’s condition as much as possible.
Provided that it is a non-emergency situation, does the employee have the right to refuse a recommendation for surgical care?
Workers can ask for a second opinion
Typically, workers’ compensation does not pay for repeat consultations for the same injury. However, a non-emergency surgery is the one exception to that rule. If the physician overseeing the claim determines that surgery is the best option, then either the worker or their employer may have the right to request a second opinion.
Doing so can lead to a different treatment plan in some cases or the worker accepting that surgery is necessary in others. There are no rules that can compel people to submit to non-emergency surgeries, but refusing to adhere to a workers’ compensation treatment plan could have implications for future benefits.
If workers want to avoid surgery if at all possible, then talking to a new doctor who may view the case differently could be beneficial. The worker typically does not have to pay to have another doctor evaluate their condition and propose a treatment plan based on their perspective.
Discussing a dispute about a workers’ compensation treatment plan with an attorney could help employees evaluate their options. Those questioning the necessity of surgery may have other options available. Making optimal use of workers’ compensation medical benefits often requires insight into the system.
