When you suffer an injury on the job, navigating things related to workers’ comp in California can feel overwhelming.
You may feel pressured to accept the first medical opinion you receive, especially if it comes from a doctor chosen by your employer or insurance company.
But did you know you have the right to a second opinion? Understanding this right can make a significant difference in your recovery and the benefits you receive.
In this article, we’ll explore your rights, barriers to benefits, and actionable steps to ensure you get the care and compensation you deserve.
Things to be aware of Workers’ Comp in California
1. Limited Choice of Doctors: Many injured workers feel frustrated because their employer or insurance company directs them to a specific doctor. It can lead to concerns about bias or inadequate care.
2. Disagreements Over Diagnosis or Treatment: The initial doctor’s assessment might not align with your injury experience. For example, they may downplay the severity of your condition or recommend treatments that don’t seem efficient.
3. Delayed or Denied Claims: If the first doctor’s report doesn’t support your claim, you may face delays or even denials in benefits, leaving you financially strained.
4. Lack of Information: Many workers aren’t aware of their rights, including the ability to seek a second opinion, which can leave them powerless.
5. Fear of Retaliation: Some workers worry that seeking a second opinion might upset their employer or jeopardize their job security.
Five Key Steps to Protect Your Rights
1. Know Your Rights: Under California law, you have the right to have a second opinion if you disagree with the initial diagnosis or treatment plan. It is crucial to ensure you receive proper care.
2. Request a Second Opinion: If you’re unhappy with the first doctor’s assessment in California, formally request a second opinion through your workers’ comp claim administrator. Be clear about your concerns and why you’re seeking another evaluation.
3. Choose the Right Doctor: While your employer or insurer may have a network of doctors, you can often select a qualified physician outside their network for a second opinion. Make sure the doctor specializes in your type of injury.
4. Document Everything: Keep detailed records of your medical visits, treatments, and communications with your employer or insurer. This documentation can be vital if disputes arise.
5. Consult an Attorney: If you’re facing pushback or confusion about your rights, a workers’ compensation attorney can help you navigate the process and advocate for your best interests.
What Not to Do: Common Mistakes to Avoid
1. Don’t Accept the First Opinion Without Questioning: If something feels off about the diagnosis or treatment plan, don’t hesitate to seek a second opinion. Your health is too important to leave to chance.
2. Don’t Delay Seeking a Second Opinion: The longer you wait, the harder it may be to challenge the initial assessment. Act promptly if you have concerns.
3. Don’t Go Outside the Workers’ Comp System Without Approval: If you seek treatment from a doctor not authorized by the workers’ comp system, you may be responsible for the costs.
4. Don’t Ignore Your Symptoms: If your condition worsens or the recommended treatment isn’t working, speak up. Your health and recovery should always come first.
5. Don’t Handle Complex Cases Alone: Many laws related to workers’ comp in California can be complicated. Trying to navigate the system without professional help can lead to costly mistakes.
FAQs About Second Opinions in Workers’ Comp
Q: Can I get a second opinion on some workers’ comp cases in California?
A: Yes, you have the right to a second opinion if you disagree with the initial diagnosis or treatment plan. However, you may need to follow specific procedures to ensure the second opinion corresponds with workers’ comp.
Q: Will my employer retaliate if I seek a second opinion?
A: Retaliation is illegal under California law. If you experience any form of retaliation, document it and consult an attorney immediately.
Q: Who pays for the second opinion?
A: With the authorization of the second opinion through the workers’ comp system, the costs should be covered by your employer’s insurance.
Q: Can I choose my doctor for a second opinion?
A: In some cases, yes. However, some restrictions depend on your employer’s workers’ compensation insurance network. Consult with your claim administrator or an attorney to understand your options.
Q: What if the second opinion contradicts the first?
A: If the two opinions differ, your case may require further review, such as an independent medical evaluation (IME) or a hearing before a workers’ compensation judge.
Conclusion
Your right to a second opinion in a California workers’ compensation case is a powerful tool to ensure you receive the proper diagnosis, treatment, and benefits. Don’t let fear or lack of information prevent you from advocating for your health and well-being.
With an understanding of your rights, taking proactive steps, and avoiding common mistakes, you can deal with the workers’ comp system.
If you’re unsure about your next steps or facing challenges in your case, don’t hesitate to seek legal advice.
A workers’ compensation attorney can provide the guidance and support you need to protect your rights and secure the care you deserve.
Remember, your health and future are worth fighting for.
About the author
Bilal Kassem President and Co-founder
Bilal Kassem, is the co-founder of Pacific Workers. Bilal has been nominated for Applicant Attorney of the Year. His passion for helping injured workers brings his leadership with his team to lead with empathy and world-class customer service. He fosters a supportive atmosphere, which is why each one of his team member feels empowered to excel. With a 98% success rate at Pacific Workers, Bilal is on a mission to continue to educate and serve any injured worker in CA.