The short answer: In most South Carolina workers’ compensation claims, you don’t get to choose your treating doctor. The employer or its insurance carrier makes that choice, and outside of an emergency, employers only have to pay for treatment from the physician they select. Have a solid reason to disagree with that doctor? You can ask the South Carolina Workers’ Compensation Commission to order a change. You generally have two years from the date of injury to file your claim.
You did everything right after your workplace accident, and now you’re stuck with a doctor you never chose. That blindsides many injured workers, who assume a work injury is processed through the system the same way their regular health insurance is. Maybe appointments feel rushed. Maybe you’re being pushed back to work before you’re ready. Maybe you just want a physician you trust. Those concerns are valid, and you are far from alone in having them. At Smith & Jones Law, consultations are free, and we work on a contingency fee basis, so there’s no fee unless we win. Here’s what South Carolina law actually says about who picks your doctor.
In this article, Lexington workers’ compensation lawyers discuss:
– Who chooses your doctor in a South Carolina workers’ comp claim
– Whether workers’ comp can force you to see their doctor
– Whether you can see your own doctor and still be covered
– What to do if you disagree with the assigned physician
– How treatment disputes can affect your benefits
– How Smith & Jones Law can help
Who chooses your doctor in a South Carolina workers’ comp claim?
In South Carolina, your employer or its workers’ compensation insurance carrier picks your authorized treating physician. You don’t. Under state law, the employer, at its own option, may continue to furnish an attending physician and any medical care or treatment considered necessary by the attending physician, unless otherwise ordered by the commission for good cause shown. In practice, that means the insurance company controls who treats you and directs your care.
This catches many injured workers off guard. You may have a family doctor you’ve trusted for years, but a work injury claim doesn’t run through your regular health insurance.
Can workers’ comp force you to see their doctor?
Essentially, yes. No one can physically drag you to an appointment, but refusing treatment from an authorized doctor can cost you your benefits. Under South Carolina law, an employee’s refusal to accept treatment when provided by the employer or ordered by the commission bars the employee from further compensation until the refusal ceases, unless, in the opinion of the commission, the circumstances justified the refusal.
That’s a steep price. Simply refusing to go is rarely a smart move. If you have concerns about your care, there’s a better path than walking away from treatment, and we get to it below.
Can you see your own doctor and still be covered?
You’re always free to see your own doctor. You’ll likely just pay for it yourself. The employer generally isn’t on the hook for care from a physician it didn’t authorize. The main exception is an emergency. If, in an emergency resulting from the employer’s failure to provide medical care, a physician other than one provided by the employer is called to treat the employee, the employer must pay the reasonable cost of the service if ordered by the Commission.
Plenty of injured workers do go to their own physician for a second opinion. Just know that unless the treatment is authorized or approved by the Commission, those bills may land on you.
Need help figuring out who should pay for your treatment? Contact Smith & Jones Law today. Call 803-784-0730 for a free consultation.
What if you disagree with the doctor the insurance company picked?
You can ask the South Carolina Workers’ Compensation Commission to order a change of your authorized treating physician. The law allows the Commission to direct different care “for good cause shown,” and when it finds a refusal of treatment justified, the Commission may order a change in medical or hospital services.
To request this, you (or your attorney) file for a hearing with the Commission and explain why the change is warranted, for example, that the current doctor isn’t properly treating your injury. Good cause isn’t just personal preference, so how you frame the request matters. This is one of the most common reasons injured workers call us.
How can treatment disputes affect your benefits?
Fights over your doctor can shape your entire claim because that physician makes the calls that drive your benefits. The authorized doctor decides your work restrictions, when you reach maximum medical improvement, and your permanent impairment rating. All of that feeds into your wage-loss payments and any final award.
South Carolina law also caps the length of guaranteed treatment. The employer shall provide medical, surgical, hospital, and other treatment for a period not exceeding 10 weeks from the date of injury, and for an additional period as, in the judgment of the commission, will tend to lessen the period of disability. If a doctor cuts you off too soon or downplays your injury, it can reduce what you recover in the end. That’s exactly why treatment fights are worth taking seriously.
How Smith & Jones Law can help
With over 55 years of combined experience, the attorneys at Smith & Jones Law understand how South Carolina workers’ comp treatment disputes actually play out, and we know how to push back when an injured worker isn’t getting proper care. Workers’ compensation and auto accidents are two of our primary areas of focus, and we represent clients throughout the Lexington and Mauldin areas.
We can request a change of physician, challenge a premature release, and fight for the benefits you’re owed, so you can focus on healing. Our offices are at 5044 Augusta Rd. in Lexington and 14 E Butler Rd., Suite C, Mauldin. Call 803-784-0730 for a free consultation. You don’t pay us unless we win.
Frequently asked questions about choosing a doctor for workers’ comp in South Carolina
How long do I have to file a workers’ comp claim in South Carolina?
In most cases, the right to compensation is barred unless a claim is filed with the commission within two years after an accident. For occupational disease claims, the two-year period does not begin to run until the employee has been definitively diagnosed with an occupational disease and has been notified of the diagnosis. Don’t wait. Evidence and memories fade.
Can I receive a second opinion on my work injury?
Yes. You can seek a second opinion, but the insurance company usually won’t pay for it unless it’s authorized or the Commission approves it. If a second opinion supports you, it can help you request a change of physician. Speak with an attorney before paying out of pocket.
Who pays for my authorized doctor?
Your employer or its workers’ comp insurance carrier pays for treatment from the authorized doctor. You shouldn’t be billed for authorized care tied to your work injury. If bills are showing up that you don’t understand, call us.
Do I need a lawyer to request a change of physician?
No, but it helps. Showing good cause to the Commission takes evidence and a clear argument, and the insurance company will have lawyers on its side. An experienced attorney can build the request and represent you at the hearing. Contact Smith & Jones Law at 803-784-0730 to discuss your case.