Can I Choose My Own Doctor for a Missouri Workers' Compensation Claim?
No, in Missouri, you generally cannot choose your own doctor for a workers' compensation claim. The law grants the employer and their insurance company the absolute right to select the treating physician for your workplace injury.
When you suffer a serious injury on the job in Missouri, your first instinct is likely to call your long-time family doctor. After all, you trust them. Unfortunately, the Missouri workers' compensation system is not designed around patient preference. Whether you were injured on a construction site in Columbia or slipped in a retail store in Springfield, the rules surrounding medical treatment are extremely rigid. Navigating this system can feel like you are fighting against the insurance company just to get basic medical care. If you feel that the company doctor is ignoring your pain, you can find an aggressive workers' compensation lawyer in our US Lawyers Directory to help you fight for the care you deserve.
The Employer's Right to Choose Your Doctor in Missouri
Under Mo. Rev. Stat. § 287.140, the employer (and by extension, their workers' compensation insurance company) has the legal right to direct your medical care. This means they get to choose the doctor, the physical therapist, and the surgeon you see. The rationale behind this law is that since the employer is footing the bill entirely, they get to control the costs. This standard has been routinely upheld in Missouri courts, such as in Blackwell v. Puritan-Bennett Corp., 901 S.W.2d 81 (MO Court of Appeals 1995), which confirmed that an employee cannot simply abandon the authorized physician without financial consequences. If you want the insurance company to pay for it, you must go to the doctor they tell you to go to.
Emergency Room Visit Exceptions
There is one major exception to the employer's right to choose: a true medical emergency. If you suffer a traumatic injury-such as a severed finger, a severe burn, or a massive head injury-you do not have to wait for your boss to fill out paperwork and assign you a clinic. You have the right to go to the nearest emergency room immediately, or call 911 for an ambulance. The workers' compensation insurance will cover this emergency care. However, once the immediate emergency is stabilized and you are discharged from the hospital, control reverts to the employer. For all follow-up visits, orthopedic consults, or physical therapy, you must use the physician selected by the insurance adjuster.
The Danger of Seeking Unauthorized Treatment
Many frustrated workers decide to skip the company clinic and go to their own primary care physician because the company doctor says they are 'fine.' This is a massive financial risk. If you seek unauthorized medical treatment, the Missouri Division of Workers' Compensation cannot force the insurance company to pay your medical bills. You will be held personally responsible for paying those out-of-pocket costs, and your personal health insurance may also deny the claim once they discover the injury happened at work. Never seek outside medical treatment for a work injury without first consulting an attorney.
How to Request a Change of Physician Through the DWC
If the doctor chosen by the insurance company is ignoring your symptoms, rushing you back to work, or refusing to order an MRI, you are not entirely powerless. You have the right to request a change of physician. First, you or your lawyer should make a formal written request to the insurance adjuster. If they refuse to provide a new doctor, your attorney can file Form WC-21, Missouri, Division of Workers' Compensation, Claim for Compensation and request an emergency hardship hearing before an Administrative Law Judge at a regional office, such as the Division of Workers' Compensation, St. Louis or the Division of Workers' Compensation, Kansas City. The judge has the authority to order the insurance company to provide a different authorized treating physician if the current medical care is deemed inadequate.
The Role of an Independent Medical Examination (IME)
Often, the company doctor will declare that you have reached Maximum Medical Improvement (MMI) and release you from care, even if you are still in agonizing pain. When this happens, your weekly workers' compensation checks will stop. To fight back, your attorney will schedule an Independent Medical Examination (IME). An IME is an evaluation performed by a completely neutral doctor hired by your lawyer. This doctor will review your MRI films, examine your injuries, and write a detailed report challenging the company doctor's conclusions. The judge will use the IME report as critical evidence during your final hearing to award you additional medical care or a larger permanent disability settlement.
Frequently Asked Questions (FAQ)
What if my employer tells me to just use my personal health insurance?
This is a common trick to avoid a workers' compensation claim. Do not do it. Health insurance policies generally exclude workplace injuries. If your employer refuses to send you to an authorized doctor, contact a lawyer immediately to force them to open a proper claim.
Will the insurance company pay for my mileage to see their doctor?
Yes. If the insurance company requires you to travel outside of your local area for medical treatment, Missouri law requires them to reimburse you for reasonable travel expenses, including mileage.
Can the nurse case manager go into the exam room with me?
Insurance companies often send a 'nurse case manager' to your appointments to pressure the doctor. You have the absolute right to request a private examination with the doctor and ask the nurse to wait in the lobby.
Do I have to pay for the Independent Medical Examination (IME) myself?
Yes, an IME is typically paid for by the injured worker or their attorney. However, most workers' compensation lawyers advance the cost of this examination and only recover the money out of your final settlement if you win your case.
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