Can I choose which doctor I want to treat me if I was injured at work and will be receiving workers’ compensation benefits in Portland, OR?

Finding a physician who not only provides you with quality care but also listens to and addresses your concerns isn’t exactly easy to do nowadays. The reality is, many doctors are overbooked and unable to consult with their patients for the length of time needed to discuss issues, complications, and/or overall health. It is for this reason that many individuals who suffer an injury in a work-related accident prefer to choose who it is that will be rendering the care they need when receiving workers’ compensation benefits.
But are workers’ comp patients in Portland, OR allowed to choose the physician they want treating them? Well, the answer actually depends on a number of different things. In this article, we are going to explore this topic as well as provide you with some guidance on what you should do if you feel your employer or their insurer is handling your workers’ compensation claim unfairly.
When it Comes to Your Independent Medical Exams (IME), the Workers’ Compensation Insurer Chooses the Physician
What are IMEs?
IMEs “are mandatory medical examinations with doctors chosen by the insurer.” The Oregon Workers’ Compensation Division says that “an insurer can only require you to attend three IMEs in each open period of a claim.” While you must attend these visits to ensure your benefits are provided (benefits may be stopped if you fail to attend the required examinations), you are not obligated to undergo any invasive procedures. In fact, “invasive procedures cannot be performed without your consent, and your benefits cannot be reduced or stopped” if you decide not to have one or more done. Your employer’s insurer is also required to pay for all costs related to an IME.
Important: If your workers’ comp claim was denied “based on an independent medical examination (IME), and your doctor (attending physician) does not concur with the IME report, you may be eligible to request a medical examination by a doctor chosen by the Workers’ Compensation Division.” You are going to need to appeal the denial in writing and submit this to the insurer within 60 days from receiving your denial notice.
When it Comes to Treatment, You May or May Not Be Able to Have Your Family Physician Treat You
Although the Oregon Division of Workers’ Compensation says that your employer cannot choose who your health care provider will be, you may be limited to choosing a physician from a managed care organization (MCO). If your employer’s insurer has enrolled you in an MCO, then you would need to choose a physician from those that participate in it, however, if it does not, then you are permitted to “treat with any health care provider who qualifies as an attending physician under Oregon law.”
If you wish to receive treatment from your family doctor who is not an MCO member, the MCO “must authorize him or her to provide your medical treatment” and he or she must qualify under one of the following three categories:
- He or she doctor “must qualify as an attending physician, be a medical doctor or osteopathic physician, and must be a general practitioner, a family practitioner, or an internal medicine practitioner.” To find out if your family doctor qualifies as an attending physician, it would be best to contact either your insurer or the MCO.
- If your physician is a chiropractor, he or she “must certify with the director of DCBS” (Division of Consumer and Business Services).
- “Your nurse practitioner must be authorized by the director to provide compensable medical services.”
Important: In the event you are not happy with the quality of care a physician is providing you with, you can change your attending physician two times. After you have changed your physician two times, you can only make a change again if you obtain approval from the insurer or the Workers’ Compensation Division. When changing health care providers, you will “need to fill out Form 827 at your new attending physician's office and check the box “Notice of change of attending physician.” This form should be sent to your insurer so that you continue to receive benefits.
What should I do if I am having an issue with obtaining workers’ compensation benefits from my Portland, OR employer?
If your employer or their insurer isn’t providing you with the workers’ comp benefits you are due, we recommend you contact Welch, Bruun & Green to speak with a Portland, OR workers’ compensation attorney. Most employees in the State of Oregon are entitled to workers’ compensation benefits but not all receive them. Rather than have to deal with a noncompliant insurer while recovering from your injuries, it is best you let a legal professional step in and help so that you can focus on getting better.
If you would like to speak with a legal representative now who can address any questions or concerns you might have regarding workers’ compensation benefits, contact our office at 503-221-0870.
Welch, Bruun & Green is located at:
4380 SW Macadam Avenue, #120
Portland, OR 97239
Phone: 503-221-0870
Website: www.wbgatty.com








