Under Idaho Worker’s Compensation law, the injured party has the burden of proof to produce medical evidence to support their Idaho Worker’s Compensation claim. This means your treating doctor needs to be on your side. He or she has to be willing to offer an opinion on a more probable than not basis that the industrial accident caused an injury to your body. If your treating doctor is unwilling to offer this testimony, you need to ask your doctor to refer you to a doctor who will help you with your Idaho Worker’s Compensation claim by offering a causation opinion as I have described above.
Sometimes, the doctor does not want to lose you as a patient because the doctor is being paid at a higher rate because it is an Idaho Worker’s Compensation claim. Under the Idaho Worker’s Compensation medical fee schedule, doctors are paid a lot higher rate for treating Idaho Worker’s Compensation claimants. Some doctors want to hold on to you as patients because you are a “cash cow” and they will not want to refer you. This presents a difficult position. At that point in time you essentially have two options. First, you file a petition for a change of physician with the Idaho Industrial Commission under Rule 20 of the Judicial Rules of Practice and Procedure under the Idaho Worker’s Compensation Law. The Commission may or may not grant your petition for change of physician. Your second option is to use your private insurance or some other non-Idaho Worker’s Compensation insurance coverage or Medicare or Medicaid card to go to the doctor of your choice who will help you with your Idaho Worker’s Compensation claim. Without a referral, and without an order changing your doctor from the Idaho Industrial Commision, the worker’s compensation insurance company is not required to pay for their services. However, this may be the only way that you can obtain the necessary medical opinions to make your claim go forward.
If you have no other type of insurance, and your treating doctor is unwilling to refer you to a doctor who will help you, your last resort will be to hire an independent medical evaluator to offer the needed testimony for your Idaho worker’s compensation case. This is where an experienced Idaho Worker’s Compensation lawyer with resources can come in and ethically advance funds necessary to hire these independent experts to testify on your behalf.
Please call me at 208-232-6101, and I will tell you if you have a case and if an independent medical expert is needed to advance your Idaho Worker’s Compensation case. Don’t give up on your Idaho Worker’s Compensation case just because your doctor will not help you.