Idaho Workers’ Compensation Claimants Can Usually Choose Their Doctor

By Fred J. Lewis

We, as Americans, love to choose the doctor who will treat us for medical problems. This streak of independence has killed most universal health care or single-payer plans that have been advanced by various politicians over the last 50-60 years. Idaho Code Section 72-432 (7) allows employers to have the first crack at selecting a physician for injured workers in Idaho. Some aggressive insurance adjusters are pushing injured workers toward insurance-oriented doctors who will lean toward telling the Idaho Workers’ Compensation insurance company what they want to hear. The good news is that very few doctors in Idaho will intentionally try to hurt their patients’ Idaho Workers’ Compensation claims. If you are an injured worker in Idaho, the referral made by the insurance adjuster is usually to an urgent care or “doc in the box” physician. They will typically do the initial treatment and attempt to help you with your Idaho Workers’ compensation claim. They may even order diagnostic tests like MRI scans or CT scans, but if these initial diagnostic tests indicate you have a more serious injury, these urgent care physicians are typically helpful in referring you on to specialists who can do surgeries or other types of curative treatment. This is the point in time when you will need an experienced Idaho Workers’ Compensation attorney to help guide you to surgeons and other specialists that are willing to testify in support of your Idaho Workers’ Compensation claim. Don’t let your Workers’ Compensation insurance adjuster pick your surgeon or specialist.

Another tactic used by Idaho Workers’ Compensation adjusters is to send you to one of their independent medical evaluators. They may offer the opinion that you need no further medical treatment. Idaho Code Section 72-432 (1) allows you to furnish your own medical care at the expense of the employer if they do not provide you with reasonable medical care. All you have to do is prove, through medical testimony, that the medical care that you are requesting is “reasonable”. Many injured Idaho workers have to use their own private health insurance to pay for medical expenses after they are injured while their Idaho Workers’ Compensation claim is being disputed. Upon settlement, the private health insurance companies now have a subrogated claim or a right to reimbursement.

If you have no private health care insurance as an injured Idaho worker, you may be eligible for Medicaid benefits. This is a state of Idaho program that pays medical bills for injured Idaho workers that qualify under their income and asset rules. This also provides injured Idaho workers with another source of payment for their medical bills. After Medicaid has paid for these medical bills, they have a subrogated claim to the proceeds of the settlement reached with the Idaho workers’ compensation insurance company. If you are an injured Idaho worker, you need the help of an experienced Idaho Workers’ Compensation attorney to help guide you through your claim so that you can get to the right doctors and get the treatment that you deserve and need. Please contact me with your questions about your Idaho Workers’ Compensation claim. I will answer your questions for free and tell you if you have a case.


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