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SIF_Stressed In Fl · 11-03-2011, 09:41 AM

I was just called yesterday by the W/C "Nurse". She has advised that they could find no neurology doctor in my county that would accept WC. The adjuster has offered (Out of the goodness of their heart-ha) to pay for transportation to a doctor in another county. I checked out the doctors ratings and he rates about a 1.5 star rating out of 5. I find very little good information about him. This adjuster has blocked or fought much of my care since the fall. I want to know if we have to see a particular doctor that is provided by WC if it is out of my area of residence? It is in the area of employment. The one thing I found interesting about this WC doctor is that he is also a psychiatrist. Does anyone else find that interesting? SIF

***kate*** · 11-03-2011, 11:17 AM

In Florida, the employer/insurance carrier has the choice of physician. If you need a neurologist and there isn't one in your area that will accept WC and you refuse to go to the one provided, you are jeopardizing your benefits. There are many specialties that are difficult to find in Florida as many do not accept WC so the nurse is finding one closest to you. And many neuros are also neuropsych, so it's not unusual.

SIF_Stressed In Fl · (This post was last modified: 11-03-2011 11:30 AM by SIF_Stressed In Fl.)

Thank you Kate for your reply. I have just located others that will accept wc in my county. But if they can send me to anyone anywhere that they want regardless of their ratings then that is just scary.

1171 · 11-03-2011, 11:33 AM

you can try giving her a couple of your names and see if she'll accept one.

***kate*** · 11-03-2011, 11:39 AM

1171 is correct. If you have names of some that will accept WC in your county, by all means, let the nurse know. They may accept one of them. They may just be going by a list that was provided to them and not realize that there are some neuros in that county that will accept WC.

SIF_Stressed In Fl · 11-03-2011, 02:20 PM

Thanks everyone, I located a wc doc one here in my town and just spoke with the WC adjuster. She states that the doctor may accept WC and may be well qualified "However, they are not on her list of acceptable doctors". She advises to go to the one they have set up and if I don't like I can change "1" time only. He will be a great distance to travel if you have to take regular trips there.

***kate*** · 11-03-2011, 02:38 PM

They are probably set up with a specific set of doctors from a PPO or managed care list that they (meaning the adjusters and nurses) are allowed to use and that is why she isn't allowing it. Many times it isn't the adjuster or nurse putting up the roadblocks. Its company policies that they are stuck following. Believe me, it makes it harder for them also and takes up way more time (when they could be doing other things) than it should.

BE CAREFUL!!! You are allowed a 1 time change but that is for the entire claim. That means if you try someone else, and you don't like them, you are stuck with them. You can't change again and you can't go back to the other one either.

SIF_Stressed In Fl · 11-03-2011, 05:46 PM

(11-03-2011 02:38 PM)kate Wrote: They are probably set up with a specific set of doctors from a PPO or managed care list that they (meaning the adjusters and nurses) are allowed to use and that is why she isn't allowing it. Many times it isn't the adjuster or nurse putting up the roadblocks. Its company policies that they are stuck following. Believe me, it makes it harder for them also and takes up way more time (when they could be doing other things) than it should.

BE CAREFUL!!! You are allowed a 1 time change but that is for the entire claim. That means if you try someone else, and you don't like them, you are stuck with them. You can't change again and you can't go back to the other one either.

TY Kate.

newknee · 11-03-2011, 08:31 PM

I don't know anything about Fl, but I had a similar problem in Cal. The w/c Dr they sent me to put me back to work after injuring my knee too soon, first day back my knee gave out and down I went. I ended spraining BOTH sides of my foot on the same leg. When I called to report it, I told them I wanted another DR ~ was not going to go back to their (quack) Dr... she did tell me that since I had been under their w/c Dr for over 30 days, I WAS allowed to change/pick my own, as long as he/ she took w/c.
Good Luck.

SIF_Stressed In Fl · 11-04-2011, 10:14 PM

(11-03-2011 08:31 PM)newknee Wrote: I don't know anything about Fl, but I had a similar problem in Cal. The w/c Dr they sent me to put me back to work after injuring my knee too soon, first day back my knee gave out and down I went. I ended spraining BOTH sides of my foot on the same leg. When I called to report it, I told them I wanted another DR ~ was not going to go back to their (quack) Dr... she did tell me that since I had been under their w/c Dr for over 30 days, I WAS allowed to change/pick my own, as long as he/ she took w/c.
Good Luck.

Thank you. I learned today it is one change allowed period but that it is per specialist. Now a question for you. Your new fall....is that a "New" workers comp claim? SIF