Yes you can, at your expense. If you’re employer tells you that you’re not permitted to this they are giving you totally wrong information. The insurance company only gets to direct your medical care if they formally accept the claim. That means they’ve filed a Form 60 with the Industrial Commission.
Be warned, however, that the Industrial Commission often pays little attention to what your family doctor has to say. The idea is that the doctor may go out of his way to take your side in a dispute. That probably does occur sometimes but not as often as the state legislature thinks and, in our experience, far less often than company doctors who defer to the interests of an employer. But if your family doctor will make a referral to an orthopedist when the employer will only send you to Urgent Care it may be in your interests to go that route. Call us and we’ll push the Industrial Commission to get you reimbursed.
In particular it can make a lot of sense to see your own doctor and put it on your health insurance if your employer and their adjuster are dragging their feet on sending you to a doctor.
Under the laws currently in effect, the answer is “yes.” We agree with you that there certainly appears to be a cozy relationship between an employer and a doctor who gets a substantial amount of business (in the form of a constant and steady supply of patients) from that employer. In a lot of settings this would be an unacceptable conflict of interest. Despite this, the current laws permit it.
You probably don’t have to worry that the company doctor is going to ignore your medical condition just for the fun and profit of your employer. But you should be aware that the doctor may have an agreement in place with your employer not to remove anyone from work or that they will answer any questions the employer may have “off the record.” We’ve seen instances when company doctors require injured workers to waive any and all confidentiality rights in order to be seen. However, both of these occur with other doctors who treat a lot of workers’ compensation claimants even when there is no formal relationship with an employer or insurance company.
Actually, yes there are a couple of great ways to do this. The biggest problem is exaggerating your symptoms. We’ve met very few people who were out and out liars about their situation. Seriously, about three or four out of several thousand. What we do see is that clients are trying to get the attention of doctors who seem to be ignoring them. It’s sort of a “I have to shout loud to get his attention” approach which shouldn’t be necessary but, unfortunately, sometimes is. In this approach sometimes the client is overstating things to underscore how much of a problem he is having.
It’s important to be very specific about what hurts and when. Statements like “it hurts all over” or “my pain is an 11 on a scale of 1 to 10” are counterproductive. Keep in mind that many of the doctors treating workers’ compensation claimants are a bit skeptical of injured workers. It’s really easy for them to just dismiss you as an exaggerator. Don’t fall into that trap. We recommend that injured workers be prepared for their doctors visits by being able to give very specific information about what hurts, when, and what makes it feel better. While in a sense you know your body better than the doctor does, the doctor knows more about bodies than you do. Saying “it hurts all over all the time” does nothing to help him determine what’s wrong. It does suggest that you’re not completely accurate though.
You’ve probably heard the phrases “slipped disk” or “pinched nerve” before. What happens is that the main nerves exiting the spinal column get pushed on by swelling tissue or a disk or disk matter. These, and other, nerves are vulnerable when they go through small spaces but have little soft tissue protection. So, if a nerve gets pinched by a piece of disc material or bit of vertebra, wherever that nerve goes you are likely to feel pain or numbness all along it. For example, we see a lot of injuries at the L3-L4, L-4-L5, and L5-S1 areas of the low back. These refer to the 3rd, 4th and 5th vertebrae in the lumbar spine (your low back) and the 1st vertebra in the sacral spine (your tailbone). The nerves involved here go down the legs. If you have burning pain down the middle of the back of your legs you may well have an injury to the S1 nerve. Similarly, if the sole of your foot and your toes are numb you may have an injury to your L5 nerve. When you talk to a doctor you need to be clear on where you hurt and when. If the pain is strictly in your back/buttocks and not down your legs be clear about this. On the other hand if the pain extends down your legs it will help your doctor if you can be clear and specific about where precisely it hurts.
It would be nice if a doctor could stop and explain everything he is doing and examining while he was in the process of doing the examination. Unfortunately in this day and age when a doctor may be seeing dozens of patients a day he may not have time, or take the time, to do so.
We’re lawyers, not physicians or doctors, but after having read thousands of pages of medical records here’s an educated guess as to what the doctor is doing. Damage to the sciatic nerve, the main nerve exiting the spinal column in the low back and going down the legs, will often result in certain abnormalities which a doctor can spot while doing a physical examination. These include weakness when bending the knee, loss of the ability to rotate your foot up or down (thus walking on your toes or heels), loss of reflexes to the knee and ankle, difficulty bending forward or backward at the waist, and pain when lifting your straightened leg up off the exam table.
In this situation what the doctor is looking for is objective evidence to confirm or supplement your subjective reports of an injury and subsequent pain.