Getting Doctor Referrals in Writing

The Previant Law Firm

It’s always better to get it in writing

There can be a limit on what a workers’ compensation carrier has to pay for medical bills. If your injury is conceded as work‑related or if you win at a hearing, the comp carrier has to pay certain bills. Those bills are your treating doctor’s care and any referrals from your treating doctor to other doctors. Also, upon notice to the comp carrier, you can have a totally separate second opinion doctor whose bills the comp carrier may be responsible for paying, along with any referrals from the second opinion doctor.

The problem arises when someone goes to a third doctor and the workers’ compensation carrier raises a defense on payment of those particular bills, because under the law they are only responsible for the first two scenarios mentioned above.

A potential problem arises when it is not clear where in the chain a particular doctor comes up (as an initial treating doctor, a referral from a treating doctor, a second opinion or a third opinion, etc.). This situation can be clarified and remedied very easily by making sure that you ask whatever doctor you are seeing to clearly state in his records the referral to the next doctor. When you see the next doctor, ask that doctor to make clear in the records that you are coming from another doctor. This way it can be easily determined that there is a referral chain and that the comp carrier is responsible for all doctor bills (as long as it is the original treating chain or second opinion chain).