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  1. #1
    Join Date
    Jan 2008
    Posts
    3

    Default Changing Rehab Providers

    My wife is getting physical therapy for a job related injury but has not made progress and does not feel she is getting proper care. She and I are both in the rehab field ourselves. I called the case manager to see if we could go to a facility that accepts workers comp and we know gives quality care. They said that we have to go to where they have a contract with. She looked for other facilities and they are all for the same large corporate facility. Can we change providers if we feel care is not helping and we want to try a specialized therapy that this provider does not provide.

  2. #2
    Join Date
    Oct 2006
    Posts
    9,108

    Default Re: Changing Rehab Providers

    yes.
    workers comp is voluntary; your wife can provide care at her own expense at any time.

    If you want work comp insurance to pay for it you have to follow the law.
    the work comp laws vary by state and whether your wife can select her own care depends on the laws.
    That's the only reason this site is divided into state posting boards.
    Most states give medical control to the employer. you are probably in such a state.
    If so, it may help to request a second medical opinion and get that doctor to recommend specific therapies that will allow a change.

    most physical therapy can be designed to be done at home by the patient. your wife might request such instruction so it will allow more patient control.
    Last edited by .SH; 01-03-2008 at 02:18 PM.

  3. #3
    Join Date
    Jan 2008
    Posts
    3

    Default Re: Changing Rehab Providers

    She has already been to an ortho and neuro Dr. Each spending about 5 min with her. I would like to go with my regular health ins but dont know if any other action could be taken against the job if doing so. If case is closed out and re opened at a later date.

  4. #4
    Join Date
    Feb 2007
    Posts
    550

    Default Re: Changing Rehab Providers

    Drew,

    SH is PATENTLY incorrect. This comment, "workers comp is voluntary; your wife can provide care at her own expense at any time."
    IS FULL OF SHIT.

    If you are in CA for example, it is AGAINST the law (forgot the LC section, presently), for a health care provider to COLLECT ANY FEE FROM AN IW. Period, plain & Simple.
    Now, if you want to lie to a rehab provider, and pay cash, no one is stopping you. However, i STRONGLY advise against this, because it will reflect on your credibility. If you end up in court, and the records are somehow discovered, you will be screwed. Not only will your (W's) credibility be in question, the mechanism of action of the injury will also be in question.

    Now, I can tell you an inside approach. Go to the provider, that is outside of your area. PAY CASH ONLY, and use a phony name.

    That is the only way i can recommend doing anything of this nature. But, i still think it is a bad idea. If she suffers an injury while in PT, this would be a nightmare.

    You also CANNOT use you Private Ins for a WC injury. Read your Evidence of Coverage (EOC) It is the fine print, 100 page document the Gucci suit wearing lawyers make IC's sendout to justify their 7 figure salaries!

    Best wishes for a speedy recovery.

    LA


    Quote Quoting drew64 View Post
    She has already been to an ortho and neuro Dr. Each spending about 5 min with her. I would like to go with my regular health ins but dont know if any other action could be taken against the job if doing so. If case is closed out and re opened at a later date.

  5. #5
    Join Date
    Feb 2007
    Location
    Western New York State
    Posts
    1,340

    Arrow Re: Changing Rehab Providers

    Drew64,
    What state are you from? In New York state you go to where a doctor wants you to (because he/she knows they accept comp. patients) UNLESS, you can find another PT that will accept comp. payments. Nothing in the law states that you can not pay for PT our of your own pocket but your private health insurance company will find out about your case being a comp., case and demand their monies back. I am not an attorney but speak from experience and live in New York State!

    Good luck!!!

    and please, (to others) we don't need that kind of language on this board

  6. #6
    Join Date
    Dec 2006
    Location
    Pa.
    Posts
    925

    Lightbulb Re: Changing Rehab Providers

    Hi Drew! Knowing Your State would Help Us Immensely in being able to Answer Your Questions. I'm in Pa., and Law here States that if You are not Satisfied with the w/c Dr.',s after 90 Days, You can Use the Provider of Your Choice, and w/c has to Pay! But for the First 90 Days, You have to follow w/c Dr.'s and Restrictions, so as You can See, the State You Reside in is Important to getting the Correct Answers! I Wish You the Best, and Have a Nice Day!!

  7. #7
    Join Date
    Jan 2008
    Posts
    3

    Default Re: Changing Rehab Providers

    We are in NJ. I have other providers that accept workers comp but they are not contracted with the ins comp i am told.

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