Can I See My Own Doctor For Workers’ Comp in South Carolina? 2025

If you’re injured at work, you may ask, “Can I see my own doctor for workers’ comp in South Carolina?” Workers’ compensation laws require treatment from an employer-approved physician, such as those at Tidelands Health Occupational Medicine. Seeking care elsewhere, like South Strand Internists & Urgent Care, could result in denied coverage for medical expenses. Understanding your rights is crucial to ensuring your treatment is covered.

Who Chooses Your Doctor for Workers’ Compensation in South Carolina?

Workers’ compensation provides important benefits for injured workers. Insurance providers issued $866 million in direct voluntary market premiums in 2022, an increase from the $792 million recorded in 2021. Knowing which doctor you can use is not always straightforward, though.

In South Carolina, your employer or their insurer provides the doctor who treats your work-related injuries. This means that you must receive care from a pre-authorized physician who works at Tidelands Health Occupational Medicine or a similar treatment center.

Employers often work with specific medical providers who understand how workers’ compensation claims work. These doctors are also focused on helping patients recover so they can return to work. While many of these doctors perform effective and objective examinations, some may give results that favor the employer.

What Happens if You See an Unapproved Doctor?

In 2023, private industry employers in South Carolina reported 30,100 nonfatal workplace injuries and illnesses. All of those injured workers had to go see an approved doctor in order to be approved by their insurance provider.

South Carolina law requires injured workers to follow their employer’s treatment plan under the direction of their doctor at Prisma Health Occupational Medicine and elsewhere. While you may prefer to see your own physician, doing so could lead to you having to pay for that visit out of your own pocket.

You could even risk losing benefits that you are entitled to if you do not follow the rules. If your chosen doctor gives treatment plans that conflict with the designated doctor, that could further complicate your claim. In certain circumstances, you may have the right to request a different doctor if the treatment you receive is inadequate.

Can You Seek Legal Representation if You Are Unhappy With Your Doctor

A workers’ compensation attorney understands how serious workplace injuries can be. South Carolina recorded a total of 132 fatal work injuries in 2022. When you secure legal representation, you gain a trusted source of advice that is not beholden to the insurers.

A workers’ compensation attorney can help you in several ways. If you are not satisfied with the designated doctor, you may have good cause to request another doctor. If your employer tries to block your request for a new doctor, your attorney can take the matter up with the South Carolina Workers’ Compensation Commission to ensure that you are treated fairly and your employer follows the law.

If your employer or their insurance carrier denies your claim or tries to delay payments, your lawyer can address those matters head-on so you are not deprived of what you are owed. A workers’ compensation lawyer can help you navigate complex cases that could involve pre-existing conditions or disputes over whether your injury is work-related.

FAQs

What Should You Avoid Saying to a Workers’ Compensation Doctor?

Avoid exaggerating or minimizing your injuries. Stick to the facts and do not speculate about your recovery time. Never say you feel fine if you are still in pain. Avoid discussing unrelated medical conditions or mentioning that you are pursuing legal action, as anything you say may be used to limit your benefits.

Who Decides Your Treating Doctor in a Workers’ Compensation Claim?

In South Carolina, your employer’s workers’ compensation insurance typically chooses your treating doctor. This physician oversees your care, prescribes treatment, and determines work restrictions. If you disagree with their assessment, you may request a second opinion, but the insurance provider must approve the change. Seeking legal guidance can help if you need a different doctor.

Are There Benefits to Having Legal Representation During a Workers’ Comp Claim?

Legal representation can significantly impact the outcome of a workers’ compensation claim. An attorney ensures that your claim is properly filed, fights against unfair denials, and advocates for the full benefits you are entitled to receive.

If your employer or their insurance carrier delays payments, disputes medical treatment, or pressures you to return to work too soon, an attorney can intervene. They can also help if you need to appeal a denied claim or seek additional medical opinions.

Can Workers’ Compensation Send Someone to Your Doctor’s Appointments?

Workers’ compensation insurers cannot send a representative to your medical appointments, but they may request medical records or updates from your doctor. Some insurers hire private investigators to monitor claimants outside of medical visits. If you suspect surveillance or interference with your treatment, speaking with an attorney may help protect your rights.

What Should You Avoid Saying to a Workers’ Compensation Adjuster?

Avoid admitting fault or speculating about how the injury happened. Do not say you are fine or recovering quickly if you are still experiencing pain. Refrain from giving recorded statements without legal guidance, as insurers may use your words to deny or minimize your claim. Keep conversations brief and focused on necessary claim details.

Schedule Your Workers’ Compensation Consultation Today

A workplace injury can disrupt your livelihood and leave you with medical bills and uncertainty about your financial future. After years of steadfast service to your employer, you have every right to expect fair treatment under the law when you apply for workers’ compensation benefits.

Whether you were injured in a sudden accident or developed a condition over time due to repetitive strain, you should not have to put up with delays or insurance carriers that act in bad faith. If you are unhappy with the appointed doctor you were given, you may have options to find better quality medical care.

At Axelrod & Associates, P.A., we advocate for injured workers, ensuring they receive the benefits they are owed. Our team can handle your claim, address disputes, and fight for your rights. Contact our office today to schedule your initial no-cost consultation.