Medical Second Opinion. Can I get one?


In many instances, an injured employee receiving workers’ compensation medical benefits may desire a second opinion or an independent medical evaluation.  Also, the Employer/Insurer may also want to send you to another physician for a “second opinion.”  If you have been injured on the job and you are receiving weekly income benefits, you are entitled to receive an independent medical examination from a doctor of your choosing.  There are some procedural requirements you must adhere to but you are entitled nonetheless.

Generally, the injured worker will go to another physician (with similar qualifications) to review his or her medical options.  Furthermore, the cost of this independent medical examination should be the responsibility of the insurance company.  For example, you have been treating for a back or leg issue with an orthopedic specialist for sometime and you are receiving weekly income benefits.  After several months, you would like to get the opinion of another orthopedic specialist, the law allows you to request and receive an examination with any other physician you choose within the area.

Similarly, the workers’ compensation law requires an injured employee to submit to the Employer/Insurer’s second opinion examination.  See, O.C.G.A. § 34-9-202(a).  These Employer/Insurer compelled examinations generally arise when the insurance company is contesting a procedure or surgery requested by your treating physician.  The insurance company will pre-select a physician who has likely performed some work for the insurance company in the past.  These physicians generally tend to be more sympathetic to the insurance company than the patient.  Many times, the physicians will produce needed opinions to help justify the insurance company’s position.  The insurance company must provide you with sufficient notice (at least 10 days prior to the examination) and advance payment of travel expenses.  Failure to attend the Employer/Insurer’s compelled second opinion examination may lead to the suspension of your weekly income benefits.

If you have any workers’ compensation questions about second opinions, independent medical examinations, or anything regarding occupational injuries, please call the Ramos Law Firm.