Legal Question in Workers Comp in South Dakota

Re: docotor referals

Technically, your employer's workers' compensation insurance carrier is required to contract with an approved managed care provider who is supposed to have an approved list of doctors and other medical care providers. Strictly speaking, your doctor can be restricted from referring you to a specialist who is not on a list of approved providers for the managed care company handling the medical expenses for your employers' workers' compensation insurance carrier. As a practical matter, this provision in the law is seldom enforced. If your treating doctor makes a referral to a specialist, the workers' compensation insurance carrier typically is required to accept that referral. You have the right to discuss this referral with your doctor and to ask that the doctor consider your preferences when making a referral, this is especially true if the doctor you want to go to is local and the doctor you might otherwise be referred to is out of state. Bottom line, you can request to see the doctor of your choice. If your treating physician disagrees with you, afeter you have made the request, and if the doctor referrs you elsewhere, you may be stuck.

I am a little curious, however. Did you pick the treating doctor in the first place or did someone else pick this doctor for you. You are supposed to get to select your initial treating doctor. Sometimes employers pretend that they can tell you what doctor to go to for treatment. They can't. Why would a doctor want to refer you out of state. It sounds to me more like an IME or independent medical evaluation that a referral for treatment. Many times doctors who are asked to give opinions for medical-legal purposes in the form of independent medical examinations come from out of state.