I fell off ladder had concussion the insurance carrier keeps asking me for past doctors name and employers for the past 10 years,is this legal?am not getting any medical attention from local hospital,I walk in tell them my face is numm and my eyes feel like they are goin to explode and they tell me that theres nothing wrong all is normal,do I have to stay within the mpn?
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2 Answers from Attorneys
Yes, the carrier may request information regarding past physicians.
You must stay within the MPN unless the MPN is defective for any number of reasons. However, you can change doctors within the MPN with out much trouble. Typically local hospitals do not have comp. doctors, so you are right to change.
DO YOU HAVE TO STICK TO DOCTORS IN THE MEDICAL PROVIDER NETWORK?? Mostly!
If you demand a switch to a doc within the MPN and the Adjuster blows you off, you can switch to a non-MPN doctor (but you'd better be certain that non-MPN doc knows how to write perfect Comp reports... NOT the family doc who never handles work injuries, never the overstressed guys at Kaiser).
IF YOU DEMAND a doc within the MPN, DO IT IN WRITING. FAX AND MAIL IT TO THE ADJUSTER. you will likely have to prove later you made a crystal-clear communication to the correct adjuster, and that letter made it to the insurance company. A FAX TRANSMISSION REPORT is very helpful.
GIVE THE ADJUSTER A DEADLINE: give them 4-5 days to ok the doctor on the MPN you've selected. include that MPN doc's fax and phone and address (and email, if you can get it). IF THE ADJUSTER can't get quick authorization to that MPN Doc, they claim they tried to reach your doc and you provided bad details.
BE VERY CAREFUL who you pick on that MPN. 90% of those are 'in bed' with the insurance adjusters. Do a lot of research on the doc you pick from that MPN. If that MPN Doc in on other insurer's MPN, he's a friend to insurance and not to injured workers.
FIND AN MPN DOC who has plenty of reviews on the internet from non Workers' Comp patients.
BETTER STILL: FIND A CERTIFIED SPECIALIST WORKERS COMP ATTORNEY NEAR YOU (not a 'TV' lawyer who sends you to a chiropractor!!! Chiros are fabulous but cannot effectively treat post-traumatic head problems) to pick a real doc from the MPN list for you.