In Florida, injured employees may see a doctor of their own choosing only if the employer has signed a medical provider agreement (MPA) that includes a "choice of physician" provision, or if the employer does not have an MPA and the employee requests a personal physician before treatment begins. Without such an agreement, the employer's designated network doctor must be used for the first 30 days of treatment.
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When a Medical Provider Agreement Allows Choice
An MPA is a contract between an employer and a medical provider network. If the MPA contains a clause granting employees the right to select their own physician after the initial network evaluation, the employee can submit a written request to the employer's workers' compensation insurer. The insurer must approve the request unless it is unreasonable or would cause undue cost.
When No MPA Exists
If the employer has not entered into an MPA, Florida law gives the employee the freedom to choose any licensed medical provider at the outset of the claim. The employee should notify the employer in writing of the chosen doctor within seven days of the injury to avoid disputes over coverage.
Steps to See Your Own Doctor
- Confirm whether the employer has an MPA and its specific language.
- Submit a written request for a personal physician to the employer or insurer, citing the MPA clause or lack of MPA.
- Provide the doctor's licensing information and ensure they accept workers' compensation patients.
- Keep copies of all correspondence for the claims file.
Potential Limitations and Disputes
Even with a "choice" clause, insurers can deny a request if the chosen doctor is out of state, lacks workers' comp experience, or charges rates significantly above the usual and customary fees. In such cases, the employee may need to appeal the denial to the Florida Department of Financial Services or pursue a hearing before the Office of the Judge of Compensation Claim.
Impact on Claim Benefits
Choosing your own doctor does not affect the entitlement to wage replacement, medical benefits, or vocational rehabilitation, but it may influence the speed of claim processing. Network doctors often have streamlined billing with insurers, while independent physicians may require additional documentation.
Quick Reference Table
| Scenario | Doctor Choice | Key Action |
|---|---|---|
| Employer has MPA with choice clause | Employee may select after initial evaluation | Submit written request to insurer |
| Employer has MPA without choice clause | Network doctor required for first 30 days | Follow network protocol; can request change after 30 days |
| No MPA | Employee can pick any licensed doctor | Notify employer in writing within 7 days |