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Connecticut Compliance

Physician Selection 31-294d

An employee may choose an attending physician AFTER the initial visit with an employer-designated medical practitioner. If the employer does not participate in an approved medical care plan, the employee may choose any medical practitioner who is licensed to practice in Connecticut, including practitioners of chiropractic, medicine, naturopathy, osteopathy, and podiatry. An employee whose employer does participate in an approved medical care plan must choose a physician from the list of doctors included in that plan. If the employee chooses a physician outside the plan, a Workers' Compensation Commissioner may suspend all rights to workers' compensation benefits. In either case, it is the injured worker who has the right to choose.

Effective July 1, 2015: If the employer utilizes an approved providers list, when an employee reports a work-related injury or condition to the employer the employer must provide the employee with such approved providers list within 2 business days of the report.

An employee may change their attending physician, if dissatisfied with the medical treatment being rendered. There are three ways in which an employee may effect a change of physician: (1) Get a referral from the present attending physician, (2) Obtain approval to change physicians from the workers' compensation insurance carrier involved (or the employer, if it is self-insured), OR (3) Write to the Workers' Compensation Commissioner in the District Office having jurisdiction. Indicate the name, address, and medical specialty of the present physician, as well as the name, address, and medical specialty of the new physician, and the reason(s) for requesting a change. In this case, the commissioner could reply by mail or set up an informal hearing.

[NOTE: If the employee is covered by an approved employer medical care plan, the new physician MUST also be a participating practitioner in the plan.] If an employee does not have an attending physician's referral to another medical practitioner, or permission to change physicians from the insurer, self-insured employer, or Commissioner, they will most likely be liable to pay for any unauthorized medical bills which may arise.

All necessary medical care for the injury or illness must be provided by a medical practitioners licensed to practice in Connecticut. If, for any number of reasons, the employee requires treatment with a doctor outside of the state, the employer/insurer could grant permission or the employee would have to request permission from a Workers' Compensation Commissioner who may or may not authorize out-of-state treatment. If the employee resides in another state, a Workers' Compensation Commissioner may authorize medical care by a physician in that state.

Medical care provided by a practitioner other than the attending physician or a specialist to whom the employee has been referred, is the employee's responsibility as these treatments and their charges are considered unauthorized.