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Employer physicians refuse to see me!

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  • Employer physicians refuse to see me!

    I live in Tennessee.

    Last week I reported an injury to my employer. My back had been bothering me from doing repetitive reaching. The area was the muscles in my mid and lower back. It was late in the evening. I had to go to the emergency room at the hospital, because I had to be drug tested. The doc checks me out and gives me some prescription meds and tells me to follow up with workers comp.

    My employer has the 3 physicians posted for WC, and they are:

    Walk-in clinic A
    Walk-in clinic B
    ER at hospital


    The next day I call my HR person. She tells me I should go see Walk-in clinic A. This Walk-in clinic is also apart of a physicians group. I told her that I don't think I can go there because I used to see one of the doctors in the physician group, and that I had been dismissed as a patient. And that they had told me that I can't go back there. The HR person told me that they would have to see me because it is WC.

    Well, I showed up at Walk-in clinic A, and they told me that the HR person told me to go to Walk-in clinic B. So, I figured they must have told the HR person that they won't see me.

    I show up at Walk-in clinic B and was seen. The doc gave me a prescription and put me on 4 day light duty. He also gave me an order for an X-ray, and told me to get one done the following week if my back was still bothering me. My employer had me off for the next two days, and then I was off another two days because it was the week end.

    Well, my back was still bothering me and I went for an X-ray last Tuesday. The nurse calls me Wednesday and tells me the X-ray was ok. I told her that an MRI should have been ordered as you can't see soft tissue on an X-ray. I told her my spine was not bothering me, but my back muscles. And that I was still having pain. Blah, blah she said.

    So, Thursday I call the Walk-in clinic B to go back because my back was still bothering me. The nurse calls me back and tells me the doctor said that he can't see me. She said that I was fine because the X-ray came back ok. I told her again that my back muscles are what was bothering me, and that I was still in pain. I told her that soft tissue won't show up on an X-ray. She told me that I'd have to call the WC insurance company.

    So, I call them. I told them I want to see Walk-in clinic A. We call them, and they say they won't see me because I had been dismissed as a patient. So, the insurance company tells me to call my employer to get a different doctor to go see.

    So, right now Walk-in clinic A won't see me at all. Walk-in clinic B saw me once, but the doc doesn't want to see me again. Then you have the ER at the hospital. But I don't think they are supposed to be on the list, as I don't think I'm supposed to be going for WC treatment at the ER of a hospital.

    I'll have to call my employer tomorrow. But can physicians on the employer's WC panel refuse to see me? That seems illegal. As of right now, I am unable to get treatment for my injury. I'm wondering what my employer will tell me.

  • #2
    Alright curiosity is killing me. Just what did you do to get a doctor to refuse to ever treat you? Most will take anyone with green money (or insurance that pays in green money).

    Yes it is legal for the doctor to refuse to treat you only because there is nothingin the law that prohibits this. It is also legal to designate the hospital as a treatment site.

    While MRI's are "better" at identifying soft tissue injuries, they are expensive and rarely done in WC unless there is reason to suspect there is something significant that might appear. A pulled muscle is rarely going to be given an MRI as even if something shows up, it isn't going to change the treatment all that much.
    I post with the full knowledge and support of my employer, though the opinions rendered are my own and not necessarily representative of their position. In other words, I'm a free agent.

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    • #3
      Originally posted by ElleMD View Post
      Alright curiosity is killing me. Just what did you do to get a doctor to refuse to ever treat you? Most will take anyone with green money (or insurance that pays in green money).

      Yes it is legal for the doctor to refuse to treat you only because there is nothingin the law that prohibits this. It is also legal to designate the hospital as a treatment site.

      While MRI's are "better" at identifying soft tissue injuries, they are expensive and rarely done in WC unless there is reason to suspect there is something significant that might appear. A pulled muscle is rarely going to be given an MRI as even if something shows up, it isn't going to change the treatment all that much.
      Well, with walk-in clinic A, it is a big building. There are a group of several doctors there, and a walk-in clinic is located in the building as well. I used to see a doctor there, and was dismissed as a patient. They have some policy that says if you are dismissed, then you can't go back. The doc dismissed me because I was harrassed and assaulted in the parking lot by someone, and I called the cops.

      The doc at walk-in clinic B is refusing to see me, I'm thinking because the X-ray came back normal. I told the nurse I'm still having pain. The nurse said if there was any swelling, then it should have healed by now. Regardless, I don't understand why the doc is refusing to see me because of a normal X-ray.

      You see, I've seen a few people go on workers comp. If they are still having pain, they get to be off work. They all went to walk-in clinic A.

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      • #4
        To get paid by WC, you must first have a doctor certify that you need to be off for a medical reason.
        I post with the full knowledge and support of my employer, though the opinions rendered are my own and not necessarily representative of their position. In other words, I'm a free agent.

        Comment


        • #5
          Originally posted by ElleMD View Post
          To get paid by WC, you must first have a doctor certify that you need to be off for a medical reason.
          Ok. How long can the employer wait to give me a list of doctors to see?

          Right now, I'm unable to get medical treatment.

          Comment


          • #6
            They gave you a list of 3 places. That is all that is required.
            I post with the full knowledge and support of my employer, though the opinions rendered are my own and not necessarily representative of their position. In other words, I'm a free agent.

            Comment


            • #7
              Originally posted by ElleMD View Post
              They gave you a list of 3 places. That is all that is required.
              What if those physicians refuse to see me? Then how long do I have to wait for my employer to give me another list of physicians to pick from? Or do I just go without medical treatment?

              Comment


              • #8
                Have all the physicans refused? You mentioned 2 that were but what of the third option? Hoenstly, it is so rare that one physican, let alone 3 would refuse to treat someone that the regs don't really take this possibilty into account. If it comes down to this, I'd call the state WCC and ask how you should proceed.
                I post with the full knowledge and support of my employer, though the opinions rendered are my own and not necessarily representative of their position. In other words, I'm a free agent.

                Comment


                • #9
                  Originally posted by ElleMD View Post
                  Have all the physicans refused? You mentioned 2 that were but what of the third option? Hoenstly, it is so rare that one physican, let alone 3 would refuse to treat someone that the regs don't really take this possibilty into account. If it comes down to this, I'd call the state WCC and ask how you should proceed.
                  At the night of my injury, I went to the ER of the hospitol. The doc told me to follow up with workers comp.

                  The next day, I called my employer. They told me to go to Walk-in clinic A. I showed up at Walk-in clinic A to be seen for my injury. They refused to see me. I guess they must have told my employer this as they said my employer told me to go to Walk-in clinic B.

                  I showed up to Walk-in clinic B and was seen. The doc gave me an order for an X-ray, and told me to get it done the following week if my back was still bothering me. I did, and that nurse called me to let me know the X-ray came back fine. The next day, I called his office at Walk-in clinic B to be seen as my back was still bothering me. My employer did tell me to go back if my back was still bothering me. Though, the nurse told me that the doctor wouldn't be able to see me and I would need to call the insurance company.

                  So, Walk-in clinic A refused to see me.

                  Walk-in clinic B saw me once, but is refusing to see me again.

                  The ER at the hospitol is not the place for me to go for ongoing treatment. I don't even know why my employer even has them on their list, as you only see them once to get to a regular physician.

                  I called my employer for another panel of physicians for me to see, they told me to get that from the insurance company as they don't have a list of any other physicians to give me. I call the insurance company, and they tell me to get that from my employer. So, that is where I am at. I'll call the insurance company Monday. I'll probably also call a lawyer.

                  I did call the WC thing for my state, and they just told me to talk with my employer. That doesn't help me much.

                  I figured these panel physicians the employer has must have a contract with my employer to see employees for WC injury.
                  Last edited by jasonsmith; 02-25-2007, 09:59 PM.

                  Comment


                  • #10
                    Were it me, I'd go back to the ER. If you are unwilling to do that, and the state can't even advise you any differently, there isn't anything I or anyone else here can tell to do.
                    I post with the full knowledge and support of my employer, though the opinions rendered are my own and not necessarily representative of their position. In other words, I'm a free agent.

                    Comment


                    • #11
                      Originally posted by ElleMD View Post
                      Were it me, I'd go back to the ER. If you are unwilling to do that, and the state can't even advise you any differently, there isn't anything I or anyone else here can tell to do.
                      Well, I called the WC for the state again, and the lady is calling the insurance company to find out what is going on.

                      Though, the WC lady told me to get another list from my employer, and I had to keep telling her that my employer didn't have another list.

                      Comment


                      • #12
                        Well, I called the insurance company. My adjuster was not there so I talked with someone else. This adjuster gave me a phone number to call for in-network physicians.

                        I called this number and was able to get a list of physicians to choose from. There is one that does industrial medicine, so that looks like the place to go. Opinion on this? I'm gonna drive and check it out real quick.

                        The lady I talked to said I could call back for more physicians. Oh, and she said that my employer shouldn't have the ER on their 3-panel physician list as that's not the place to go to for treatment, just emergencys. She also told me that Walk-in clinic A is contracted with them to see patients for WC. So, she doesn't know why they would refuse to see me. I told her I wanted to file a complaint. HAH ha ha ah aha.
                        Last edited by jasonsmith; 02-26-2007, 06:08 AM.

                        Comment


                        • #13
                          File a complaint with who about who?
                          I post with the full knowledge and support of my employer, though the opinions rendered are my own and not necessarily representative of their position. In other words, I'm a free agent.

                          Comment


                          • #14
                            Doctors are not in the habit of refusing to see patients for no reason. I can't help wondering what has transpired to make more than one doctor refuse to see you?
                            The above answer, whatever it is, assumes that no legally binding and enforceable contract or CBA says otherwise. If it does, then the terms of the contract or CBA apply.

                            Comment


                            • #15
                              Originally posted by cbg View Post
                              Doctors are not in the habit of refusing to see patients for no reason. I can't help wondering what has transpired to make more than one doctor refuse to see you?
                              I think I mentioned this one thing before. Walk-in clinic A is in the same building as a large physician group. I used to see a doctor there that was in this physician group. This doctor dismissed me as a patient nearly a year ago. If you must know, this doctor dismissed me as a patient because I was in their office one day. A man started harrassing me because of his wife, who was present. (His wife used to work where I work at, and was fired for harassing people.) I tell him to leave me alone. He tells me he is going to follow me. I tell him again to leave me alone. Well, I leave and he follows me out and ends up assaulting me by hitting me in the face. I call the police and make a report. And my doctor at the time dismissed me as a patient because of the "incident". This physician group has a policy that says a patient can't come back there if they have been dismissed by a doctor.

                              I don't know why the doctor at Walk-in clinic B refused to see me again. His nurse did call me and tell me my X-rays were ok. I told her I was still in pain and needed treatment. The nurse says that my clean X-ray means I'm fine. I again tell her I'm having pain. She says any inflammation should have healed by now.

                              I don't know, I guess this doctor is a retard. He doesn't have a good reputation anyways. He likes to tell people they should go somewhere else like the hospitol. I didn't want to see him anyways, as I went there around 4 years ago because I was on the state health insurance at the time. He walked out of the office and refused to treat me. I was there because I was having on going fatigue, etc.

                              But, I was able to squeeze a couple more names from the insurance company. I'll have to call them tommorrow. Here's the low down:

                              I called the insurance company again early this morning. The person I talked to gave me a 1-800 number to call to get a list of in-network physicians.

                              I called it and got a couple of names. I called one place to check it out, and I asked if they can treat back injuries. The lady said that she didn't know, and didn't know how to respond to my question. So, I figured I wasn't going there.

                              I called one of the other places, which is a physician clinic 30 miles away. They told me that they don't take WC patients.

                              So, I call the insurance company and talk with the supervisor. He said he'd check it out and call me in one hour. After 3 hours of waiting, I called him back. He looked and could only find the one place that had refused to see me, and the other place where the lady didn't know if they could treat a back injury.

                              He said that's all he has in a 50 mile radius. I tell him that I'm NOT driving 1 hour to 1 1/2 hours to see someone. I told him he needs to give me a list of 3 physicians not in the same practice that are within a 10 mile radius of where I live. And that if he can not do this, then they would need to let me see someone out-of-network. I even told him that by law, I was supposed to have been offered a Cyropractor to see as well. He looks again and seems to find a couple more physicians in my town. I wrote them down and told him I'd have to check them out the next morning because I had to go to work. Though, I did tell him I probably wouldn't see a Cyropractor since my injury isn't related to my spine. I don't think he had one to offer me anyways.

                              These two physicians are in the same practice I believe as they have the same address. I'll call them tommorrow. Though, I'm betting they tell me they don't see WC patients. If that happens, **** em, I'm going to the ER to see if I can get time off of work. I think I've done been through enough bull**** as it is.

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