If your employer is a non-subscriber to Texas Worker's Compensation, you can see any doctor you'd like for your work injury. But there's a catch.
After any work accident, the main thing most workers are focused on is obtaining medical attention and any other treatment that will get them back on their feet. Naturally, most workers would like to see a doctor of their choosing, but they're often told by their employer that they have to see a "company doctor."
When a company opts in to a bona fide workers' comp plan, Texas law requires the company's injured employees to see a doctor of the insurance carrier's choosing. However, when a company opts out of workers' comp coverage, thereby making them a non-subscriber, Texas law says that they cannot make the injured worker see a particular doctor. In this article, we'll explain how this all works.
Questions Answered on This Page:
- Do I have to use a specific doctor if I've been injured on the job?
- Can my employer require me to use a company doctor following my work injury?
- Can I use my own doctor if my employer is a non-subscriber?
- In a Texas non-subscriber work injury, what rights do injured workers have?
Texas has two sets of work injury laws.
Before we get started explaining the inner workings of this topic, let's cover some of the basics of Texas work injury law. First and foremost, Texas is unique among the 50 states in that it is the only one where employers can opt out of workers' comp coverage. When an employer buys workers' comp coverage, they are considered to be a "subscriber." Employees of a subscriber are eligible to receive several types of benefits (paid out through a welfare type program), including medical benefits, but they are not able to sue the employer for their injuries.
Think of it as a trade-off. By subscribing to workers' comp coverage, the employee gets more or less guaranteed benefits (though they're not very valuable) and the employer gets blanket immunity from work injury lawsuits. Naturally, if an employee gets benefits without having to put up a fight, the workers' comp insurance carrier gets to call the shots as to how the worker receives those benefits, namely, they get to choose the injured worker's doctor for him or her.
But when an employer opts out, they are considered to be a "non-subscriber" to Texas workers' comp coverage, and everything changes. Now, suddenly, there are no automatic benefits for the injured worker, and to get any type of compensation, the worker must usually sue their employer in court. In the absence of conflict-free benefits, the employer certainly does not have the right to dictate how the injured worker receives medical attention. In other words, under the workers' comp system, the employer's insurance carrier covers everything without a fight, so, sure, it's fair that they should be able to have to some degree of control over how the medical attention is administered. But when they are non-subscribers and aren't going to give up without a fight, it's not fair for them to attempt to control the injured worker's medical treatment.
All that to say, workers' comp cases and non-subscriber cases are polar opposites. So, why then, are so many injured workers who work for non-subscribers under the impression that they have to see a company doctor? The answer is simple: their employer and/or the company's insurance carrier lies to them about this supposed requirement.
The Story on Company Doctors
When an employee is injured on the job, companies often encourage them to see company doctors because the this doctor will downplay the extent of worker's injuries. Since these doctors are either employed by the company or a large percentage of their work is provided by the company, they also have a vested interest in keeping the company profitable. While these doctors are probably not "bad" doctors, per se, they may be motivated by a desire to make their company money, since their income depends on the success of their employer. This is known as a "conflict of interest."
Should you see the company doctor or your own doctor? The short answer: you should avoid the company doctor unless it is an emergency, you are required by law to see them, or if you can derive some extraordinary benefit from doing so. It is typically a good idea to consult an attorney before electing to see a company doctor (in non-emergency situations, of course).
The problem with the company doctor, as we stated, is that they either work for the company that owes you money or depends on that company for large parts of their income. As you would expect, company doctors are normally loyal to companies that pay their salaries. Like business people everywhere, doctors are motivated by the bottom line: money. Doctors do not like to risk the relationships they have with the companies that pay their bills and will, all too frequently, do whatever it takes to maintain good relationships with the companies that refer them business.
As we mentioned, if your employer has workers' comp coverage, you get automatic medical benefits that the law requires your employer to pay you. But, if your employer is a non-subscriber, they don't have to provide you any type of medical benefits (or any kind of benefits at all, for that matter). Further, the law gives you the power to sue your employer for all the many categories of damages (such as pain and suffering, medical bills, disfigurement, etc.).
But here's where things get tricky. Sometimes, a company will be a non-subscriber, and even though the law does not require them to provide their injured workers with any kind of benefits, they will do so voluntarily. Some of these companies will basically adopt many of the practices that a workers' comp subscriber would be obligated to operate under, by law. Why do they do this? Sometimes they legitimately care for their workers and want them to get back on their feet, so, even though they opt out of workers' comp and the law does not require them to provide benefits, they do so out of sheer generosity. Other times, non-subscribers provide benefits they are under no obligation to provide because they figure they can throw a little bit of compensation your way, trick you into believing they've done all they need to do, and it will cost them less than paying for very expensive workers' comp coverage.
Irrespective of their reasons, if they provide you with medical coverage, even on a voluntary basis, that does not mean that they can suddenly start dictating terms to you... Unless you allow that to happen. Any two adults can enter into a contract, and the terms of that contract can consist of virtually anything, so long as it's not concerning illegal activities, etc. So, if you consent to the employer subjecting you to a claims process that sort of mirrors a workers' comp claim, even though the employer does not have workers' comp coverage, then you are basically allowing them to dictate the terms of this arrangement. If you're comfortable with that, then don't say anything, and perhaps they'll continue to generously provide you with fair and reasonable compensation. Just know that the law doesn't require them to, and it's all too easy for them to change their minds.
Pressure from the Company
Companies that know they are financially responsible for worker's injuries get desperate. They sometimes try to force workers to see company doctors with threats, lies and misrepresentations.
If you have been injured at work, after receiving emergency medical care, you and your family should speak with an attorney at Grossman Law Offices. We can help you get through this challenging and complicated time and we will refer our clients to independent doctors where you can receive individual care and accurate diagnoses.
Call Grossman Law Office:
Dealing with companies, company doctors, hospitals and insurance companies is a job for an experienced attorney. Do not attempt to tackle these on your own. If you have been hurt on the job, do not trust your healthcare to the company that is potentially responsible to you for your injury. Let our worke's compensation lawyers fight your cases and get you the compensation you deserve. You can reach our staff at (855) 326-0000 at any time, day or night, toll-free.
Other articles about non-subscriber work injuries that may be helpful: