A short answer to this question in Missouri is: Yes.
Of course, after helping injured workers file MO work comp claims for almost 40 years, i have found that there are no short answers in Missouri workers’ compensation.
The Workers’ Compensation Law of Missouri is a state statute, like traffic laws, criminal laws, probate and divorce laws, etc. MO state law tells workers who are injured on the job what they can and cannot do.
As I point out in my book, Missouri Workers’ Compensation Law and Practice, RSMo Section 287.140.1 requires an injured worker’s employer to provide ” . . . such medical, surgical, chiropractic, and hospital treatment, including nursing, custodial, ambulance and medicines, as may reasonably be required after the injury or disability, to cure and relieve from the effects of the injury.”
Sounds pretty simple, right? Not so fast.
The next sentence of the statute says: “If the employee desires, he shall have the right to select his own physician, surgeon, or other such requirement at his own expense.”
It’s those last four words that make Missouri the envy of the workers’ compensation insurers in many states (like Illinois, for example).
So yes, an injured worker can go to any doctor she or he wants, SO LONG AS THE INJURED WORKER PAYS FOR IT. In other words, a Missouri employer is usually not liable for medical expenses from medical providers that it did not pre-authorize or designate to provide medical care to its injured employee.
There are, as you might guess, several exceptions to this rule, involving emergency situations, various waivers of the right to designate the provider, and similar circumstances.
But this power to select their injured employees’ physicians gives Missouri employers a huge advantage in the management and control of workers’ compensation claims.
Unlike some of my colleagues, I don’t go out of my way to demonize “company doctors”: by and large, employees – especially my many clients living outside Missouri’s larger cities – can be very well served by being directed to experts who are familiar with and well qualified to diagnose and treat work-related injuries.
However, being alone in the examining room with an injured worker can result in the “white-coated expert” consciously or sub-consciously having the power to exert a great deal of influence on his or her patient. I have heard too many stories from my clients in this regard to deny that it happens. I always say that if the company doctors won’t practice law, I won’t practice medicine. So far, none of them has taken me up on that offer.
And, reasonable or not, being told by someone he or she perceives as a “company doctor” that treatment or testing that sounds reasonable to an injured worker isn’t needed, or that it’s time to return to work, can sound to an employee like it’s coming directly from his or her employer who is paying the physician who is making what sounds to the worker like an unfair decision.
So, an injured worker does not have to go to the company doctor. But, if the worker’s employer offers medical treatment to its employee, an employee who declines that treatment is on his or her own, and any treatment he or she gets will be paid for out of the employee’s own pocket.
And not by health insurance. Most health insurers – all the ones I have seen in almost 40 years of helping MO WC claimants – will not pay for medical expenses associated with work-related injuries.
Although health insurance does – too often (a subject better left to a future blog) – pay for medical expenses once a claim is denied, or further treatment is denied, while an employer is still agreeing to provide treatment at its expense for a work-related injury, a worker injured in Missouri must assume that health insurance will not pay for any charges for health care that the employee seeks out on his or her own.
So the short answer is: Yes. So long as your Missouri employer is willing to send you to a company doctor at its expense to test or treat your work-related injury, you need to go to the company doctor, unless you can afford to pay for your medical care yourself, without relying on health insurance.