Can You Change Doctors Under Virginia Workers’ Compensation
Not automatically. After a work-related injury in Virginia, medical care is governed by specific rules under the Workers’ Compensation Act. Understanding the panel of physicians requirement and the limited ways you can change doctors is critical, because the physician who treats you plays a central role in your recovery, work restrictions, and benefits.
The Panel of Physicians Requirement and Changing Doctors
What Is the Panel of Physicians?
Under Virginia Code § 65.2-603, your employer (or its workers’ compensation insurer) must offer you a panel of at least three physicians. You select one from that panel, and the doctor you choose becomes your authorized treating physician.
A valid panel generally requires:
- At least three physicians
- Physicians from independent practices (not all in the same group or corporate chain)
- Doctors who are reasonably accessible to you
- The panel to be offered within a reasonable time after you report the injury
If your employer never provides a valid panel, or provides an invalid one, you may be able to choose your own doctor. That doctor can then become your authorized treating physician, and the employer/insurer is generally responsible for reasonable, necessary, and causally related treatment.
Important notes:
- Emergency care is covered even without a panel.
- Once you select a doctor from a valid panel (or begin a course of treatment), you generally must continue with that physician and any specialists they refer you to.
- Unjustified refusal of authorized medical treatment can result in suspension of your wage-loss benefits.
The treating physician’s opinions on causation, work restrictions, referrals, and impairment ratings carry significant weight with the Virginia Workers’ Compensation Commission.
Can I Change My Treating Physician If I Don’t Like the One I Chose?
Not freely. Once a treating physician is established, you generally cannot switch doctors on your own and expect the insurer to pay for the new care. Unauthorized treatment is typically your responsibility.
There are limited paths to change doctors:
- Referral from your current treating physician
This is often the cleanest approach. If your authorized doctor refers you to another physician (or transfers your care), the new doctor is usually within the authorized treatment chain and should be covered. - Agreement with the employer or insurer
The employer or insurer can agree to a change. Any agreement should be confirmed in writing before you switch doctors. - Order from the Virginia Workers’ Compensation Commission
You (or the employer) can ask the Commission to order a change. The party requesting the change must show a reasonable justification. Recognized grounds include:
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- Inadequate treatment
- Need for specialized care that is not being provided
- Lack of progress without an adequate explanation
- Failure to use conventional treatment methods
- No treatment plan for a long-term disability
- Failure to cooperate with Commission discovery orders
Simply not liking the doctor, disagreeing with their opinions, or preferring a different physician is generally not enough. The Commission looks for objective reasons related to the quality or appropriateness of care.
Other situations that may support a new panel or change include:
- Your treating physician releases you from care in writing while you still have ongoing symptoms and need treatment
- You move a substantial distance that makes continued treatment with the current doctor unreasonable
- The treating doctor misses a diagnosis which is found by a subsequent doctor
What You Should Not Do
Do not simply stop seeing your authorized doctor and start treating with someone else. This can leave you responsible for the bills and may create problems with your claim. Document your concerns, explore proper channels (referral, written agreement, or Commission process), and get legal advice before making a switch.
“Having represented both major insurance carriers and injured workers, we know firsthand the exact tactics adjusters use when curating medical panels to minimize claim value.”
How We Can Help
Navigating the panel rules and a request to change physicians involves both medical and legal issues. The right steps depend on the specific facts of your case, the medical records, and the timing. Our experienced Virginia workers’ compensation attorney can review your situation, evaluate whether a change is justified, and handle the necessary communications or filings with the employer, insurer, or Commission.
If you are dealing with a panel of physicians, unhappy with your current treating doctor, or facing questions about authorized medical care, contact Miller & Webb, LLP for a consultation at 540-627-5131. We help injured workers understand their rights and pursue the medical treatment and benefits the law provides.
Dale W. Webb has represented injured workers, first responders, and employers throughout Southwest Virginia for nearly 40 years. A former Vice Chair of the Virginia Association of Defense Attorneys (VADA) Workers’ Compensation Section and Best Lawyers in America honoree, Dale leverages decades of insurance defense insight to help claimants navigate medical panels, protect their wage-loss benefits, and secure approved treatment.