What Injured Workers Need to Know About Medical Care, Second Opinions, and IMEs
When you get hurt on the job, few things feel more frustrating than being sent to a doctor who seems rushed, dismissive, or like they’re working for the insurance company, not for you.
It’s a common experience. One minute you’re in pain. The next, you’re wondering:
“Do I have to keep seeing this doctor? Can I choose my own?”
If you’re asking these questions, you’re not alone. And the answer is: You do have rights, including the right to request different medical care, but that right exists under limited circumstances. Here’s what you need to know.
Who Picks the Doctor in a North Carolina Workers’ Comp Case?
In North Carolina, your employer or their insurance company typically chooses your initial treating physician and have a valid legal right to do so by statutory law. This is standard under state workers' comp law (N.C.G.S. § 97-25).
That means if you’re hurt at work, you’ll likely be sent to a doctor chosen by the insurer, and you must attend those appointments to keep your benefits in place.
But here’s the key: You’re not necessarily stuck with that doctor forever. If the care is inadequate, biased, or not improving your condition, you can request to switch, with proper steps. Court intervention may be required to make the change.
Can I Request to See a Different Doctor?
Yes, North Carolina law allows you to request a change in treating physician — but it’s not automatic, and there’s a formal process and you may not prevail.
If you feel like your assigned doctor isn’t listening to your concerns, rushing your visits, or underestimating your pain, you’re not alone. Many injured workers feel frustrated or dismissed by physicians chosen by the insurance company. These doctors may be more focused on getting you back to work quickly than truly understanding your condition.
Here’s how it works:
- You or your attorney must formally request a change of physician, either through the insurance company or by petitioning the North Carolina Industrial Commission (NCIC).
- The request must demonstrate that the current care is inadequate, not improving your condition, or that you have valid medical reasons to see another doctor.
Common valid reasons include:
- Lack of progress under the current provider which is verifiable in medical records
- Distrust or bias in how your condition is being treated or reported with evidence to support the same
- Referral needs for a specialist or a different type of treatment
These petitions are more likely to succeed when backed by legal representation, so you don’t have to take on the system alone.
Can I Get a Second Opinion?
Yes, and in many cases, you should — especially if your recovery is stalling, your pain is being downplayed, or you’re being told you’ve reached “maximum medical improvement” but still don’t feel healed.
North Carolina law gives you the right to a second opinion on certain aspects of your care — specifically, you are entitled to a second opinion as to your permanent impairment rating, which affects how much compensation you may receive.
You may also request a second opinion on diagnosis, treatment plans, or return-to-work restrictions. Here’s why that matters:
- The first opinion isn’t always the full story. Especially when the doctor works with the insurance company, their recommendations may lean toward cost-saving measures.
- Specialists may offer better insight. If you’re seeing a general physician, but your injury involves the spine, nerves, or a joint, a second opinion from a specialist could change your treatment plan significantly.
- Independent voices can strengthen your case. A second opinion that supports your symptoms or limitations gives you leverage if your claim is questioned or denied.
These second opinions must usually be approved in advance and handled carefully to avoid jeopardizing your benefits — another reason legal guidance is essential. A full blown second opinion evaluation is not an automatic right and it is in the discretion of the North Carolina Industrial Commission (NCIC) whether to permit said evaluation.
The second opinion is usually:
- Paid for by the insurance company, if properly approved
- Provided by a qualified and licensed medical provider
- Subject to NCIC approval, depending on the situation
Even if the insurer refuses to cover it, a second opinion can still be valuable. With legal help, it might shift the outcome of your claim, or open the door to more appropriate treatment.
What’s the Difference Between an IME and a Second Opinion?
This is where it gets tricky, and where many injured workers get blindsided.
An Independent Medical Exam (IME) is not the same as a second opinion.
What is an IME?
- An IME is an exam ordered by the insurance company, typically when they disagree with your current doctor’s opinion.
- IME doctors do not treat you, they evaluate your condition and report back to the insurer.
- These exams are often framed as “independent,” but the goal is frequently to limit your benefits.
Important: Just because an IME doctor says you’re “fine” doesn’t mean your case is over. You still have options, and rights.
What If I Don’t Trust the Workers’ Comp Doctor?
It’s not uncommon to feel uneasy about a doctor who seems more interested in what the insurance company wants than in what you need.
If you’re questioning your care, trust that instinct. Here’s what you can do:
- Take action, but don’t go it alone.
- Keep notes after every visit. What was said? What was or wasn’t examined? Were your concerns acknowledged or brushed off?
- Document red flags. If your doctor is minimizing pain, refusing to order imaging, or pressuring you to return to work before you’re ready, those are warning signs.
- Don’t stop attending appointments — yet. Failing to follow the treatment plan before officially changing doctors could hurt your case.
- Don’t go treat with your own doctor without going through the proper legal channels. We strongly recommend consulting a workers’ comp attorney first.
- Talk to an experienced workers’ comp attorney. They can help you determine if your concerns are grounds for requesting a different provider, and they can handle the formal process for making that change.
Remember, your health is not a line item on someone else’s spreadsheet. You deserve care that’s focused on healing — not just closing a claim. The right legal help can protect your health and your claim.
How Shankle Law Firm Protects Your Right to Medical Care
At Shankle Law Firm, we know how hard it is to recover from an injury when you feel like the system is stacked against you.
We fight for clients who need:
- Second opinions that reflect the real impact of their injuries
- Protection against biased IMEs
- Physician changes that actually lead to recovery
Our team will help you navigate the formal request process with the insurance company or the NCIC, and make sure your care reflects your real needs, not just the insurer’s bottom line.
Don’t Settle for a Doctor Who Doesn’t See You
Your recovery matters. Your voice matters. If you feel overlooked, rushed, or dismissed, you don’t have to accept it.
You don’t have to put your health in the hands of someone you don’t trust.
Let Shankle Law Firm help you fight for the care, and outcome, you deserve.
Call us today for a free consultation with Board-Certified Workers’ Compensation Specialist Maggie Shankle.
*Please Note - The content on this website is for informational purposes only and does not constitute legal advice. Viewing this site, using information from it, or communicating with Shankle Law Firm, PA through this site does not create an attorney-client relationship. For legal advice tailored to your situation, please contact us directly at (704) 370-1212.