Nothing in this article should be taken as legal advice. Every case is different.
In Virginia, your employer must give you a panel of at least three doctors, and you choose your workers’ comp doctor from that list (Va. Code § 65.2-603). Once you choose, you generally have to stay with that doctor unless the Commission orders a change or your employer agrees to one. If your employer never gives you a panel, or the insurance company denies your claim, you can generally choose your own doctor.
How the Panel of Doctors Works
The employer picks at least three doctors, and you pick one of them. The statute says the employer provides “a physician chosen by the injured employee from a panel of at least three physicians selected by the employer” (Va. Code § 65.2-603(A)(1)). The Commission’s own guide for injured workers puts it the same way: your employer should give you a list of at least three medical providers to choose from.
What to know about the panel:
| Question | The rule |
|---|---|
| How many doctors? | At least three physicians (§ 65.2-603(A)(1)) |
| Can the panel list a clinic instead of doctors? | The Court of Appeals has said “a clinic . . . is not a physician,” and a panel that doesn’t really offer three suitable doctors can be defective (Turner Gilbane JV v. Guzman, 59 Va. App. 128 (2011)) |
| Does it have to come quickly? | The panel must be offered within a reasonable time after the injury (Peninsula Transportation District Commission v. Gibbs, 228 Va. 614 (1985)) |
| Can I ask about my health insurance? | Yes. On request, the employer must say whether each panel doctor takes the health insurance your employer provides (§ 65.2-603(E)) |
| Can a chiropractor be on it? | Yes, where the injury is one a chiropractor treats (§ 65.2-603(F)) |
Choose carefully, because the choice usually sticks. Once you pick, you have to accept that doctor “unless otherwise ordered by the Commission” (same law). Your treating doctor’s opinions on surgery, time out of work, restrictions, and your permanent rating will carry a lot of weight in your claim. Before you choose, look up each doctor’s specialty and make sure it fits your injury. A family practice doctor may not be the right choice for a torn rotator cuff or a herniated disc.
What If Your Employer Never Gives You a Panel?
If your employer doesn’t provide a panel, you can generally choose your own doctor, and that doctor becomes your treating physician. The Court of Appeals has said the worker’s own doctor “becomes the treating physician if the employer fails or refuses to provide a panel” (Davis v. Brown & Williamson Tobacco Co., 3 Va. App. 123, 126 (1986)).
Trying isn’t enough. In 2023 the Court of Appeals held that the statute “does not permit an employer to make only a good faith effort to provide a panel” (Jalloh v. S.W. Rodgers, Va. Ct. App. 2023). A defective panel, such as one with only two real doctors, can also free you to choose (Turner Gilbane).
If no one has handed you a list, write down that you asked for one, when, and whom you asked.
What If Your Claim Is Denied?
When the insurance company denies your claim, you can generally choose your own doctor. The Court of Appeals has held that “where an insurer denies liability and refuses to pay compensation, the claimant is entitled to choose his own physician” (Trammel Crow Co. v. Redmond, 12 Va. App. 610, 615 (1991)).
If the Commission later finds your claim compensable, the employer can be ordered to pay for that doctor’s reasonable, necessary care (Goodyear Tire & Rubber Co. v. Pierce, 9 Va. App. 120 (1989); § 65.2-603(C)). Until then, the bills are in dispute, so keep every bill and record. Here’s what to do if your workers’ comp claim is denied.
Can You Change Your Workers’ Comp Doctor?
Yes, but you need your employer’s agreement or an order from the Commission. If the employer or insurance company agrees to the change, you don’t need any other reason (Food Lion, LLC v. Wright, Va. Ct. App. 2008). If it won’t agree, you can ask the Commission to order a new doctor or a new panel.
The Commission has ordered a change of treating doctor when, among other things (Allen & Rocks, Inc. v. Briggs, 28 Va. App. 662, 675 (1998)):
- The treatment is inadequate
- You need a specialist and aren’t getting that care
- You aren’t improving and the doctor can’t adequately explain why
- The doctor isn’t using conventional treatment
- The doctor has no plan of treatment for your long-term care
In one case, a worker whose treatment wasn’t relieving her pain or improving her function won a new panel (H.J. Holz & Son, Inc. v. Dumas-Thayer, 37 Va. App. 645 (2002)).
The insurance company can’t force a change on a whim either. It has to show specific reasons, and wanting you to switch to a doctor closer to where you live isn’t enough (Apple Construction Corp. v. Sexton, 44 Va. App. 458 (2004)).
What If Your Doctor Retires or Stops Treating You?
You may be able to pick a new doctor. The answer depends on what happened: a referral to the doctor’s successor, a release from care, or a doctor who simply stops seeing workers’ comp patients. The published case law doesn’t settle every version of this, so get the details in writing before you schedule with anyone new.
Are Referrals to Specialists Covered?
Yes. Care your treating doctor refers you to is authorized. The employer pays for the care the attending physician “deems necessary,” including referrals to specialists (Volvo White Truck Corp. v. Hedge, 1 Va. App. 195, 200 (1985)). A referral to an orthopedic surgeon, a pain management doctor, or physical therapy from your treating doctor doesn’t need a new panel. Ask your doctor to put each referral in writing.
Seeing a Doctor Who Isn’t Authorized
Treatment outside the panel generally isn’t paid, with three exceptions. Under Va. Code § 65.2-603(C), the Commission can order the employer to pay for other care in an emergency, when the employer fails to provide care, or for “other good reasons.”
For “other good reasons,” the Court of Appeals looks at whether you acted in good faith, whether the care the employer provided was inadequate, and whether the outside care was reasonable and necessary (Shenandoah Products, Inc. v. Whitlock, 15 Va. App. 207 (1992)). An emergency room visit right after the accident is the classic emergency.
Seeing an unauthorized doctor is not automatically a refusal of treatment (Southland Corp. v. Welch, 33 Va. App. 633 (2000)). But refusing the treatment your authorized doctor recommends, without a good reason, can stop your wage checks until the refusal ends (§ 65.2-603(B)).
The Insurance Company’s Doctor Is Not Your Doctor
The insurance company can send you to its own doctor for an exam, but that doctor doesn’t treat you. Under Va. Code § 65.2-607, you have to attend an exam the employer asks for, and it can request one exam per specialty without the Commission’s approval. You can bring a doctor of your own to the exam, at your own expense.
These exams are often called IMEs. The insurance company picks and pays the doctor, and the report often disagrees with your treating doctor. Here’s how to prepare for an IME in Virginia and what happens after one.
Looking for a Workers’ Comp Doctor Near You?
Whether you’re in Norfolk, Newport News, Richmond, or anywhere else in Virginia, the first question is the same: has your employer given you a panel? If it has, your choice is limited to that list. If it hasn’t, or your claim has been denied, you can generally choose any doctor, including one in your health insurance network. Either way, choose a doctor whose specialty fits your injury, and tell the office at the first visit that it is a work injury.
Steps to Take
- Ask your employer for the panel in writing if you haven’t received one.
- Look up each doctor’s specialty before you choose, and ask which ones take your health insurance.
- Tell every doctor the injury happened at work and exactly how.
- Keep referrals and work notes in writing.
- Give your employer written notice of the accident within 30 days (Va. Code § 65.2-600).
- File your claim with the Commission within two years of the accident, generally (Va. Code § 65.2-601), even if the insurance company accepts your injury and is paying. You can ask the Commission for a hearing on a change of doctor or unpaid medical bills, whatever the insurance company decides.
Workers’ Comp Doctor Questions
Can I Go to My Own Doctor for Workers’ Comp in Virginia?
Not usually at first. You choose from your employer’s panel. You can generally choose your own doctor if the employer never gives you a valid panel, the claim is denied, or the Commission orders a change.
Does Workers’ Comp Pay for the Emergency Room?
Emergency care is one of the situations where the Commission can order the employer to pay for a doctor outside the panel (§ 65.2-603(C)). Tell the hospital it was a work injury.
Does the Insurance Company Have to Pay for Everything My Doctor Orders?
It is required to pay for treatment that is reasonable, necessary, and related to the accident. That doesn’t mean it will. Insurance companies often push back on surgery, injections, and specialist referrals. If it refuses, you can ask the Commission for a hearing.
Talk to Pathfinder Injury Law About Your Medical Care
Pathfinder Injury Law handles only Virginia workers’ compensation claims. Call 804-505-0633 or use our online contact form.