Injured at Work – Where Can I Get Medical Treatment (under the Maine Workers’ Compensation Act of 1992)

If you’ve been injured at work – where your injury occurred within the course of your employment, you are entitled to reasonable and proper medical care, paid for by your employer.  Depending on your injury, reasonable and proper medical care could include a trip to the hospital, a visit to the doctor’s office, surgical care, and nursing services.  Reasonable and proper medical care could also include medicines prescribed related to your work injury, mechanical or surgical aids, and a vast array of other therapeutic treatments.

Initially, your employer has the right to select a health care provider to treat your injury (so long as they are authorized to practice as such under the laws of Maine).  But after 10 days from the inception of health care related to your work injury, you have the right to select a different health care provider – one of your choice (please note that you may seek medical care from your preferred provider at any point, but your employer may end up disputing the payment of such treatment if it occurred outside the rules’ applicable time frames).  

Your employer has a right to object to you seeing a particular health care provider.  If they do so, your employer must file a petition with the Maine Workers’ Compensation Board (the Board) objecting to the named health care provider that you selected, and included in such they must state the reasons for their objection.  If this occurs, the Board will first hold a mediation between you and your employer on this issue.  If not resolved during mediation, the Board will schedule a prompt hearing on the issue, and an Administrative Law Judge will decide whether your employer has shown cause on why you shouldn’t get medical care from your medical provider of choice.  If the Judge rules in your favor, they will order your employer to pay for treatment received from the particular health care provider at issue.  If the Judge rules in the favor of your employer, the Judge will order that you are responsible to pay for treatment received from the particular health care provider at issue from the date the Judge’s order is mailed.

It is important to note that once you receive treatment from a health care provider of your choice, you may not change health care providers more than once without approval from your employer or the Board.  

Lastly, the rules regarding doctor choice do not limit your right to be treated by a specialist when a referral is made by your health care provider.  But it is important to note that once you have begun treatment with a certain type of specialist, you may not seek treatment from a different specialist in the same specialty without prior approval from your employer or the Board.

The above rights do not apply if your work injury claim arises under the Longshore Act.  If you’ve been injured at work and have questions about what rights you have regarding medical treatment, or are wondering what rights are applicable in your situation (including questions about the Longshore Act), please do not hesitate to contact us.