For example, if you injure your back and the doctor asks you if you have ever had back problems before, it would be unwise to treat the doctor to a 20-year history of every time you suffered a minor pain or ache. The desire to get future business from your employer or the insurance company may motivate a doctor to minimize the seriousness of your injury or to identify it as a pre-existing condition.
Keep in mind that a doctor paid for by your employer's insurance company is not your friend. Your doctor's report will have a big impact on the benefits you receive. If the agency decides the conflicting medical opinions are of equal weight and declares a "tie," it will appoint a third doctor, or "referee," to resolve any conflicts in the medical evidence.
If your compensation is modified based on the second opinion, you have the right to appeal. The workers' comp office will usually give more weight to the second opinion doctor's evaluation than to the treating physician's. If the second opinion doctor's report is different from the first doctor's report there are two options: the office can either weigh the medical evidence to determine which doctor's opinion is more accurate or declare a "tie" and seek a third doctor's opinion. If the second opinion doctor's report agrees with your treating doctor's opinions, there generally is no problem, and FECA compensation payments will continue uninterrupted.
If the initial second opinion report is unclear, the workers' comp office is responsible for following up and requesting a supplemental report. The doctor is supposed to provide only medical opinions. The doctor must submit a written report within 30 days of the exam. Any representative you've appointed must receive formal notice of the exam. Under the statute, you have the right to bring your own doctor to these exams. The agency pays all associated expenses and is responsible for forwarding to the second opinion doctor all relevant medical documents, a statement of accepted facts (a 'SOAF'), and any specific questions that it wants the doctor to address. The doctor is chosen by the agency and need not be Board-certified in any field of medical expertise (although many are). The following guidelines apply to second opinion exams: Under FECA, if your doctor submits medical reports that address workers' compensation officials' questions and concerns, usually no problem will arise unless your employer asks for a second opinion examination. Usually, you will only be required to see the company doctor for a maximum of 30 days, and then you will be able to choose your own physician. More typically, however, injured workers are referred to a doctor recruited and paid for by their employers. In some states, you have a right to see your own doctor if you make this request in writing before the injury occurs. If you are not a federal employee, you are not covered by the FECA, and state law will apply. Under the FECA you may initially select any qualified doctor to be your treating doctor - although the law does place some restrictions on the use of chiropractors.
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