В США выявлены три модели выбора лечащего врача в системе компенсаций работникам

Share This Article: Around the States Who chooses the treating physician, when can the worker change physicians, and how much control does the employer/carrier have? Current reference: September 2026 Workers' compensation systems take markedly different approaches to medical-provider selection. Some jurisdictions give the injured worker broad authority to select a treating physician. Others give the employer or insurer primary control. Still others use panel, preferred-provider, managed-care or medical-provider-network systems that divide responsibility between the parties. For claims professionals, the critical question is not simply “Who chooses the doctor?” It is: Who controls medical treatment at each stage of the claim? This chart therefore identifies the initial selection method, the worker's ability to change physicians, and significant network/panel or direction-of-care requirements. 50-State Chart The Three Major Models The 50 states can be broadly understood through three medical-provider models. 1. Employer-Directed Care The employer or insurer has substantial control over the treating physician. Examples include: Alabama • Florida • Indiana • Iowa • Missouri • New Jersey • North Carolina • Oklahoma • South Carolina These states tend to give the employer/carrier greater ability to coordinate treatment, although most provide some mechanism for a worker to seek a change of physician. WCRI's survey identifies the initial choice of physician and the procedures for subsequent changes separately—an important distinction when analyzing these states. 2. Employee-Choice Systems The injured worker generally selects the treating physician. Examples include: Alaska • Delaware • Hawaii • Illinois • Louisiana • Maryland • Massachusetts • Montana • Nebraska • New York • Ohio • Oregon • Rhode Island • South Dakota • Washington • West Virginia • Wisconsin • Wyoming But “employee choice” does not necessarily mean unlimited choice. Networks, provider authorization, managed-care arrangements, utilization review and requirements that the physician participate in the workers' compensation system can still affect treatment. For example, Ohio requires the treating provider to be BWC-certified, while Washington requires the treating physician to be within the workers' compensation provider network. 3. Panel / Hybrid Systems A third group gives the employee some choice but controls the universe from which that choice can be made. Examples include: Colorado Employee chooses from a list of four providers. Georgia Employee chooses from an employer-provided panel of six. Pennsylvania Employee chooses from an employer-provided list during the first 90 days. Tennessee Employee chooses from a list of at least three providers. Virginia Employee chooses from an employer-provided panel. Nevada Employee chooses from the insurer's treating-provider list. These systems are particularly important because describing them simply as either “employer choice” or “employee choice” would be inaccurate. States With Especially Important Rules California — Medical Provider Networks California is one of the clearest examples of a system in which the answer depends upon several preliminary questions: Does the employer have an MPN? Did the employee properly predesignate a personal physician? Is the physician within the MPN? How long has it been since the injury? An employee who properly predesignated a physician can have substantially different rights from an employee who did not. Where an MPN applies, the worker generally chooses within the network and has statutory procedures for changing physicians and obtaining second and third opinions. WCRI identifies the MPN rules as governing initial physician selection, physician changes and second/third opinions. Florida — Employer/Carrier Choice Florida is a classic employer/carrier-directed jurisdiction. The employer or carrier selects the authorized treating physician, but the injured worker is entitled to a one-time change of physician upon written request. This distinction is important: Florida is not a “no-choice” state. Rather, the carrier initially controls the authorized treating physician, followed by the employee's statutory one-time change right. Georgia — Panel of Six Georgia uses a panel model. The employer provides a panel of six physicians, and the employee chooses the treating physician from the panel. The employee is also entitled to one free change from one panel physician to another. That makes Georgia neither a pure employer-choice nor pure employee-choice jurisdiction. Pennsylvania — 90-Day Rule Pennsylvania is another state where the timing matters. If the employer properly provides a physician list, the employee generally must treat with a provider from that list for the first 90 days. After 90 days, the employee can select a physician of choice, subject to the statutory notice requirement. If the employer does not provide the required list, the employee may choose the treating physician. WCRI identifies this 90-day transition explicitly. Michigan — 28-Day Employer Control Michigan provides employer direction for the first 28 days of care. After that period, the injured worker may select a treating physician. This makes Michigan particularly important when analyzing whether a particular physician was authorized at a particular point in the claim. Maine — 10-Day Employer Control Maine follows a similar—but shorter—transition. The employer controls medical-provider selection for the first 10 days after injury. After that, the employee can seek his or her own provider. The employee also has a statutory opportunity to change physicians, subject to the employer/insurer's ability to contest the change. New Mexico — Two 60-Day Periods New Mexico has an unusual structure. The employer can direct care for the first 60 days, or allow the worker to select a provider. The other party may then have the opportunity to direct care for the next 60 days. If the employer directed care during the first 60 days, the employee can change physicians after that period. This is exactly the type of jurisdiction that gets lost in a conventional “employer choice/employee choice” chart. Utah — Preferred Provider Utah requires the employee to use the employer's declared preferred provider when one exists. If no provider has been declared, the employee receives a choice of provider. The employee can make one change without employer/insurer approval; subsequent changes require preauthorization. Texas — Network vs. Non-Network Texas requires particularly careful analysis. The provider-choice rules differ depending upon whether the claim is treated through a certified workers' compensation health-care network. For network claims, the network establishes the applicable provider-choice rules. For non-network claims, the employee generally has broader provider choice, subject to Texas Division of Workers' Compensation requirements concerning changes. WCRI specifically notes that a network claimant may change treating doctors once without network approval, while subsequent changes generally require network approval. Direction of Care vs. Utilization Review These concepts should not be combined. Direction of care asks: Who decides which doctor treats the worker? Utilization review asks: Is the treatment being recommended medically reasonable and necessary under the applicable rules? An employee can have the right to select a physician while the insurer retains the right to conduct utilization review. Illinois is a good example: the employee has two free physician choices, but treatment remains subject to utilization review. California similarly combines provider-network rules with utilization review and treatment guidelines. Second Opinions and IMEs Are Different A second medical opinion should not automatically be treated as a physician-selection right. The two questions are different: Treating physician: Who provides ongoing authorized treatment? Second opinion / IME: Who evaluates the worker or provides an opinion concerning diagnosis, treatment, impairment, causation or another disputed issue? States impose very different limits on these examinations. For example: - Florida generally gives each party one IME per accident. - Georgia permits an employer an unlimited number of second opinions but gives the employee one under specified circumstances. - Oregon permits up to three employer/insurer IMEs, subject to additional procedures. - Virginia generally permits the employer to require one IME per medical specialty per year. - Ohio permits employees to obtain second opinions without a numerical limit, subject to a reasonableness requirement. What Claims Professionals Should Ask When determining whether a particular medical provider is authorized, a useful checklist is: 1. What state governs the claim? 2. What is the date of injury? 3. Who had initial control of medical-provider selection? 4. Was there a panel? 5. Was there a managed-care organization? 6. Was there a preferred-provider network? 7. Was there a medical-provider network? 8. Did the employee have a predesignated physician? 9. Has the statutory employer-control period expired? 10. Has the employee already exercised a physician change? 11. Was the change approved? 12. Is the new physician within the required network/panel? 13. Was proper notice given? 14. Is the treatment itself authorized? 15. Is utilization review required? 16. Is a second opinion or IME being requested instead of a treating-physician change? Source & Methodology The principal cross-jurisdictional source for this chart is the WCRI/IAIABC Workers' Compensation Laws as of January 1, 2025, Table 3, which specifically examines medical benefits, limitations on medical treatment, initial physician selection, circumstances for changing treating physicians, and limitations on second medical opinions. The participating jurisdictions reviewed the resulting tables as part of WCRI's quality-assurance process. WorkersCompensation.com also published a state-by-state survey in February 2026 discussing employer-choice, employee-choice and hybrid physician-selection models. Because medical-provider rules can change through legislation, regulation, agency guidance and case law, the state statute and administrative rules should be checked before applying a rule to an individual claim. Last reviewed: September 2026 Disclaimer: This chart is an educational and research reference, not legal advice. The actual right to select or change a treating physician may depend upon the date of injury, employer/carrier status, managed-care or network participation, predesignation, panel requirements, prior physician selections, emergency treatment, authorization requirements and other jurisdiction-specific circumstances. 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