Research · 8 min read

Who Chooses the Doctor After a Covered Work Injury

One federal compensation statute answers the question in a single sentence — the employee chooses — and then spends several subsections on the conditions, the ten-day report, and the one change of physician you get without permission.

By Erin Vasquez, Reviews Editor · Updated September 2026

Key takeaways

The employer's duty is to furnish treatment for such period as the nature of the injury or the process of recovery may require — no cap or fixed term appears in that sentence.
The employee has the right to choose an attending physician authorized by the Secretary; the employer selects only where the injury prevents selection and requires immediate care.
The Secretary maintains an annual list of providers not authorized, with five enumerated grounds, a three-year minimum duration, and an emergency exception to non-reimbursability.
On acquiring knowledge of the injury, the employer or carrier must forthwith authorize treatment from the physician the employee selected.
Changing physicians requires prior consent, which must be given for a move to a necessary and appropriate specialist and may be given on good cause otherwise.
Self-arranged treatment is reimbursable only where the employer refused or neglected, and a claim is unenforceable without the treating physician's report within ten days of first treatment.

Answer first: the employee chooses, from an authorized list

The Longshore and Harbor Workers' Compensation Act contains a section on medical services and supplies, and it opens with the employer's obligation. The employer shall furnish such medical, surgical, and other attendance or treatment, nurse and hospital service, medicine, crutches, and apparatus, for such period as the nature of the injury or the process of recovery may require.

There is no dollar cap and no time limit in that sentence. The duration is set by the nature of the injury or the process of recovery.

The next subsection answers the question people actually ask. The employee shall have the right to choose an attending physician authorized by the Secretary to provide medical care under the chapter.

That right has a condition built into the same clause — the physician must be authorized — and one narrow exception immediately after it. If, due to the nature of the injury, the employee is unable to select his physician, and the nature of the injury requires immediate medical treatment and care, the employer shall select a physician for him.

One caution before going further, and it matters more than anything else on this page. This is one federal statute covering one set of workers. Workers' compensation in the United States is overwhelmingly a matter of state law, and state schemes answer this same question in different ways — some giving the employer the first choice, some giving the employee a choice from a panel, some giving the employee a free choice. None of them is described here, because none of them was consulted for this page.

The authorization list, and how a provider gets off it

The right to choose is a right to choose from a set, and the statute defines the set by exclusion rather than by inclusion.

The Secretary shall annually prepare a list of physicians and health care providers in each compensation district who are not authorized to render medical care or provide medical services under the chapter. Those names shall be made available to employees and employers in each compensation district through posting and in such other forms as the Secretary may prescribe.

The grounds for inclusion on that list are five, and they have to be determined under the section's own procedures. Knowingly and wilfully making, or causing to be made, any false statement or misrepresentation of a material fact for use in a claim for compensation or for reimbursement of medical expenses. Knowingly and wilfully submitting, or causing to be submitted, a bill or request for payment containing a charge the Secretary finds substantially in excess of the charge prevailing within the community or in excess of the provider's customary charges, unless the Secretary finds good cause. Knowingly and wilfully furnishing a service, appliance, or supply determined to be substantially in excess of the recipient's need, or of a quality that substantially fails to meet professionally recognized standards. Conviction under any criminal statute, without regard to a pending appeal, for fraudulent activities in connection with any federal or state program making payments to physicians or similar providers. Or having otherwise been excluded from participation in such a program.

The consequences are two. Medical services provided by anyone named on the list are not reimbursable under the chapter, except that the Secretary shall direct reimbursement of medical claims for services rendered by such providers in cases where the services were rendered in an emergency. And a determination remains in effect for a period of not less than three years and until the Secretary finds and gives notice to the public that there is reasonable assurance the basis for the determination will not recur.

The statute also puts a duty on the provider side: a provider of a service, appliance, or supply shall provide to the Secretary such information and certification as the Secretary may require to assure that the subsection is enforced.

Authorization is supposed to be automatic once the injury is known

The provision that turns the right into something operational is easy to miss, because it sits at the end of a subsection about a list.

Whenever the employer or carrier acquires knowledge of the employee's injury — through written notice or otherwise as prescribed by the chapter — the employer or carrier shall forthwith authorize medical treatment and care from a physician selected by an employee under the choice provision.

Two words carry the weight. Acquires knowledge means the trigger is not a form; it is knowledge, however obtained, in the manner the chapter prescribes. And forthwith is the timing standard.

The employee's side of that arrangement is one restriction: an employee may not select a physician who is on the list of those not authorized.

Then comes the rule on switching, which is stricter than the rule on choosing. An employee may not change physicians after his initial choice unless the employer, carrier, or deputy commissioner has given prior consent for such change.

The statute makes one category of change mandatory rather than discretionary. Such consent shall be given in cases where an employee's initial choice was not of a specialist whose services are necessary for and appropriate to the proper care and treatment of the compensable injury or disease. In all other cases, consent may be given upon a showing of good cause for change.

So there is one change that is supposed to be granted — the move from a generalist to a necessary and appropriate specialist — and a discretionary route for everything else, conditioned on good cause.

Paying out of pocket, and the ten-day report

The statute is restrictive about reimbursing an employee who arranges treatment themselves, and it names the only two circumstances.

An employee shall not be entitled to recover any amount expended by him for medical or other treatment or services unless either the employer refused or neglected a request to furnish such services and the employee complied with the choice and authorization provisions and the applicable regulations, or the nature of the injury required such treatment and services and the employer, or his superintendent or foreman, having knowledge of such injury, neglected to provide or authorize the same.

Both routes turn on the employer having had the opportunity and not taken it. The first requires a request that was refused or neglected, plus the employee's own compliance. The second does not require a request, but requires that the employer or a named supervisor had knowledge of the injury and neglected to act.

There is also a filing requirement that falls on the treating clinician rather than on the injured person, and it is short. No claim for medical or surgical treatment shall be valid and enforceable against the employer unless, within ten days following the first treatment, the physician giving that treatment furnishes to the employer and the deputy commissioner a report of the injury or treatment, on a form prescribed by the Secretary. The Secretary may excuse the failure to furnish that report within the ten-day period whenever he finds it to be in the interest of justice to do so.

The statute adds a valuation route for treatment the employee did obtain: the Secretary may, upon application by a party in interest, make an award for the reasonable value of such medical or surgical treatment so obtained by the employee.

Examinations, refusals, and who is allowed in the room

The last part of the section governs disputes about the medical facts, and it gives the Secretary a distinct role rather than leaving the question to the two sides.

In the event that medical questions are raised in any case, the Secretary shall have the power to cause the employee to be examined by a physician employed or selected by the Secretary, and to obtain from that physician a report containing his estimate of the employee's physical impairment and such other information as may be appropriate.

Either side can contest that report. Any party who is dissatisfied may request a review or reexamination by one or more different physicians employed or selected by the Secretary, and the Secretary shall order it unless he finds it clearly unwarranted. The review or reexamination shall be completed within two weeks from the date ordered, unless the Secretary finds that because of extraordinary circumstances a longer period is required.

The cost has a discretionary allocation: the Secretary has the power in his discretion to charge the cost of examination or review to the employer if he is a self-insurer, or to the insurance company carrying the risk, in appropriate cases, or to the statute's special fund.

Where the examination happens is also regulated. An employee shall submit to a physical examination at such place as the Secretary may require; the place or places shall be designated by the Secretary and shall be reasonably convenient for the employee. And no physician selected by the employer, the carrier, or the employee shall be present at or participate in any manner in such an examination.

Finally, there is a consequence attached to refusing. If at any time the employee unreasonably refuses to submit to medical or surgical treatment, or to an examination by a physician selected by the employer, the Secretary or an administrative law judge may by order suspend the payment of further compensation during such time as the refusal continues, and no compensation shall be paid at any time during the period of suspension — unless the circumstances justified the refusal.

Two words limit that. The refusal must be unreasonable, and the suspension does not apply where the circumstances justified the refusal.

What this does and does not tell you

Read as a whole, the section is built around a sequence rather than a single rule. The employer owes treatment for as long as the injury or recovery requires. The employee picks the attending physician from those authorized. The employer or carrier is supposed to authorize treatment from that physician forthwith on learning of the injury. Changing physicians afterwards needs consent, which is mandatory for a move to a necessary specialist and discretionary otherwise. Self-arranged treatment is reimbursable only where the employer refused or neglected. And a clinician's ten-day report is a condition of the claim's enforceability.

The most useful thing in it for a general reader is the shape of the questions, which recur in other compensation systems even where the answers differ: who chooses, from what set, who authorizes, how quickly, what happens on a switch, and what happens if someone pays privately.

It bears repeating that this is one federal statute. It does not describe the compensation scheme in any state, and it does not describe the separate federal scheme covering federal employees. Neither was consulted for this page, and nothing here should be read as describing them.

Nor does this page tell any reader that a particular injury is covered, that a particular treatment would be paid for, or how a dispute would come out. Those are determinations made on a specific record.

Sources

33 U.S.C. 907 — Medical services and suppliesOffice of the Law Revision Counsel, U.S. House of Representatives · Retrieved September 2026The general requirement that the employer furnish medical, surgical and other attendance or treatment, nurse and hospital service, medicine, crutches and apparatus for such period as the nature of the injury or the process of recovery may require; the employee's right to choose an attending physician authorized by the Secretary and the emergency exception where the employee is unable to select; the Secretary's supervisory powers over medical care and to order a change of physicians or hospitals; the annual list of providers not authorized, the five grounds for inclusion, the posting requirement, the non-reimbursability rule with its emergency exception, the three-year minimum duration and the notice condition, and the provider information and certification duty; the requirement that the employer or carrier forthwith authorize treatment from the employee's selected physician on acquiring knowledge of the injury; the bar on selecting a listed provider; the consent requirement for changing physicians, the mandatory consent for a necessary and appropriate specialist, and the good-cause route otherwise; the two circumstances permitting recovery of amounts the employee expended; the ten-day physician report requirement and the interest-of-justice excuse; the Secretary's power to award the reasonable value of treatment obtained; the suspension of compensation for an unreasonable refusal of treatment or examination and the justified-circumstances proviso; the Secretary's examination and reexamination powers, the two-week completion requirement and the extraordinary-circumstances exception; the discretionary allocation of examination costs; and the requirements that the examination place be designated by the Secretary and reasonably convenient and that no physician selected by the employer, carrier or employee be present or participate.

Frequently asked questions

Under this statute, who picks the treating doctor?

The employee. The section provides that the employee shall have the right to choose an attending physician authorized by the Secretary to provide medical care under the chapter. If the nature of the injury makes the employee unable to select and requires immediate treatment, the employer selects a physician instead.

Is there a limit on how long treatment must be furnished?

The section states the employer shall furnish medical, surgical and other attendance or treatment, nurse and hospital service, medicine, crutches and apparatus for such period as the nature of the injury or the process of recovery may require. It sets no dollar cap or fixed period in that sentence.

Can an injured worker change doctors?

Not freely. The section says an employee may not change physicians after the initial choice unless the employer, carrier or deputy commissioner has given prior consent. Consent shall be given where the initial choice was not of a specialist whose services are necessary for and appropriate to the proper care and treatment of the injury or disease; in all other cases consent may be given on a showing of good cause.

What if someone pays for treatment themselves?

The section allows recovery only in two circumstances: where the employer refused or neglected a request to furnish the services and the employee complied with the choice and authorization provisions and applicable regulations, or where the nature of the injury required the treatment and the employer or a superintendent or foreman with knowledge of the injury neglected to provide or authorize it.

Why does a ten-day report matter?

Because the section makes it a condition. No claim for medical or surgical treatment is valid and enforceable against the employer unless, within ten days following the first treatment, the treating physician furnishes a report of the injury or treatment to the employer and the deputy commissioner on the Secretary's form. The Secretary may excuse a late report where it is in the interest of justice.

Does this describe workers' compensation generally?

No. This is one federal compensation statute. Workers' compensation in the United States is overwhelmingly state law, and state schemes answer the choice-of-physician question in different ways. No state scheme, and no separate federal-employee scheme, was consulted or is described here.