Arizona Workers’ Compensation: Can a Private Self-Insured Employer Choose Your Doctor?

If you have been injured on the job in Arizona, you might be surprised to learn that your employer may have the legal right to choose your doctor. While most Arizona workers have the "unrestricted right" to select their own treating physician, this changes if your employer is a private self-insured entity authorized to provide directed medical care.

Here is what you need to know about directed care and how it affects your rights to medical treatment.

What is Directed Medical Care?

Under A.R.S. § 23-1070, certain large, private employers are permitted by the Industrial Commission of Arizona (ICA) to act as their own insurance company. These "self-providers" are granted the authority to direct the medical, surgical, and hospital care for their injured workers.

• Private vs. Public Employers: Only private self-insured employers can legally direct your care. The State of Arizona, counties, cities, and other political subdivisions are strictly prohibited from directing medical care, even if they are self-insured.

• Employee Contribution: Employers authorized to direct care may collect a small fee of up to one dollar per month from your wages to help maintain these medical services.

  
  

How Directed Care Limits Your Choice of Doctor

In a standard claim, you can generally see any doctor you choose. However, if you work for a company with a directed care program:

1. Mandatory Facilities: You must generally accept the medical services and practitioners provided by your employer.

2. Financial Risks: If you seek treatment from an outside doctor without written authorization, you may be held personally responsible for the medical bills.

   
   

The Higher Standard for Changing Doctors

Changing doctors is much more difficult under a directed care program than in a standard claim. For most workers, a change only requires written permission from the carrier or current doctor. But for employees under directed care, the Industrial Commission will only order a change if there are reasonable grounds to believe your "health, life or recovery is endangered or impaired" by the employer's treatment.

• Insufficient Reasons: A simple "lack of confidence" in the company doctor or a preference for a different specialist is typically not enough to justify a change if the medical care is otherwise successful.

• The ICA Investigation: To request a change, you must apply in writing to the ICA, which will then investigate whether your recovery is truly being hindered by the employer’s chosen care.

• No Retroactive Approval: The ICA cannot backdate authorization for a change of doctors. Approval only applies from the date of the request forward.

Important Exceptions

• One-Time Evaluations: Any employer, even if not self-insured, has the right to send an injured worker to a doctor of their choice for a one-time evaluation. After this single visit, you remain free to treat with any doctor you choose unless the employer is a qualified private self-provider.

• Compliance Issues: If the ICA orders a change and the employer fails to comply, you may elect to have your treatment provided through the State Compensation Fund.

Summary: Directed Care vs. Standard Care

Feature	Standard Arizona Claim	Self-Insured, Directed Care Claim
Who Chooses Doctor?	The Injured Worker	The Employer
Changing Doctors	Requires Written Permission	Must prove health is "endangered"
Payment Risk	Carrier pays authorized care	Worker pays if care is unauthorized

Understanding your employer's insurance status is critical to ensuring your medical bills are covered and your recovery stays on track. If you are unsure whether your employer is a self-provider, check for notices posted in your workplace or contact the Industrial Commission of Arizona.