The employee has the right to a second opinion from a participating physician on which topic?

• A. Wage level
• B. Medical benefits eligibility
• C. Diagnosis or treatment
• D. Employment status

Answer: (C)

A second medical opinion is available for medical care decisions—specifically diagnosis or treatment. If there’s doubt about what illness or injury the employee has or about the proposed medical plan, they can consult another physician who participates in the plan to review the diagnosis and treatment options. This helps ensure the care is accurate and appropriate. It’s not about wage levels, eligibility for benefits, or employment status, which are administrative issues outside medical decision-making. The second opinion is sought from a participating physician to keep recommendations aligned with the plan's coverage and procedures, and the process typically involves the employee requesting it through the treating physician so another participating physician can review within a reasonable time. The outcome may confirm, modify, or change the recommended course of treatment.