The amount that a doctor can charge in workers’ compensation cases is strictly regulated and in most instances is considerably less than that doctor may be able to charge to a private health insurer or self-paying individual. In addition, the treatment of patients under workers’ compensation involves problems of obtaining approval for specific treatments, extra time and effort devoted to paperwork, and occasional involvement in litigation. Many physicians, particularly those in highly skilled specialties such as orthopedics or neurosurgery, have discontinued or restricted the numbers of cases that they will take under workers’ compensation.