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Receiving Medical Care Is Complicated When Filing A Workers' Compensation Claim

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Receiving treatment for your injuries at work should be straightforward. But workers' compensation insurance providers will try to avoid paying you when possible. You will especially face obstacles when receiving medical treatment and trying to prove you were indeed injured. Three aspects of a workers' compensation claim that are especially difficult to handle are panel physicians, insurer-directed medical care, emergency room visits, and company doctors.

Panel Physicians

These physicians are chosen by the employer or insurance company. They evaluate your condition and determine the appropriate treatment. Panel physicians must follow specific guidelines and protocols when evaluating workers' compensation claims and provide accurate and detailed reports to ensure that you receive proper care and benefits.

You must provide them with all relevant medical history and information to ensure you receive a fair evaluation and appropriate treatment. If you consult with a doctor, not on the list within a specific time frame, the insurance carrier might refuse to pay your doctor's bill.

Insurer-Directed Medical Care

Under workers' compensation law, the insurance company directs your medical care, except in emergencies. Workers' compensation insurance providers direct medical care to manage costs.

By controlling care, insurance providers can ensure that you receive prompt care from experienced medical professionals who can accurately diagnose your condition and develop a treatment plan to help you recover as quickly and safely as possible.

Why Your Care Will Be Carefully Managed

The management of your care benefits you, your employer, and your insurance provider, as it helps to reduce the likelihood of:

  1. Long-term disability
  2. Lost productivity
  3. Increased insurance premiums

However, you might disagree with the decisions the insurance provider has made, and you might consult with a workers' compensation attorney who can help you make a strong case for why the decision should be overturned.

For example, you might believe that you need a specific treatment, the insurer may disagree, and your treatment might be delayed. An attorney will help you fight for your right to adequate care.

Emergency Room Visits

There may be confusion about whether workers' compensation will cover emergency room visits, especially if the emergency room is not on the panel list. You have no choice but to receive care from the nearest emergency room as quickly as possible.

Generally, workers' compensation should cover emergency room visits. Still, rules vary by jurisdiction, and an attorney licensed to practice in your jurisdiction can better guide you through the process.

For more info, contact a local company like Law Offices Of Edward Seplavy.