June 26, 2017

How to Combat Insurance Company Delay Tactics and Refusal to Authorize Medical Treatment

What can you do if your treating doctor wants to refer you to a specialist, or tries to order an MRI or CT scan, but the workers’ compensation insurance company refuses to authorize this needed treatment?
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Under Georgia workers’ compensation law, if you are receiving care from a “authorized treating physician” and that authorized physician refers you to a specialist, the referred doctor is supposed to be authorized automatically.

Similarly, if an authorized treating physician writes an order for an MRI, CT or other diagnostic test, that test should also be authorized.

What we are finding, however, is that when the referred doctor or the medical testing center calls the insurance company to verify that they will be paid, the insurance adjustor may say “no.” And of course, if a medical provider or testing center does not have a source of payment, they will not provide treatment to you. [Read more…]

Delays in Medical Treatment: Bad for Your Work Injury Case

 

When you are hurt on your job, you should not delay seeking medical care.

Your employer and their insurance company will treat your delay in seeking treatment as an “admission” that your injury really is not that severe.  They will fight to avoid paying for medical tests and they will oppose your effort to see a specialist.  Your settlement will likely be negatively impacted.  When an insurance company lawyer deposes one of my clients, one of the first questions asked is “how soon after your injury did you first seek medical care.”

It does not matter if you think that you have a good reason for waiting to see a doctor.  Perhaps you believe that ice packs and a little rest will solve the problem, or perhaps you are concerned about reporting a work injury to a cynical or even hostile supervisor. [Read more…]