The adjuster won’t authorize my medication

The adjuster won’t authorize my medication

“Workers’ comp won’t approve the medication my doctor prescribed.” This is one of the most common and frustrating complaints we hear from injured workers in Alabama. It is not limited to prescriptions. Delays and denials frequently involve MRIs, surgical recommendations, pain management referrals, and other necessary medical treatment ordered by an authorized treating physician.

Under Alabama workers’ compensation law, medical care that is reasonably necessary to treat a work-related injury is supposed to be provided by the employer’s insurance carrier.  Alabama law makes this clear in Ala.Code §25-5-77(a), which states the employer “shall pay…fees herein of reasonably necessary medical and surgical treatment, and attention, physical rehabilitation, medicine, medical and surgical supplies, crutches, artificial members and other apparatus as the result of an accident arising our of and in the course of employment….”

In theory, that means treatment recommended by the authorized physician should be approved without unnecessary delay. In practice, injured workers are often left waiting—sometimes for weeks or months—while their condition worsens.

Medication denials are especially common when pain medication is involved. Injured workers are often told there is a “computer issue,” a need for additional review, or a request for another doctor to weigh in on whether the medication or treatment is “reasonably necessary.” These explanations rarely result in prompt approval. Instead, the worker goes without medication or treatment while the insurance carrier continues to delay.

The same issues arise with diagnostic testing and procedures. MRI requests sit unapproved. Surgery recommendations are questioned. Referrals to pain management specialists are ignored or postponed. Meanwhile, the injured worker is still in pain, unable to heal, and often unable to return to work.

These delays are not without consequence, and they are not unavoidable. Alabama law allows an injured worker to seek court intervention when an insurance carrier refuses or fails to authorize reasonably necessary medical care. An experienced workers’ compensation attorney can bring the issue before a judge and ask the court to order approval of medication, diagnostic testing, surgery, pain management, or other appropriate treatment.

Workers’ compensation is meant to provide medical care, not obstacles. When necessary, treatment is delayed or denied, there are legal options available to enforce those rights.

If you have suffered a job injury and you have questions about your rights under Alabama Workers Compensation laws, please do not hesitate to contact and speak with one of the experienced Alabama+ Workers Comp Lawyers at Powell and Denny today for a free consultation; and remember, virtual appointments are available through Zoom so you can meet with one of the attorneys of Powell and Denny from wherever you live.

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Powell and Denny have been selected as one of the Best Law Firms by U.S. News and World Report for each of the last 7 years, have been selected as one of Birmingham’s Top Lawyers by B-Metro Magazine for the last 3 years, have been selected by The National Advocates as one of the Top 20 Workers’ Compensation Firms (plaintiffs) and Powell and Denny, P.C.-has been selected as one of the “Best of the Best” law firms by The American Registry

Mr. Denny is AV rated by Martindale Hubbard (the highest rating possible) and Mr. Powell has been rated as Superior by The National Registry and selected as a Lawyer of Distinction.

+ Powell and Denny have successfully represented injured workers from Birmingham, Huntsville, Florence, Muscle Shoals, Tuscumbia, Athens, Decatur, Town Creek Ardmore, Hartselle, Madison, Toney, Scottsboro, Ft. Payne, New Hope, Guntersville, Albertville, Boaz, Ashville, Anniston, Gadsden, Cullman, Jasper, Gardendale, Morris, Kimberly, Centerpoint, Leeds, Tarrant City, Fairfield, Hueytown, Bessemer, Adger, Tuscaloosa, Cordova, Alabaster, Pelham, Harpersville, Opelika, Phenix City, Montgomery, Clanton, Calera, Enterprise, Monroeville, Mobile, Evergreen, Centreville, Brent, West Blocton, Woodstock, Brierfield, Lakeview and towns and cities in between.

The adjuster won’t authorize my medication