What Are Your Rights When Medical Treatment Is Denied in an Alabama Workers’ Compensation Case

What Are Your Rights When Medical Treatment Is Denied in an Alabama Workers’ Compensation Case

In recent years, injured workers have increasingly reported difficulty obtaining medical treatment recommended by their authorized treating physicians. Diagnostic testing such as MRIs are frequently delayed or denied, pain medication is harder to obtain, and surgical recommendations are often met with resistance. These denials can be frustrating and, in some cases, harmful to recovery.

Under Alabama workers’ compensation law, an employer and its insurance carrier are required to pay for all reasonably necessary medical treatment related to a compensable work injury. This includes diagnostic testing, medication, referrals to specialists, and surgery when recommended by the authorized treating physician.

Insurance carriers are permitted, however, to submit requested treatment for utilization review. In that process, a physician hired by the insurance carrier reviews the records and offers an opinion on whether the recommended treatment is reasonably necessary. This reviewing doctor typically has not examined the injured worker and based the opinion solely on medical records they have been provided.

When utilization review results in a denial, it does not end the matter. The treating physician’s opinion carries significant weight, particularly because that doctor has actually examined and treated the injured worker. Alabama courts—not insurance companies—have the final authority to determine whether medical treatment must be provided.

If an insurance carrier refuses to authorize treatment, the issue can be taken before a judge, who may order the carrier to approve and pay for the recommended care. In many cases, treatment is authorized only after the dispute is formally raised and addressed through the legal process.

Delays and denials of medical care are not uncommon, but they are not necessarily lawful. If the medical treatment ordered by your authorized treating physician has been denied, it is important to understand that you do have options under Alabama law. Workers’ compensation benefits are intended to provide medical care—not obstacles—when an employee is injured on the job.

If you have suffered a work injury and you have questions about your rights and benefits under Alabama’s workers compensation laws -don’t hesitate to contact and speak with one of the experienced Alabama Workers Compensation and Social Security Disability attorneys at Powell and Denny today for a free consultation. Appointments are available in person, or virtually via Zoom if more convenient.  Powell and Denny would appreciate the opportunity to help.  And remember, there is no fee unless you collect.

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+ 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.

What Are Your Rights When Medical Treatment Is Denied in an Alabama Workers’ Compensation Case