Why can’t I get the tests I need
Why can’t I get the tests I need? The other day I was reading an article on how adjusters should treat job injury claims when they first get to their desk. This article centered on explaining why the workers compensation adjuster should NOT authorize tests ordered by the treating physician at the beginning of the claim. This article exemplifies the logic workers compensation insurance carries use to justify the way many injured workers are treated.
Honestly, if you were injured, had stabbing pain shooting from your lower back down your left leg and were having trouble controlling your bladder you would want-nay demand-immediate medical treatment to actually find out what is wrong and what to do to fix the problem, but workers’ comp does not see things that way (because they aren’t the ones in pain).
As explained in this article, why listen to the doctors? As this article states, “doctors are usually not helpful in putting the pieces of the puzzle together. ” I’m not joking, this is an actual quote.
What about the complaints of the injured worker? Don’t trust them, because “They know what to tell the doctor in order to get what they want.” Additionally, how does the insurance carrier know the injured worker is not lying? The fact 3 co-workers saw him fall from the top of a truck and that the ambulance took him straight to the hospital does not mean that they did not have some preexisting problem which really is to blame for their injured condition (actual fact pattern from a case we had to file suit on in order to get our clients the workers compensation benefits they were legally entitled to).
Also, the author states doing expensive tests in a timely manner might “validate the “injury” in the mind of the claimant.” Basically, he is saying that undergoing an MRI could convince the simple-minded injured worker that they really were hurt, even if they weren’t.
So, given the fact neither the doctors or injured workers can be trusted, the workers compensation adjuster is told not to authorize any costly-yet possibly effective-medical treatment. Authorize some physical therapy or some other cheap form of treatment which is not expected to really help the injured worker while you dig under every rock to try to find something to justify your underlying suspicions that the injured worker is lying.
I am not saying that there aren’t times when the workmans comp carrier needs to investigate the validity of a claim before authorizing expensive treatment, but this intentional refusal to authorize needed medical treatment occurs much more than is warranted in Alabama workers compensation claims, and as we have shown in earlier blogs, fraud is not really an issue with the VAST majority of workers compensation claims.
Again, would you accept this kind of treatment from Blue Cross/Blue Shield if you were injured in a car wreck or fall at home? No, and injured workers should not have to accept it either.
If you are having problems getting the medical treatment your doctor says you need, or if you just have questions about your rights to workers’ compensation benefits in Alabama, don’t hesitate to contact Powell and Denny and speak with one of the experienced workers compensation social security disability lawyers and schedule a free consultation and let us see if we can help. Appointments are available in person, or virtually through Zoom for your convenience from wherever you live.
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Why can’t I get the tests I need