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How Diagnostic Tests Can Affect Your Workers Compensation Claim


Diagnostic testing may be requested by the insurance company in order to confirm an injured worker’s diagnosis.

Diagnostic testing is a process of evaluating a person’s medical status to either reach or confirm a diagnosis.

Testing takes on many forms, from X-rays, MRIs, blood tests, or even CAT scans. A medical professional will choose which tests to perform on a patient based on the symptoms they are showing, which will also help them determine the treatment needed.

However, diagnostic testing may also be requested by the insurance company in order to confirm an injured worker’s diagnosis.

Why Would They Require It?

Virtually the only real reason the insurance company can ask for diagnostic testing in a workers’ compensation case is to confirm a worker’s diagnosis.

Usually, whenever a worker’s comp case reaches the insurance company, an adjuster will analyze the claim and first see if it has merit, by determining if, in fact, the worker’s injury or illness is a result of employment. Under Missouri’s worker’s compensation laws, workers can only access these benefits if their condition is a direct result of their job.

For common injuries like slip and falls, chances are rather low for anyone to doubt your claim (though it does happen). But for more complicated conditions, it’s likely for the insurance company to ask for additional tests, usually ones done by doctors they have worked within the past.

How Diagnostic Tests Can Affect Your Worker’s Compensation Claim

Your entire claim could very well depend on the diagnostics test. Consider this scenario: you file a claim with your employer to receive treatment for asthma. You work on a construction site and often inhale many chemicals and particles, which over time has led to asthma.

However, the insurance company may not be that convinced this is true. It could be that you haven’t worked on the site that long, so they question if the job itself leads to the condition. Or, they had another doctor look at your file, and the doctor believes you don’t have asthma, just another, maybe smaller issue.

In either case, the insurance company can take their doubts and ask for another diagnostic test. If the test they run comes with a different result, your entire claim can be dismissed, or you may end up seeking treatment for a different condition.

What Are Your Options?

The diagnostic testing won’t necessarily break your case since it will be done by a medical professional, but there is a chance it could.

Medical testing isn’t a perfected science as people would like to assume, and sometimes the results can be interpreted differently by different doctors. To protect your rights, and your benefits, get in touch with an experienced workers comp attorney.

They can step in and make sure the insurance company does not take advantage of your situation.

Updated: June 19, 2020
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