It is important to follow the proper protocol if you are injured on the job.
In one month alone, close to 10,000 workman’s compensation injuries may be reported. Fortunately, a minority of these are the result of a life-threatening accident that requires emergency care. More often, an employee has a small accident, reports it to their employer who sends them to a medical facility that has been pre-approved by their workman’s compensation insurance company. If the employee decides to seek treatment from an unapproved physician they not only risk losing the workman’s compensation benefit, but their own insurance company may refuse to pay for the medical expense if the injury or condition is found to be work-related. If you have any doubt about the treatment plan of your employers chosen physicians, consult with a Missouri workman’s compensation attorney before making a change on your own. You may be doing yourself a great disservice by not following the protocol.
Seeking Medical Assistance After a Work Accident
After reporting an injury to your employer, it is his responsibility to provide you with a list of doctors and medical centers that are covered by his workman’s compensation insurance. Be sure on your first consultation to make it clear to the health care provider that your injury is work-place related. Keep in mind that ultimately these doctors are employed by the insurance company but must still use their own medical judgment when directing your care. If the insurance company or employer disagree with the physicians findings or treatment plan, they may have the right to authorize a change in your medical provider. You have the right to choose your own doctor, but understand it will be at your own expense, even if you have medical insurance, since most of those policies exclude treatment for an injury or condition that could be covered by workmans compensation.
Even if you follow all the proper procedures and continue care with the insurance companies authorized doctor, they still may decide to not provide treatment or discontinue it. This may happen if they are planning on denying your claim. They may feel that the injury is not job related or find that you did not properly notify your employer of the accident before seeking medical attention. Another cause for denial is the insurer’s belief that your condition was a pre-existing one. If they opt to discontinue your treatment it may be because they have been notified that you are not complying with the doctor’s treatment plan or that your condition has been improved by your medical care and that future treatment is not necessary.
Missouri Workmans Comp
A St. Louis employee followed protocol and consulted with an authorized physician after injuring her knee at work. She received treatment and some physical therapy before the insurance company ceased benefits citing that she had reached maximum medical improvement, even though she was still suffering from pain. Through her own health insurance she consulted with an orthopedic surgeon and had knee surgery performed to correct the injury. In a case like this it is important that the employee write a letter to the employer demanding extended care. If they deny and then it is proven that such care was necessary, the employer will likely be held responsible to pay for all of the medical costs. In this instance they had to pay the employee $44,587.
If you are being treated for a work injury and find your benefits suddenly cut, call a Missouri workman’s compensation attorney at the Law Office of James M. Hoffmann. How you deal with the employer and the insurance company from that point forward can determine whether or not you get compensated for any additional medical bills.
Schedule a free consultation by calling us at (314) 361-4300.
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