medical treatment

Workers’ compensation laws are in place to make sure that Missouri injured workers can access life-saving medical treatment when needed. But what happens when access is reduced?

This global health crisis, unfortunately, leaves many injured workers on the sidelines waiting to find out if they are able to see a doctor or not, as many consultations or procedures have been delayed, in hopes to flatten the curve.

How to See a Doctor Even in Difficult Times

This is one of the many moments where working with an experienced St. Louis worker’s compensation lawyer really makes a difference. An experienced attorney doesn’t just have a good grasp on the law – they also have a lot of contacts, specifically contacts from the medical field. As a result, they may be able to recommend a good doctor who knows how to treat your particular condition and even see you during these difficult times.

As a result, you may be able to continue your treatment as needed, instead of simply waiting until things cool down. Plus, they can help with laws specific to Missouri when it comes to workers’ comp.

You Cannot Technically Choose Your Own Doctor

In Missouri, your employer has the right to choose who will be treating you during your worker’s comp case. Usually, they leave this decision to the insurance company since they have a lot more connections in this area. However, when you’re faced with a difficult time like the present, the insurance company may not know a doctor who is able to treat you, in which case they may try to postpone your case until they do.

This is where your lawyer can step in again and argue in your favor. They can build a strong case that shows you (a) cannot afford to sit around and wait until the company eventually finds a doctor to treat you, and (b) should accept a different doctor to do it, even if they’ve not worked with them before.

Even if you’re not choosing your own doctor, you still have the right to high-quality care. The insurance company can sometimes forget this and base their choice in physician on criteria like who they have an established rapport with. Your attorney can ensure you that you receive the quality care you are entitled to.

Speak With an Attorney ASAP

If you’ve been injured on the job, a global crisis or lack of access to a doctor should not stop you from getting the best medical care possible. However, in a situation where the party deciding who treats you doesn’t necessarily have your best interest in mind, it becomes essential to work with someone who does. Reach out to a qualified St. Louis worker’s comp attorney right away to make sure your legal rights are protected and you are given the best possible care.

Missouri workers who are injured soon discover a string attached to their worker’s comp case: they are unable to choose their doctor.

According to state laws, your employer has the right to choose the doctor who will be treating your worker’s comp injury. In reality, your employer will likely not concern themselves with this decision and let the insurance company decide instead. This can lead to some awkward situation, especially if you notice your worker’s comp doctor isn’t helping you.

What then?

You Should Not Experience a Difference in the Quality of Care

Though the insurance company (or your employer) will choose the doctor treating your worker’s comp injury, they have no say in your medical treatment.

The insurance company prefers to choose the doctor because they have a relationship previously established with them, meaning they know the sort of treatments and medication they use, trust them and can handle the reimbursements a lot easier. In all honesty, dealing with a new doctor can take up a lot more time for them.

What If Your Doctor Isn’t Helping You? What Are Your Options?

Unfortunately, some doctors may provide sub-par care, or even treat their patients poorly. But when you are on worker’s comp, it may be more difficult to switch doctors while also retaining the benefits.

One option you have is to honestly speak to your employer about your situation, and tell them your doctor is not offering you adequate services. Your boss may be empathetic to your situation and allow you to switch to a new doctor, even if the insurance company may prefer that you don’t.

By far, the best option you have is to get in touch with a St. Louis worker’s compensation attorney to see what you can do based on your particular situation. It’s possible, with a help of a lawyer, to even get a second opinion on your medical cases, which can provide enough evidence to show your worker’s comp doctor was not offering the best care. In this instance, the insurance company can’t push back on your request to change doctors.

Additionally, if you have been treated poorly, you may also be entitled to seek compensation for medical malpractice, if your care resulted in additional injuries or worsened condition.

Speak With an Experienced Attorney in Missouri

If your worker’s comp doctor isn’t providing you with the best care, or you suspect your treatment is being influenced by the insurance company, please reach out to a St. Louis worker’s comp attorney right away.

With the help of a lawyer, you may be able to switch your worker’s comp doctors while still retaining your compensation benefits. Do not seek a different doctor on your own, as this may result in all your benefits stopping, and it may prove difficult to get them back.

Accidents at work happen all the time, whether you are a construction worker or a computer operator in an office. From the mildest to the most severe ones, work-related injuries often affect one’s life in unpredictable ways, from being unable to go to work and get the necessary income to experiencing pain, emotional distress, and isolation.

Fortunately, work injuries are covered by workers’ compensation, a system through your employer’s insurance company will pay for your medical expenses, lost wages, and other damages. Even if the employer is uninsured or underinsured, you still have the possibility to ask for compensation through state-funded programs.

However, most of us who have dealt with insurance companies at least once in our lives know how carefully they verify every single claim to make sure they will not cover any expense that is not included in the policy.

Some companies go as far as denying your claim, even if it’s perfectly justifiable. Other times, the victim does not get the surgery they need because the medical provider is awaiting approval that is not actually required under the Workers’ Compensation act. Quite often, these situations get tricky and tend to linger over a long period of time, which is why having an experienced St. Louis workers compensation attorney on your side from the very beginning can help tremendously.

Will Workers’ Comp Pay for Your Surgery?

Getting back to the main question, it’s important to know that workers’ compensation should cover any medical treatment that you need for an injury caused by your work conditions or your employer’s negligence. This generally includes surgery, no matter what the insurance company wants you to think.

As long as your surgery is reasonable, necessary and related to your work injury, the insurance company has no grounds for refusing the coverage. They can hire an independent doctor who can give a second opinion and decide if the surgery is needed or not, but if the final answer is not satisfactory, you can make an appeal and defend your case further.

If you find yourself in such a situation, it’s highly recommendable that you speak with an experienced St. Louis workers’ comp attorney who has experience with these cases and knows what kind of proof is needed to get your claim through.

How a Lawyer Can Help

As mentioned above, insurance companies will go to extreme lengths to lower the amount or even deny it. That’s why it’s important to see a doctor as soon as you can after the injury and follow their recommendations carefully. You don’t want to give the insurance company any grounds for denying your claim.

Surgery is a big medical decision, and if you want to have it, it’s clear that your injuries are not getting better through alternative treatments. If you believe you need the surgery, contact a good attorney, follow your doctor’s advice thoroughly and don’t give up.

The insurance company will generally make strategic decisions to save themselves money.

In Missouri, workers’ compensation laws are designed to bring some comfort to workers who might get injured or sick on the job. They state that should workers have a medical need directly resulting from their work, then the costs will be fully covered by these benefits.

However, Missouri also has a rule that many other states do not; it allows the employer to choose the doctor who will be treating you. In a best-case scenario, this would not pose much of a problem, and the workers would continue their treatment until they are ready to resume their work. However, what happens when the workers want a second opinion?

Getting a Second Opinion

Even if the law says your employer has the right to choose the doctor, you should know that in most cases this choice is given to the insurance company which ultimately pays the costs of your medical treatment. For your boss, it’s one less hassle to worry about. For the insurance company, it’s a strategic move that allows them to control, at least in part, how their money is spent.

Though they will choose the doctor, the insurance company cannot suggest what kind of treatment or medical interventions you should get, nor can they try to persuade the doctor in altering their medical advice based on what’s more cost-effective for them. If you suspect the insurance company gets a say in your treatment this should be discussed with your attorney as soon as possible.

However, even if the insurance company is doing things by the book, it doesn’t mean you’re in for smooth sailing. For instance, if you do not agree with the diagnosis or treatment plan the doctor decided, in normal circumstances you’d get a second opinion. However, to have that reimbursed by the insurance company (under workers comp benefits), you first need their approval.

And frankly speaking, it’s very unlikely they will approve this move, as it can be seen as an unnecessary extra cost.

You’re Not Without Options

If you go at it alone, you are going to have a tough time getting anywhere with the insurance company. However, you should consider hiring a St. Louis workers compensation attorney for additional help. With a strong case, you may be able to convince the insurance company of approving a second opinion, but even if you don’t, there is another option.

The Missouri Workers Comp Division routinely weighs in on cases where there is an issue, such as not agreeing with the recommended treatment. With the help of a lawyer, you can take your case in front of an administrative judge. The judge, upon reviewing the evidence, can then order a second medical opinion which you do not have to pay for. Additionally, you won’t face any repercussions for this either, as you are well within your right to do so.

If you have been injured on the job in the state of Missouri, give us a call 24/7 at (314) 361-4300 to learn more about your legal options.