After a severe work-related injury, it is important to get the best medical treatment available. However, it is not always so easy. Medical treatment and workers’ compensation in Florence can come with certain obstacles, especially from the insurance company. These obstacles can be overcome with help from an experienced workers’ comp attorney.
Seeking Medical Treatment from a Specific Provider
An injured worker in Kentucky is generally able to select their own physician, which sets Kentucky apart from other states. Typically, an injured worker can treat with their family doctor and let that doctor determine what type of specialist to see. One of the most important things is to get treatment as quickly as possible and get evaluated by a doctor that they trust, which builds confidence that can guide their recovery.
A lawyer who has been working in Florence for many years will have developed great relationships with all of the local medical facilities and treatment providers, and can help place an injured worker in the care of a high-quality doctor to immediately begin proper treatment.
What is the Role of the Insurance Company in Dictating Medical Treatment?
The insurance carrier for the injured worker’s employer has an important role in any worker’s compensation case. The carrier must typically approve of any and all medical treatment that is recommended, including physical therapy, pain management, and surgical procedures. That is why it is critically important to contact an experienced workers’ compensation attorney who can make whatever arguments necessary to convince the insurance company that the medical treatment being recommended is reasonable and necessary.
An insurance company cannot deny medical treatment simply because they do not want to pay for it. Rather, they have to have some type of medical analysis or evaluation to support their decision to deny treatment. It is not difficult for an insurance company to contact one of their own doctors to provide an opinion that might be counter to the injured worker’s physician’s opinion.
An attorney can begin preparing for whatever disputes and litigation that might arise, reducing the amount of time it will take to get the treatment approved.
Insufficient Treatment
The insurance company may attempt to suspend or deny medical treatment early in the recovery and deny them access to a full range of treatment. The most common option when the insurance has denied treatment is to file the claim into litigation and have a judge determine whether the treatment is reasonable and necessary. At this point, the sides submit evidence to the court and a decision is made.
What is a Medical-Only Claim?
A medical-only claim typically involves an injury that requires treatment but does not prevent the injured person from returning to work. The worker is still eligible to receive all the benefits that any other injured worker may receive but they are able to continue working during the course of treatment.
Maximum Medical Improvement
There are many different definitions for maximum medical improvement. It is essentially a determination made by a doctor that a patient’s condition has plateaued and they have recovered as much as they are going to.
Insurance companies tend to have a different definition of maximum medical improvement and will attempt early on to make an argument that the person’s condition has fully recovered. In many cases, injured workers will achieve maximum medical improvement but continue to have disabling or functional limitations requiring treatment and may not be able to return to work. A person should not have their benefits suspended or denied just because they have medically improved.
Pursuant to the Kentucky Workers’ Compensation Act, if an employee has a permanent injury at the time that they have achieved maximum medical improvement, they are entitled to either partial or total disability benefits. Those benefits are directly related to the severity and extent of their injuries and the impact that those injuries have on their ability to work and earn money in the future. Again, insurance companies have a different opinion of the severity of the injured worker’s condition, which is where an experienced attorney can fight back against those assertions.
Find a Florence Attorney to Protect Your Medical Treatment Under Workers’ Compensation
The insurance carriers will likely put up a fight in trying to deny you coverage for medical treatment. A lawyer has seen these tactics before and can put their years of experience to work in protecting you. Call us to discuss your situation and learn more about medical treatment and workers’ compensation in Florence.
