If you’ve been hurt in an accident at work, your treating physician may determine that surgery is needed, but workers’ compensation insurance may refuse to pay for it. There are several reasons why this could happen. However, this decision is not final, and with your doctor’s help, a workers’ compensation attorney can help you reverse it. If the surgery is urgent, you can use your health insurance to pay for it and file a personal injury lawsuit to be compensated for it later.
How Does the Insurance Company Decide?
When an employee has been injured at work and the employee’s treating doctor decides that a certain course of treatment, such as surgery, is needed, an employer’s insurance company has the right to request an independent medical exam (IME). This IME is, in theory, supposed to be a medical examination by a doctor who is an objective third party. However, in reality, this doctor is not always objective and may be inclined to deny whatever the treating doctor has recommended. The IME doctor may deny authorization for a surgery by saying that it is not necessary or reasonable, or that it is unrelated to the work injury.
When the Insurance Company Denies Payment
When the employer’s insurance company denies payment for a treatment like surgery for the work-related injury of an employee, the employee has the right to file an appeal. Unless the denial is based upon an error or lack of information or documentation, it’s wise to hire a workers’ injury attorney. An attorney can help with the appeal process and hearing, which will take place before an Administrative Law Judge. Furthermore, they can help you gather the evidence and necessary information to make a successful argument for your appeal.
Call a Workers’ Compensation Attorney Today
If you have been injured at work or have been denied workers’ compensation benefits, do not take chances. Take the first step towards recovering the benefits you deserve. Schedule an appointment with a work injury attorney in Saint Louis Park or Hennepin County, Minnesota today by calling Thill and Freeman at (952) 512-7512.