Denied Diagnostics in Worker’s Compensation Claims

• Apr 09, 2021
• Blog
• Michael Burgis & Associates, P.C

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It happens all too often. A person is injured or becomes ill while on the job, they file a workers’ compensation claim, and are sent to a physician for assessment, diagnosis, and treatment. The doctor orders diagnostic tests which are promptly denied by the workers’ comp carrier.

If this has happened to you, your first thought is probably, “why?”

Your second thought is likely, “What can I do about it?”

At Michael Burgis & Associates, we believe that there’s plenty you can do about it. And we’re ready to help you.

What are Diagnostics and Why do You Need Them?

All areas of medicine use diagnostic testing to determine the injury or illness and its extent. It is also used to determine the best course of treatment in order to relieve the effects of the injury. When it comes to workers’ compensation claims, diagnostic testing is necessary in order to determine the proper and accurate compensation. In other words, you typically need some type of diagnostic testing in order to get a true and accurate picture of what’s going on with you and how it should be treated.

Some of the more common types of diagnostic testing include:

• Magnetic Resonance Imaging (MRI)
• Endoscopy
• Nerve conduction testing
• Echocardiogram
• Computed Axial Tomography (CAT)
• Colonoscopy
• Bone scan
• X-ray
• Bronchoscopy
• Electrocardiogram
• Complete blood count (CBC)

Without diagnostics, you simply cannot get a clear picture of your illness or injury the majority of the time.

Why do Diagnostics Get Denied?

Often the workers’ compensation carrier claims that diagnostic testing is not reasonably medically necessary. At this point, it is pure speculation just what the motivation is for denying diagnostics. Perhaps the person reviewing the order doesn’t understand why the tests are needed.

The bottom line is diagnostic testing is expensive. Insurance companies are notorious for denying certain diagnostic tests in an effort to cut costs. They count on the individual not having legal representation, someone to fight for them. And to be honest, if you go into a workers’ comp situation on your own, you are not likely to get all the compensation that you are entitled to receive.

You need a good worker’s comp lawyer to help you get what you deserve.

What Are Your Rights When It Comes to Diagnostics for Your Workers’ Comp Claim?

At Michael Burgis & Associates, we believe that not only are you entitled to diagnostic testing, we believe that you have a constitutional right to it. Diagnostic testing, assessing an injury or illness in order to determine its extent as well as the best course for action for treatment and cure is a fundamental right afforded all American citizens by the U.S. Constitution in their pursuit of life, liberty, and the pursuit of happiness. Denying diagnostic testing is essentially denying you access to that pursuit and to those fundamental rights.

If you have filed a workers’ compensation claim and the insurance company has denied it, we can help. We will file for an expedited court hearing so we can get your case before a judge quickly – and you don’t have to wait for the diagnostic testing that you need, which is so vital to your health, happiness, and life.

Contact us today to get started. Don’t wait another minute to get what you deserve.