Need Medical Treatment But Have A Denied Work Comp Claim?

Need Medical Treatment But Have A Denied Work Comp Claim?

  • Mar 30, 2022
  • Blog
  • Michael Burgis & Associates, P.C

Did you recently get your workers’ compensation claim denied? If so, you’re likely trying to recover on your own dime by seeking care from a skilled and experienced physician. Timely medical treatment is key to recovering fast, after all, and getting back on the job. Unfortunately, your decision to seek care could cause problems in the long run – but only if you don’t know your rights. So, take a look at this guide about how to navigate your case after getting medical care despite the initial denial.

How Workers’ Compensation Insurance Responds After Delayed Approval

After getting your workers’ compensation claim denied, it’s always a good idea to appeal. As you do that, you cannot wait for medical care. So, you go to your own doctor for care, resulting in problems down the road when your claim finally gets accepted.

More often than not, workers’ compensation insurance will demand you switch to their medical provider network immediately, interrupting your flow of care. As revisited in the recent Gonzales VAC Transit case, they simply cannot do that.

In most cases, you’re entitled to stay with your selected network after a denied claim gets approved after appeal. Your doctor just has to fill out paperwork stating that the switch would prove detrimental to your health and wellbeing. Workers’ compensation insurance must then pay your medical providers just as they would for their own network.

What to Do About In-Network Demands While You’re Under Proper Care

Despite the ruling, workers’ compensation insurance will likely demand that you switch to their medical provider network after finally approving your claim. Even worse, they’ll usually do just that without following the set protocol of sending out transfer of care notices.

So, it’s often best to work with an experienced lawyer to ensure their actions follow the right protocols. Your lawyer will insist that they send out the transfer of care notices as required by law. Then, they will ensure they recognize your doctor’s orders if they determine you need uninterrupted care for your serious chronic condition.

Workers’ compensation lawyers will cite cases like Gonzales VAC Transit plus bring up the applicable labor codes to keep the insurance company operating within the confines of the law. You can then simply focus on getting the care you need to properly recover from your on-the-job injuries.

Need Help with Your Workers’ Compensation Claim? Call Us Today

If you’re dealing with issues related to a workers’ compensation claim, get the help you deserve with a call to 888-287-4471. At Michael Burgis & Associates, we’re experienced in fighting for the rights of workers injured on the job. We can help you avoid interruptions to your medical care treatments while ensuring you can simply focus on getting well. So, please feel free to give us a call at your convenience to schedule a free consultation appointment. We’ll go over the facts of your case, and then create a plan on how to properly manage your claim from the start.

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    Jerry DiLeva

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