Many people think that since they have a lifetime medical award, they will not need legal help because they are covered for life. They usually soon find out otherwise. Many times a workers’ comp. carrier will just refuse to authorize medical care without explanation and ignore your calls. They won’t honor the lifetime award unless you know how to make them honor the award.
“How do I make the workers’ comp. insurance carrier honor the award?”
To put it simply, the best way is usually to take ‘em to court. If your doctor says certain medical care is necessary and related to your workers’ comp injury, workers’ comp (insurance) should have to pay. The opinion of the authorized treating physician usually carries a lot of weight in these cases. As I’ve said in previous blogs, an experienced workers’ comp attorney (like me) can help you through this & often times get the comp carrier to pay without having to go to court. A lifetime medical award is an enforceable order. Don’t let them get away with ignoring you.
“What if they say the treatment is not necessary or related to my work injury?
You really need to get your doctor’s opinion as to whether the suggested treatment is necessary and related to your work injury. If they won’t pay for a visit to the treating doctor, often times it is worth while to put the visit on your own insurance or pay out of pocket if you can. If the doctor agrees with you, you have a good chance to win your case. If you can’t pay out of pocket, many doctor’s offices will work with you on a payment plan or you may qualify for “charity care” or other programs for assistance with payment of medical care.
The statements contained herein are for general information purposes only. This is NOT to be considered specific legal advice to your situation as Mr. Shoen would need to meet with you individually to ensure the client confidentiality and would need additional information not provided in this article. This article does not create an attorney-client relationship. Please consult directly with an attorney for legal advice.