Workers’ compensation is intended to provide several benefits to injured workers who have suffered from a work-related accident or an occupational disease. Workers compensation includes medical benefits, such as payment of hospital and medical bills, as well as a portion of the loss of income during any period in which an employee is disabled. But even if your initial claim is approved, getting the proper treatment you need to recover from your injuries may not be as straight-forward as it seems.

What Is a Medical Treatment Authorization in Workers Comp?

During the course of treatment for your injury, your care may require expensive diagnostic tests, like MRIs or CT scans. Or, you may need to see a specialist for care. In these cases, the insurance company (or employer) may require medical treatment authorization before you can receive treatment -- or be left paying the costs out-of-pocket.

What Happens If Medical Treatment Authorization is Denied?

Insurance companies are in the business of minimizing claims and can make receiving adequate care and treatment more difficult, adding even more stress and worry to your situation. If your request for medical treatment has been denied, it's a good idea to contact a workers compensation lawyer about your claim. There are a variety of reasons medical treatments are denied by insurers and employers, including:

  • Stalling and delaying the claim as a frustration tactic to persuade the injured victim to no longer pursue the claim or develop other conditions that will make the claim harder to prove.
  • Claiming the injured worker waited too long to request medical treatment.

It’s common for insurance companies to deny medical treatment authorization for injuries not initially reported. For instance, if your back is injured in a fall which causes symptoms of shoulder and neck pain days or weeks later, an insurance company may claim the shoulder pain is not related to the fall. It’s important to report symptoms and be very clear and direct about everything you’re experiencing as a result of your workplace accident. 

Tips for Building a Strong Case for Your Workers Comp Settlement

In order to maximize your settlement and avoid a claim denial, it’s important to build a strong case that links the severity of your injuries to the workplace and follows the process and timelines.

Make sure to seek medical treatment immediately and report the accident and your injuries to your employer. Your medical record will be an important piece of evidence to build your case for a workers compensation settlement. Take pictures of your injuries and any evidence of the accident and make sure to keep all records related to your medical treatment.

New Jersey has a very short timeframe for workers to report their injury to their employer in order to be eligible for workers compensation benefits. It's critical to follow the workers compensation process and be aware of the time limits. You don’t want your claim to be denied just because you missed a deadline. 

We Can Help You Get the Medical Treatment You Need

At Brandon J. Broderick, Attorney at Law, we are dedicated to assisting clients throughout New Jersey and New York with their workers’ compensation cases. We have years of experience and the extensive resources you need to secure a fair case result. Our lawyers are here to use our extensive resources to help you obtain the treatment you need to recover from your work-related injury. We will:

  • File an emergency request for a hearing.
  • Find crucial medical records that prove you need ongoing medical care.
  • Demand immediate authorization for medical care or diagnostic testing.
  • Demand authorization of referrals to specialists, like surgeons, neurologists, neurosurgeons, physiatrists, physical therapists, and chiropractors.

You have the right to file a claim for benefits after suffering a work-related injury; however, the process of actually obtaining benefits is a major challenge for most people. Our experienced workers compensation attorneys will handle your case and make sure you get the benefits you need to recover from your injury and get back to work. Contact us today for a free consultation.


Posted by: Brandon J. Bro…
Date: Fri, 07/30/2021 - 19:46

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