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Originally Posted On: https://vancamplawfirm.com/combating-doctor-shopping-by-employers-insurers-in-workers-compensation-cases/
Combating Doctor Shopping by Employers & Insurers in Workers’ Compensation Cases
Recovering from a serious injury is a tough challenge under any circumstances.
But if your accident occurred at work, that adds a whole extra layer of complexity. Workplace injuries and occupational diseases typically qualify for workers’ compensation benefits, but those benefits vary based on the state you live in.
Obtaining your benefits can be a long and frustrating process. One complicating factor is that Missouri law gives your employer the right to choose the doctor who treats your injuries. Those benefits an employee is entitled to in workers’ compensation become a financial obligation upon the employer and their insurer. Employers – and their designated insurance companies – have a vested interest in minimizing the benefit you receive or denying your claims altogether.
This can make it harder to obtain the treatment you need and the fair settlement you deserve. That’s why it’s highly recommended that you speak with a workers’ compensation attorney regarding your medical treatment and your case.
At Van Camp Law Firm, our attorneys have extensive experience with the workers’ compensation process, from assisting with medical intake paperwork to working with judges, doctors and other attorneys. Your attorney will advise you on what information to provide to the workers’ comp physician and how to appeal a denial or unfair settlement offer.
Why is doctor shopping a problem in workers’ compensation cases?
As noted above, Missouri workers’ compensation law lets employers choose the doctor who treats workplace injuries. Most employers designate the final selection to their insurance company. The employer may also direct the insurer to change physicians if they disagree with the first doctor’s diagnosis or treatment decisions.
This legal arrangement has led to numerous instances of “doctor shopping” by employers and their insurers. Many insurance companies develop cozy relationships with workers’ compensation doctors and will often continue to authorize those doctors who provide the reports and findings favorable to their interests. They typically seek out doctors who will side with them in an evidentiary hearing, also known as a trial.
This can lead to a number of problems for injured workers:
- The doctor may minimize the extent of your injuries
- Delays in getting tests such as an MRI or X-ray
- Receiving less than the full amount of treatment or therapy you need
- Having to return to work before you are ready
- Receiving less than the full settlement that you qualify for
What role does the attorney play in a workers’ compensation case?
The process of receiving treatment and collecting benefits after a work injury is often a complex and frustrating experience.
An experienced workers’ compensation attorney will have in-depth knowledge of how the system works, from completing paperwork to doctor visits to negotiating against settlement offers. Your attorney will help you navigate the system to make sure you don’t get taken advantage of by employers, insurers and their chosen doctors. He or she will assist you with many aspects of your case, such as:
- Completing required documents
- Gathering evidence to support your claims
- Helping you obtain a second opinion if you feel the employer’s doctor has provided less than the medical care you need
- Requesting a Hardship Hearing to challenge the Employer/Insurer’s doctor
What are the essential duties of an attorney in these cases?
Your workers’ comp attorney will advise you on how to accurately complete forms and describe ongoing symptoms and limitations resulting from your injury. This is essential for preventing miscommunication between you, the doctor, and other medical staff.
Above all, you must never lie, exaggerate, or minimize your condition when seeing a workers’ comp physician. To the best of your ability, always provide the doctor with accurate information about preexisting conditions, prior injuries, and medical history. Be completely truthful about how your workplace injury occurred and the extent of your injury. Don’t delay medical treatment, as this can make your condition worse and reduce your chance of a full recovery.
Speak with your worker’s comp attorney about your medical appointments as they can guide you on what to expect, common issues that arise, and questions to ask during medical appointments. Your attorney will also assist you with negotiating settlements and making sure you receive payments in a timely manner.
When to Contact a Workers’ Comp Attorney
If you’ve suffered a workplace injury, there are three steps you must take immediately:
- Notify your employer: Don’t wait! Speak up immediately.
- Contact a workers’ compensation attorney.
- Request medical treatment: Follow all doctors’ orders with respect to any surgery, medication, therapy or other treatments.
At Van Camp Law Firm, we will educate you on your rights as an injured worker. We handle all aspects of a claim and understand the importance that obtaining necessary medical care has to an employee to get them not just back to work, but back to living. If your employer or their insurer denies your claim or minimizes your injury, we will assist you with the process and fight through litigation and appeal.
Our attorneys have almost a combined half century of legal experience. We’ll work closely with you to protect your rights at every step of the process.
Give us a call at 573-644-7777 or contact us online to schedule a free consultation.
