My Workers’ Comp Medical Benefits Aren’t Getting Authorized. What Should I Do?

The whole point of workers’ compensation benefits is to help you recover from an injury on the job—in most cases so you can eventually return to work and get your life back to normal.

The most important part of filing a workers’ comp claim is getting the medical treatment you need (paid for by the workers’ comp insurance that your employer is required to carry).

You should receive medical care, covered by workers’ comp, in a timely way.

But the workers’ compensation insurance company, looking to keep its costs down, can refuse to authorize your medical treatment. That causes delays in getting the care you need.

At Workers’ Compensation, LLC, our Louisiana workers’ comp lawyers find this unacceptable. You can and should fight for what you’re entitled to receive, and for what’s fair, under workers’ comp.

Because understanding how this process unfolds can help you down the road, let’s lay out what happens next after you’re hurt at work.

How to Start Your Medical Treatment Under Louisiana Workers’ Comp

The process for getting medical treatment after a workplace injury can be long and involved.

It always starts with your doctor requesting authorization from the workers’ compensation insurance company.

Basically, your doctor is asking for permission to treat you under the umbrella of workers’ comp. If the insurance company gives your doctor permission, your doctor can provide the treatment you need.

If the insurance company doesn’t give your doctor permission, then your doctor has to take certain steps to appeal that decision.

Often, insurance companies will deny a doctor’s request because, in their eyes, the treatment is not medically necessary. But making that decision isn’t the insurance company’s job.

Louisiana law has guidelines for workers’ comp claims, and these guidelines alone determine what treatment is necessary.

So as long as your doctor is requesting treatment that is covered in the guidelines, the insurance company must give your doctor permission to treat you, no matter what the company’s opinion is about how much you need the course of treatment.

Appealing a Denial of Workers’ Comp Medical Benefits in Louisiana

Of course, insurance companies often disregard the guidelines entirely and refuse to authorize treatment even if it is clearly covered.

If this happens, your doctor will have to file an appeal with the Louisiana Office of Workers’ Compensation – Medical Services Division.

Once your doctor files this appeal, the state will rule whether, according to the guidelines, the treatment is medically necessary. Once the state makes its decision, the insurance company has 45 days to dispute it.

If the insurance company does not object, the treatment is considered medically necessary, and the insurance company must authorize it.

If the insurance company decides to dispute the decision, it can file a lawsuit and try to overturn it. But overturning a decision by the state is very difficult and rarely happens.

Frustratingly, even when the state says the treatment is medically necessary, insurance companies sometimes still refuse to authorize treatment.

Then, as the injured worker, you’re forced to file a lawsuit simply to get the treatment you’re entitled to receive.

This is why you want to have an experienced workers’ compensation attorney fighting for your claim. Your workers’ comp attorney can step in at any point in the process to get your claim back on track, and file a lawsuit if that’s what it takes.

A Workers’ Comp Lawyer Stands Up for Your Right to Treatment

If you’re having trouble getting the workers’ compensation insurance company to authorize the medical treatment you need after you were hurt at work, contact the Louisiana work injury lawyers at Workers’ Compensation, LLC.

Making sure you receive the medical care you should have access to after a work injury is an important part of our job. We deal with this system every day.

Our workers’ compensation law firm has helped thousands of people secure millions of dollars in benefits. Our attorneys have more than 130 years of combined legal experience.

If you were hurt at work, no matter how or why, you have a right to medical treatment under workers’ comp law. It’s a crucial step in your path to recovery.

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