Whenever you get a workplace injury, the logical thing to do is to seek medical treatment for your injuries, whether they’re minor accidents or serious lesions. But this is easier said than done. Although the California Workers’ Compensation system exists to protect the rights of injured workers, things do not always run smoothly.
There are some things you must know before you ask for treatment. So, today we will explain what it means to get medical care after your work injury, as well as some tips to help you in the process.
Summary:
1. How does the medical care system work?
2. How to handle treatment authorizations?
3. What to do if you have problems with medical care?
1. How does the medical care system work?
The first thing to do after your work injury is to report it. To do so, you fill out a DWC-1 claim form, which will help you access medical care and benefits, depending on your injury. In such cases, the insurance company is the one that provides this medical treatment and benefits.
However, it may happen that the insurer won’t make it easy for you. The medical system is not always there to help you. It can even deprive you of your medical care and limit the scope of benefits you can obtain.
It pays to know that insurance companies search for profit all the time. That means they will pay as few claims as possible, so their shareholders can make more revenue.
You might also have either a shady employer or insurer attending your situation. When that is the case, access to the medical care you deserve will be hard to get. Besides, the medical system won’t be there to help you as you need.
2. How to handle treatment authorizations?
In Workers’ Comp, we have a process called Utilization Review, where insurance companies authorize or deny medical care requests. Although anything could happen, they would likely deny them.
In simpler words, even if your doctor claims you need surgery, the insurance company can say no. Therefore, you might have to pay for your surgery out of pocket. This situation also applies to medication, physical therapy, diagnostic studies such as MRI’s, etc.
3. What to do if you have problems with medical care?
The first thing you can do is be your own voice. If you’re unhappy with the treating doctor, you can ask for a second opinion. And if you think the insurance company is not acting as expected, you can file penalties and sanctions.
Unfortunately, filing such a process is not always easy. In many cases, getting medical care after your work injury is complex, and you might face frustration and confusion. A lawyer’s guidance and support can help you relieve stress and take the right path.
The advantage of having a lawyer by your side is that they know how to navigate the system. Also, they have the experience to make the right decisions about what to do at every step of the process, especially when it comes to holding the insurance company accountable.
Conclusion
The pursuit of medical care after your workplace injury is not a piece of cake. You can be faced with some challenges that could make you feel disappointed and frustrated. Despite the challenges, you must be patient and act smartly.
Remember that you don’t have to go through this alone. A lawyer will help you fight for your rights and get the medical treatment you’re entitled to. Do you need help to get your medical treatment? Talk to us for free at 800-606-6999 or schedule an appointment here.
Pacific Workers', The Lawyers for Injured Workers in Northern California's Premier Workers' Compensation Law Firm. Representing First Responders, Health Care Workers, Construction Workers, Delivery Workers, Warehouse Workers, and all the hard-working people that keep our community moving in their Fight for Justice against Insurance Companies.
With over 250+ Five Star Reviews; an incredible staff of caring, well-trained, advanced technology for superior client communication: a track record of an over 98%-win rate and giving back to our community through the Pacific Workers' Foundation, it is easy to see why Pacific Workers' is the go-to law firm for all injured workers in Northern California. Offices in Oakland, Concord, Stockton, Tracy, San Jose, and Sacramento.
If you or a loved one need help or just have a question, give us a call at 800-606-6999.
