I was receiving workers compensation benefits and my doctor referred me to a pain specialist. The workers comp insurance carrier would not pay for the specialist and sent me to another doctor who got my benefits cut. I then was referred to the pain specialist who said I could not work.
What is going on here? How can I get my workers comp medical straightened out?
Disclaimer: Our response is not formal legal advice and does not create an attorney-client relationship. It is generic legal information based on the very limited information provided. Do not rely upon the information in our response, or anywhere else on this site, when deciding the proper course of a legal matter. Always get a personalized case review from a local attorney.
You were receiving Workmans Compensation insurance coverage for the medical bills from an approved physician. That physician referred you to a pain specialist and Workmans Compensation refused to agree to pay for the costs.
Q: Why won’t Workmans Compensation pay for some doctors and not for others?
A: When your employer entered into an agreement with the Workmans Compensation insurance company a list of approved physicians was agreed to. That agreement states Workmans Compensation will pay for any doctors on the agreed list. If a doctor is not on the list you will have to receive an exception from the insurance company. Those are rare.
From the facts you present we are unable to tell if the pain specialist is a physician, chiropractor, acupuncturist, or other provider. We are unaware of any instances when an insurance company, especially a Workmans Compensation provider ever approved payment for an acupuncturist.
Regrettably there is little you can do if the insurance company refuses to pay. You can pay the costs out of your own pocket but you should not expect to be reimbursed by thge insurance company
Learn more here: Problems with Independent Medical Exams
The above is general information. Laws change frequently, and across jurisdictions. You should get a personalized case evaluation from a licensed attorney. Find a local attorney to give you a free case review here , or call (888) 647-2490.
Best of luck with your claim,
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