The Insurance Company Stopped My Medical Treatment, But I’m Still Hurt

You’re hurt at work. At first, your employer does the right thing and sends you off for treatment. Everything seems to be going fine until the employer’s doctor tells you that you’re released back to full duty work. What do you do? At BiState we see this type of thing happen all too often. Just because your employer or their doctors try to tell you that you don’t need more treatment, does not mean you’re out of options.

What Does Missouri Workers’ Compensation Say About Treatment?

In Missouri, the employer must provide medical treatment “reasonably required to cure and relieve the employee of the work injury.” Usually, doctors determine what treatment is reasonably required. However, the doctors your employer sends you to are not looking out for you. They are looking out for your employer. Your employer’s doctors want to keep medical expenses as low as possible. Often, the employer’s doctor will not recommend expensive tests that need to be done, will not recommend expensive procedures that need to be done, and releases you from care before
you’re fully healed.

The Missouri Workers’ Compensation Commission dealt with an example of this in Bertels vs. Houghton Mifflin Harcourt Publishing Co. In that case, the employee hurt her right knee. The employer paid for her to undergo a fairly minor routine knee surgery but refused to pay for a total knee replacement, which is much more expensive. The employer had the doctor that they hired write them a report saying that the employee did not need a total knee replacement. The employee hired an attorney who sent her to a different doctor that believed she did need a total knee replacement. At a hearing, the Commission determined that the employee’s expert was right and that the total knee replacement was necessary.

How Do I Request More Medical Care?

The first step to getting more treatment is usually getting a second opinion. As Bertels shows, getting the right second opinion can have a big impact on your case. However, getting a good second opinion is not as easy as it sounds. First, you have to know what doctor to choose. This doesn’t just mean that if you’ve hurt your back you need to see a doctor that treats backs. Actually, you need to see a doctor that treats backs and understands how Workers’ Compensation works. Second, you’ll need to get all of your medical records to that doctor. This requires an understanding of HIPAA and medical records departments. Third, you’ll need to be able to actually afford to see that doctor. Some doctor’s opinions can cost thousands of dollars.

At BiState, we have great relationships with a variety of doctors. If your attorney and doctor work together, it is much easier for everyone to get on the same page and make sure your case is as strong as it can be. We also understand that many injured workers are out of work and not getting their full paycheck so paying spending thousands of dollars simply isn’t an option. At BiState, we will front the cost to go see a doctor, so you don’t have to.