Case Closed? Not So Fast! Know Your Rights to Medical Treatment if You've Been Hurt at Work

So the insurance company has denied your claim for a work related injury.  Your co-workers are giving you the stink eye because you're not pulling your weight.  Your boss is handing you assignments he knows you can't handle because of pain.  You're missing work days here and there just to recover from the prior day's assignment.   Why isn't the insurance company paying for your medical treatment?

Lots of reasons, it turns out.  Maybe your co-worker thought he heard you say you got hurt at home.  Or maybe someone mentioned a pre-existing condition.  Maybe there were no witnesses to your accident.  Whatever the reason, you have rights so don't just let the carrier tell you "no" and close your file!

Your recourse is to first file a claim petition.  You can do this on your own with the workers' compensation court or with the assistance of an attorney.  (If your claim is denied, don't mess around....go with a lawyer).  Then you must prepare and file a motion for medical treatment and temporary disability benefits, commonly referred to as a motion for med & temp.  Your motion will be backed up by a doctor's report recommending treatment, possible diagnosis, and a causation opinion.    Your certification as to the events leading up to the motion will also be included.

Once your motion is filed, it will be listed before a workers' comp judge within 30 days.  This gives the insurance company an opportunity to review the matter and answer the motion.  Sometimes, the issue is resolved before your court date.  Other times, the judge recommends an insurance company doctor be scheduled to evaluate your condition.  You might not even have to give your testimony, but if you do, the judge will listen to your side of the story, the doctors will give their opinion, and usually the treatment issue will be resolved promptly.

The moral to this story:  Don't just accept "No" as an answer to your request for medical treatment.  Knowing your rights in these circumstances will be the difference between feeling better soon and needlessly suffering.

If you or anyone you know need help with a workers' compensation injury, please join me for a free seminar at the Ocean County Library on April 30, 2013 @ 6:00.  Call 732-221-5640 to reserve your seat.