Does Workers’ Compensation Cover Myelograms and Discograms?
Many people get frustrated when they are trying to get medical treatment and testing after a workers’ compensation injury. These frustrations often arise from insurance companies not approving what the doctor orders.
These insurance company delays and denials can take several forms:
- The insurance company tells you that the doctor is not “authorized” to order the treatment or testing
- The insurance company denies the testing as not related to your injury
- The insurance company tells you that workers’ compensation does not cover that type of treatment or testing
- The insurance company does not give you a reason for the delay or denial
You may wonder whether certain types of treatment or testing are covered under workers’ compensation. This article discusses some types of testing that are sometimes performed for back and neck injuries and whether workers’ compensation covers those tests.
What type of medical treatment and testing does workers’ compensation cover generally?
Before going further, it is important to understand that each state has different workers’ compensation laws. This means that what is covered under one state’s laws may not be covered in another. I practice law in Georgia, and this article refers to what Georgia’s workers’ compensation laws cover.
Generally, Georgia workers’ compensation law provides coverage for your medical treatment and testing that you need as a result of work-related injuries. This treatment and testing must be ordered by “authorized” doctors. Also, there are limits as to how long the insurance company is responsible for paying for medical treatment and testing in many cases.
Does Georgia’s workers’ compensation law limit the types of treatment and testing that is covered?
For the most part, Georgia’s workers’ compensation law does not limited the types of treatment and testing that is covered. In other words, it is different from many other types of insurance policies. In most cases, if an “authorized” doctor orders the treatment or testing and it is needed because of your work injury, then it should be covered.
What are myelograms and discograms?
Most people are familiar with MRIs. and those are some tests that provide some detailed information about injuries to your spine whether it be your low back your lumbar spine, your middle back, which is your thoracic spine or your upper back/neck, which is your cervical spine. So it’s fairly common in workers’ compensation case for a doctor to perform an MRI.
Myelograms and discograms are two specialized types of testing that doctors will sometimes order if they believe you could need surgery on your neck or your back. Where myelograms and discograms come about is often when that MRI is showing that there is something that is potentially messed up in your back that might need surgery or might not need surgery.
Your workers’ compensation doctor may recommend a myelogram or discogram in order to get a more detailed picture of exactly what’s going on with your back. In the case of a discogram, a surgeon may recommend it to determine whether the pain that you are having is coming from the area in your spine that looks like it has been injured.
This article is not intended to provide medical advice since I am not a doctor. If you have concerns about getting a myelogram or discogram performed, be sure to discuss those concerns with your doctor and get answers.
Are myelograms and discograms covered under Georgia workers’ compensation?
The short answer to that question is yes. Workers’ compensation is responsible for paying for this testing as long as its done by authorized doctors and it is reasonable and necessary testing for your injury.
In other words, if you had an injury to your back or neck and a surgeon who is an authorized doctor in your workers’ compensation case was recommending this testing; the insurance company would probably have to pay for it. But, if you had an injury to your foot and the doctor recommended a myelogram on your back, the insurance company probably would not have to pay for it because it would probably not be related to your work injury.
Jason Perkins is an attorney who specializes in representing injured workers. He regularly publishes videos and write blog articles about Georgia’s workers compensation system and issues that are important to injured workers and their families.
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