One of the best things about workers compensation is that it covers medical treatment you need to recover from your injury. But, one of the most frustrating things about workers compensation is when insurance company’s do not approve the medical treatment your doctor says you need.
I speak with too many people who have been waiting weeks or months to get the medical treatment they need. This delay causes several problems:
You have more pain than you should have
You cannot do the things you enjoy doing outside of work.
Your life is put on hold
Sometimes, the delay may even cause your injury to get worse.
Fortunately, there are some steps you can take to get your workers compensation medical treatment faster.
What Can You Do to Get the Medical Treatment You Need?
There are two main ways that the workers compensation insurance company slows down your medical treatment:
Failing to approve your medical treatment
Denying your medical treatment
You have several options for dealing with these insurance company delay tactics. The best approach to take will depend on which tactic the insurance company uses as well as the specific facts of your case.
Get the adjuster to approve the medical treatment
One option that you or an attorney representing you can take is to talk to the insurance adjuster and get the treatment approved. The adjuster is the person with the insurance company that has the power to make decisions in your case.
If the adjuster communicates to the doctor’s office that your medical treatment is approved, that generally solves the problem and you will be able to get the medical treatment. Communicating with the adjuster can sometimes make that happen.
The difficult thing about this approach can be getting in touch with the adjuster. Sometimes, you cannot get the adjuster on the phone to have a conversation about getting medical treatment approved.
There are some tricks that are helpful in overcoming this problem. Emailing some adjusters works. Also, it sometimes help to try to communicate with someone else in the insurance company’s office to get an answer.
What can be done if communicating with the adjuster does not work?
Often, trying to communicate with the adjuster may not fix the problem. There are other things that can be done to make sure you get the medical treatment you need.
Often, what I will do in a case is to file a document known as a Form WC-PMT. The PMT is short for Petition for Medical Treatment. The State Board of Workers’ Compensation created this form to address delays with medical treatment approval.
Filing the form requests that the insurance company file a written response approving or denying the requested medical treatment. If the insurance company does not respond, a phone call takes place with a workers compensation judge. After the phone call, the judge can order approval of the treatment.
Are there other methods for getting treatment approved?
The Form WC-PMT can be a great tool for getting treatment approved. But, the State Board’s rules require that attorneys follow certain procedures to file this form. Also, the form cannot be used in all medical treatment denial situations.
Fortunately, there are other ways to get treatment approved. One of the most common methods is a hearing in front of a workers compensation judge.
The State Board also has a form to request hearings. It is a Form WC-14. Using this document can allow you or an attorney representing you to request a hearing in front of a workers compensation judge.
You do not have to have an attorney to request or move forward with a hearing. But, the workers compensation insurance company will have an attorney representing them who specializes in workers compensation. Many people who try to proceed to a hearing without an attorney representing them end up losing their case because they do not understand all the rules associated with gathering evidence before a hearing and presenting it at a hearing.
Before you move forward with requesting a hearing in your case, talk to a workers compensation attorney to find out if that is the best option for you and whether you should get an attorney involved to go that route. Our firm provides free consultations in workers compensation cases.
What if I have other questions about workers compensation?
Georgia’s workers compensation system can be very confusing. You have to worry about getting the treatment you need and paying your bills while also worrying about not missing any deadlines that could cause you to lose your right to receive workers compensation benefits.
If you have questions, I would recommend that you try to get answers. To find out more about how to schedule a time to talk to me about your workers compensation questions, just read this short article.
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.
To be notified of Jason’s new workers compensation videos, subscribe to his Georgia Workers Compensation Video Series channel on YouTube by clicking the subscribe button below.
Amazing! Jason and his team were very helpful and had the best communication by far. Walked me though every step with great detail and had answers for any question I had. They handled my case better then I could imagine, it was a weird case and they stayed on top of it and kept me updated every step of the way! Highly recommend this Team! Thanks so much to Jason and his Awesome team!-Brittney
I absolutely love this group of attorneys, when I was at my lowest they did everything they could to help me get justice for my injury. I believe if I were to have never picked my phone up and called the amazing group that helped me I definitely would not have received my idea of rights. If you have an issue and are just not sure please understand that they will help you, stay in contact, answer any question you have, and for sure get you the justice you deserve I thank them from the bottom of my heart and I will definitely refer them to anyone who has been hurt because they most definitely care about their work and clients.
If you must get a lawyer involved, you’d do well to work with Jason Perkins and his team at Perkins Studdard Law.They were thorough in gathering information and in sharing all the steps in the workers comp process specific to my case. Jason and the team were responsive to my bevy of questions and concerns.I appreciated the informative videos and consultations provided by Jason over video meetings and multiple phone calls.I hope I’m never injured on the job again. However, if I am and if my employer responds as my previous employer did, I’ll contact Perkins Studdard Law immediately to handle the case.
Everyone at Perkins Studdard was kind and professional. They were always extremely responsive and answered all questions that I had and followed up to make sure I had an understanding of what was going on along with emailing videos to explain every step of my case so I would know what to expect and be prepared. Jason is a very genuine person and I trusted him with my case. He answered so many questions for me even before I retained him as my WC lawyer. I highly recommend him and his associates at Perkins Studdard.
