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Getting My Workers Compensation MRI Scheduled4 minute read

Your doctor ordered an MRI to diagnose your injury.  But, the workers compensation insurance company has not authorized the MRI.

So, you are stuck in limbo because you cannot get better until the doctor can get the test and diagnose your injury.  What do you?

Unfortunately, I hear about these problems much more often than I used to.  It seems like insurance companies make it more difficult to get what should be relatively simple treatment or testing for your injury.  This article will discuss some of the reasons that MRIs and other testing gets delayed and what you can do about it.

Doctor examining leg of patientWhat is an MRI?

MRI is an abbreviation for Magnetic Resonance Imaging.  It is a test ordered by a doctor to get a better internal picture a particular part of your body.

In workers’ compensation cases, doctors often order MRIs to determine how badly you have been injured

  • MRIs on your back or your neck help doctors determine whether you have suffered a herniated disc or pinched nerve
  • Shoulder MRIs help doctors diagnose rotator cuff and ligament tears and other shoulder injury
  • Knee MRIs can show a torn anterior cruciate ligament (ACL) or a torn meniscus, among other things.

If my doctor says I need an MRI, why does it not get approved?

Unfortunately, your doctor ordering the MRI does not always mean that it is going to happen quickly in a Georgia workers compensation case.  Most MRI testing facilities will want the insurance company to approve the MRI before they schedule an appointment for you.

Sometimes, the doctor orders the MRI and you receive a call a few days later that it has been scheduled.  But, the MRI will probably not get scheduled if the insurance company does not approve it.

This can be very frustrating.  You just want to get the test you need so you can get better.Why is this delay happening?

Female doctor with older man showing xray of spine and back at hospitalSeveral things can cause this delay:

  • The workers compensation coordinator at the doctor’s office or MRI testing facility cannot get an answer from the insurance adjuster
  • The insurance adjuster says that they need time to “review the file” before making a decision about approving the MRI
  • The insurance company wants a second opinion before approving the MRI
  • The MRI is denied by the insurance adjuster
  • The insurance adjuster sends the MRI request to utilization review

All you may know is that the doctor said you need an MRI and the MRI has not been scheduled yet.  You do not know why the MRI has not happened unless you or your lawyer does some research.

What can I do to get the MRI approved?

Delay and denial of medical treatment is a serious problem in many Georgia workers compensation claims.  You would like to get the treatment you need as quickly as possible so that you can get out of pain and move on with your life.

You may have to do some things and step in to try to get the MRI approved.  A good first step is to contact the doctor’s office or the facility where the MRIs going to be performed.  They should be able to tell you what the status of scheduling the MRI is.

If they indicate that they are waiting on approval, try to find out what has been done so far to get approval.   If the MRI is not being approved because the adjuster is delaying things, then you may need to contact the adjuster directly.

If you have a lawyer representing you, then that lawyer should take care of that for you.  But, you may need to let your attorney know that the MRI has been ordered but has not been scheduled yet.

What if the adjuster still does not approve my MRI?

Middle aged man talking on cell phone

If you have a lawyer, talk to them to find out the best strategy for getting the MRI approve.  If you do not have a lawyer attorney, you can take additional steps to get the MRI approved.  Some of your options include:

  • Getting the doctor to send a Form WC-205
  • Filing a Form WC-PMT
  • Requesting a hearing in front of a workers compensation judge

While you can try to take these steps yourself, I would certainly recommend talking to a lawyer if you reach this point.  There are special rules and procedures that you need to follow under Georgia’s workers compensation law.  A lawyer could be helpful to you in making sure you follow those rules.

Even if you do not think you will hire a lawyer, you may want to talk to one.  Our law firm provides free consultations in workers compensation claims.  This gives you an opportunity to get your questions answered so you can make a decision about the best way to pursue your case.

If you want to find out more about free consultations, just read this short article that explains the consultation process in more detail.  To set one up, just call our office at (770) 214-8885 or complete and submit this consultation request form.

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.

Brittney-lee orourkeBrittney-lee orourke
05:23 18 Feb 22
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
China JonesChina Jones
18:58 08 Feb 22
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.
Luv LocsLuv Locs
16:08 15 Jan 22
The entire law office was attentive and responsive to all of my concerns dealing with my workers compensation case.
moombimoombi
21:14 02 Jan 22
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.
Dana BessDana Bess
23:57 10 Dec 21
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.
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