Utilization/Peer Reviews and Your Workers’ Compensation Case
If you are injured on the job, and your claim is accepted by your self-insured company, or your company’s workers’ compensation carrier, your employer is responsible for paying your medicals bills, time out of work, and possibly compensation for a permanent injury. Your employer or their workers’ compensation insurance carrier gets to dictate what doctors you see in exchange for paying the bill. But, sometimes, the workers’ compensation carrier seeks an opinion that second guesses the doctor they picked to send you to in the first place!
Called utilization, or peer review, if your authorized treating doctor recommends performing a surgery, or other treatment that the workers’ compensation insurance company doesn’t want to pay for, your records get sent to yet another doctor. Peer review doctors have never seen you, have contracts with the insurance company that pays them by the review, and often are retired, or do not have an active practice anymore, surgical or otherwise. Naturally, if someone is paying you to do something, you are going to make sure that they get what they want. It is no different with peer, or utilization reviews. Generally, the workers’ compensation insurance companies get what they pay for, and that is where you need an attorney that will fight for your rights, and in particular for the treatment the doctor says you need!
Workers’ compensation claims can be quite frustrating without someone on your side! You need someone to look out for you, so call Tippens & Zurosky, so we can be your voice, answer all of your questions, and file your claim! Tippens & Zurosky has knowledgeable, experienced attorneys certified in North Carolina and South Carolina, who can fight for your rights during this often long and difficult workers' compensation process. Call us toll-free at 877-872-3580, or at 704-343-0018, for a free consultation. Let us help you!
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