Workers’ Compensation and Medical Care
In workers’ compensation, your employer, or their workers’ compensation insurance company are responsible for paying all of your medical bills one hundred percent if they accept your case as compensable under the law. The rub on this is that they get to direct your medical care to a doctor of their choice, not your choice. This quirk of the law would seem to be a built in conflict of interest in that the person responsible for paying your bills gets to send you to whomever they choose.
Quite often, companies choose to send injured workers to urgent care clinics that “specialize” in workers’ compensation injuries. These organizations are the gatekeeper to an injured worker seeing a true specialist. The prime directive of these organizations is to keep the costs of medical care down, and to get the injured worker back to work as soon as possible. It stands to reason if the person paying the bill wants a certain result, you can bet the medical provider will do what they can to make that happen. The built in conflict of interest part comes in where the medical provider wants to keep getting business from the employer, or workers’ compensation insurance company. Naturally, they are afraid of doing something the employer, or workers’ compensation insurance company doesn’t want them to do: like recommend an expensive MRI, take the injured worker out of work, or refer the injured worker to see a surgeon. We have had clients that were told by these types of medical facilities that they “weren’t allowed” to take them out of work, or “couldn’t” recommend an MRI. So, if the company, or their workers’ compensation carrier, is the one driving the medical care bus, you can imagine why your workers’ compensation doctor may be rather dismissive.
The other thing which sometimes can result in speedy physicians in and out of an exam room is the fee schedule. The fee schedule is set by the state and determines what the physician is paid for his, or her, services. The amount of money set by the fee schedule is usually less than that of what the physician gets paid for the same services from other sources such as private health insurance. Thus, in workers’ compensation it is not unusual to hear of a physician, triple or quadruple booking the same hour for workers’ compensation patient appointments. If this happens to you don’t be discouraged from asking questions and getting the care you need, and deserve. The doctor has a professional obligation to be there for you, and answer your questions!
Tippens & Zurosky is here to serve your auto accident and workers’ compensation needs, and has skilled and compassionate attorneys available to answer any and all questions that you might have about your case. Tippens & Zurosky has represented people involved in auto accidents, or hurt on the job in North Carolina and South Carolina for nearly twenty years. Let us answer any of your questions regarding any automobile accident, or work-related injury. Call us toll free at (877) 372-3580, or 704-343-0018 to schedule a consultation so that we may assist you.
