Suffering an injury in the workplace is often a double-edged sword for the victim. On one hand, it is generally better to suffer an injury at work than on one’s private time, because workplace injuries generally qualify for workers’ compensation. On the other hand, workers who suffer injuries on the job must navigate numerous restrictions and guidelines in order to receive the treatment they need and a fair settlement they can accept.
In fact, many workers’ compensation claims run into complications because of these restrictions, often compromising the care that the victim receives for the benefit of the insurance provider or employer. If an employee does not pay attention during the process and fights for one’s own best interests, a workers’ compensation settlement may significantly benefit everyone but the victim.
If you suffered an injury on the job and now face recovery under workers’ compensation, then you may have very reasonable concerns about the medical care you receive and the parties who provide that care. You may also find that your employer’s provider does not work with your preferred care provider. With careful attention and action, it is still possible to receive care from your preferred provider, if you know how to go about addressing the issue.
Insurance companies are ultimately companies with corporate interests that supersede the interests of their customers and even the individuals they cover for their customers. While this probably seems normal in other business contexts, many people still expect insurance companies to act benevolently toward those who file claims, because of the great need of an injured worker.
Unfortunately, insurance providers are likely to only provide what they must in order to satisfy the minimum needs of the victim, in order to protect the provider’s bottom line.
However, with careful communication and proper negotiating, it is often possible to convince an insurer to approve a medical care provider they do not typically work with. To do so, you must follow the internal guidelines of the insurer to petition for your preferred provider’s approval, within the window of time you have to make the claim.
While the process changes from provider to provider and from injury case to case, each insurance provider has internal processes it uses to determine which providers do and do not receive approval and how an injured worker may petition for approval of someone not initially approved.
It is important to understand that navigating these internal systems and receiving approval for providers and treatments outside of the insurer’s standard approved options takes significant time and energy. Make sure that you understand these systems fully, or consider the other legal resources you have to support you as you make your recovery and seek a fair, just resolution to your workplace injury.