Medical Benefits

Colorado Workers Compensation Medical Benefit Lawyer

Injured workers are entitled to medical treatment at the expense of the workers’ compensation insurance carrier to help cure and relieve the effects of the injury. This treatment is given by “authorized treating physicians.” What is often a problem for injured workers is that these “authorized treating physicians” are chosen by the employer, not the employee. Many of the physicians have long and profitable relationships with the employer or the insurance company and have had no long-term relationship with the injured worker. Thus, pressure may be put on the physician to release the injured worker from treatment early or to find that the injured worker has no impairment.

Authorized Treating Physician

The authorized treating physician is determined by the employer at the time the employer is told that the worker was injured. The employer usually sends the claimant to a predetermined clinic. However, if the employer fails to send the worker to a doctor, the worker can chose his own doctor. Once that choice is made, the worker must continue with the authorized treating physician (“ATP”) or any other doctor that ATP refers the worker to.

Denied Medical Treatment

The insurance company can still deny treatment even if it is recommended by the ATP. Frequently, especially when surgery is recommended, the insurance company will refuse to authorize treatment and will seek the opinion of an “independent” medical examiner. The “independence” these doctors is questionable. Many of them do a great deal of business with insurance companies. If the insurance company’s doctor disagrees with the treating physician, the matter may have to be determined by a judge.

Nurse Case Manager

Frequently, an insurance carrier will accompany an injured worker on his medical appointments. This gives the insurance company more direct access to the treating physician. Sometimes, these nurse case managers can help coordinate treatment and help get treatment authorized. However, sometimes the nurse case manager can push doctors to release the worker early or to reduce the workers restrictions.

The injured worker does not have to agree to have a nurse case manager. If the worker does not want a nurse case manager, he should tell the insurance company in writing that the nurse’s services are no longer needed. The worker should also say in writing that he withdraws any authorization which the nurse case manager had to talk to medical providers.

Call the Eley Law Firm today at 866.458.6360 or 720.279.9172 for a free case evaluation from a workers compensation attorney. You may also e-mail us or fill out the form on the Contact Us page of this website, and a representative from the office will be in touch with you shortly. We look forward to hearing from you and helping with your workers comp case!