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A Cause of Unnecessary Litigation

On Behalf of | Apr 9, 2012 | Medical Benefits |

Medical benefits seem to be a constant fight in workers compensation cases.  I just finished a deposition of a doctor who performed an independent medical examination of my client, who suffers from a knee injury. While they call it “independent” there is nothing independent about it. This doctor is very dependent on insurance company business and is used frequently by various defense attorneys. My client needs to lose weight in order to get the maximum benefit of the knee surgery that the doctor has performed. This is the opinion of her orthopedist. The doctor has prescribed a weight loss program which the insurance carrier refuses to authorize. It’s commonly accepted that excess weight can cause problems with joints and that this can also reduce the effectiveness of surgery. Still, the carrier is willing to spend money on an examination, go to hearing and also pay for the deposition of their doctor. This is much more expensive than the program they are contesting. Even at the deposition their doctor admitted on cross-examination that the results would probably be better if the patient lost weight. I asked the respondents’ attorney why they would spend so much more on denying the program than the program actually costs. The response was that if they approved this, everyone that hurt their knee would want a weight-loss program. So it appears that this is some kind of line in the sand for them. Of course, doctors make treatment recommendations all the time. That’s part of the job. In my experience they do it based on good medicine, not just because a patient asks for it. My client is very overweight and would greatly benefits from the program. Still, the carrier is too worried about some mythical claimant out there somewhere than to actually provide treatment for someone who really needs it. Insurance companies frequently complain about unnecessary litigation when in fact, they often are the cause of the litigation. This one certainly is.  For on medical benefits go to: /Colorado-Workers-Comp/Medical-Benefits.shtml


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