Wednesday, February 22, 2012

Work Comp. is Denying My Surgery, What Do I Do?: MN Workers' Compensation

We often get calls from folks who have Minnesota work-related injuries who find themselves in a difficult spot when the workers’ compensation insurance company refuses to authorize a proposed surgery or other recommended treatment. 

 A workers’ compensation insurance company frequently refuses to authorize surgeries and other medical treatment either on the basis that the proposed surgery or treatment is not reasonable or necessary, that the proposed treatment or surgery is outside the Minnesota permanent treatment parameters, or that the underlying injury is not a substantial contributing factor to your need for surgery or other medical treatment. Often times, the workers’ compensation insurer will base its denial on the findings of an Independent Medical Exam. Unless the proposed surgery is done on an emergency basis, the workers’ compensation insurer does have the right to require you to attend an Independent Medical Examination before agreeing to the proposed treatment.

No matter what the reason for the denial, don't have to simply accept it if the workers' compensation insurance company disputes your entitlement to medical care!

The rules and hoop-jumping that can go along with getting pre-approval for surgical treatment in a Minnesota workers’ compensation case can, unfortunately, substantially delay your medical care.

Where medical care is disputed in a Minnesota workers’ compensation case, particularly in disputes over pre-authorization for surgery or other treatment, there are procedures that allow many of these disputes to be heard on an expedited, or “fast-track” basis. In some cases, the injured worker can file a Request for Certification of Dispute, and a Medical Request, and the issue will be heard at the Department of Labor and Industry at an Administrative Conference. Other cases are initiated by filing a Claim Petition, and the issue is heard by a judge at the Office of Administrative Hearings.

Unfortunately, disputes over medical care are very common in Minnesota workers’ compensation cases. In fact, it’s not unusual to have multiple disputes over medical care during the course of an injured worker’s claim. When an insurance company starts disputing medical care on a workers’ compensation case, it’s usually only a matter of time before they start disputing other benefits, if they haven’t already been denied.

For a free, no-obligation case evaluation to learn more about your options when the workers’ compensation insurance company is disputing your medical care, call Meuser & Associate at 877-746-5680 or click here to send us an email. 


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