Pushing for the treatment you need in your workers' comp. case

Suffering a serious injury at work can cause all kinds of complications. For example, you may have to miss many weeks or months of work while you recover from your injuries. It may only be possible to return to your job after substantial treatment and therapy. For some people, it may never be possible to return to the same role they once filled within the company, meaning that they will always make less money.

The benefits available through California's workers' compensation insurance program can help workers obtain the care they need and offset the loss of income they experience. Partnering with an attorney who has experience navigating this complex system can make it easier to connect with benefits initially and then advocate for yourself moving forward.

If you need to obtain new or different treatment for medical conditions, you will likely need to take extra steps to secure the care you need. Mistakes regarding the proper procedure could result in unnecessary denials and delays.

You may have to undergo a utilization review

If the care you need involves a surgery, physical therapy or other costly procedures or care, it is likely that your employer or their insurance company will request a utilization review before approving the claim.

A utilization review involves a thorough review of the records from your injury and the potential benefits of the procedure or treatment requested. The idea is to prevent individuals or medical providers from unnecessarily taking money from the public coffers for treatments that aren't necessary or won't improve your condition or prognosis.

Utilization reviews can sometimes be unfairly skewed against the individual applying for benefits, especially if the company that performs the review has a direct relationship with their employer. Having a second opinion or someone to advocate on your behalf can make it easier for you to secure a positive outcome to your utilization review.

Changing doctors may also require some effort

If you wanted to use your standard medical insurance to cover the cost of treatment for an injury or illness, you typically have the right to select your primary care physician. Even if you have been with the same doctor for years, you could choose at any time to change practices or doctors with little difficulty involved.

However, the same is not always true of a workers' compensation case. Although you do have the right to seek care from doctors you trust, it can be more difficult to change doctors once you begin treatment. Getting the help you need with this complex process is essential. It can make it easier to connect with the medical professionals who can give you the best care and the treatments or procedures that offer you the best prognosis for the injury you suffered at work.

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