Many times a worker will begin experiencing pain and discomfort which they believe is caused or aggravated by their job. When the workers compensation insurance company sends the employee to the doctor tests are ordered to find out whether the complaints are caused or aggravated by the work activities. For example, the employee may be feeling sick after working around fumes or dust or the employee’s back is sore after doing heavy lifting.
Medical tests for exposure to chemicals or radiological studies such as an MRI can be expensive and the insurance company will deny the request for authorization of the tests. In addition to avoiding the expense, the insurance company may be avoiding responsibility for paying the claim.
In some instances, the workers compensation insurance carrier may claim that the employee has not shown that the work activities are the major contributing cause (MCC) for the tests. The workers compensation insurance company is ignoring the law if it takes this position.
The court has held that the injured workers compensation claimant’s attorney need only show that the evaluation and testing is reasonably required to determine the cause and extent of the claimant’s injuries. Even if it is later found that the condition is not caused by the work activities, the insurance company must investigate the claim and provide the tests. The workers compensation insurance company cannot ask the employee to pay the insurance company back for the cost of the tests.
If your authorized workers compensation doctor has ordered evaluations or testing and the workers compensation insurance company will not authorize it, contact us today for a free consultation. Compensation you deserve….it’s what we work for.