Insurance vs Doctor: What If I am Still Recovering?

August 22nd, 2017

Q: I had a severe back injury at work. The doctor said that I do not need surgery but I am still in tremendous pain and have been getting physical therapy for the past three months. I am not yet able to bend or lift, much less return to work. Now the insurance company is telling my doctor I have had enough physical therapy and I should be released to return to work. The doctor says he does not want to fight with the insurance company. Is there anything I can do?

 

A: Yes, there is a lot you can to do. Insurance companies are interested in saving money for themselves and their clients (employers). Their goal is not to see that you get the best care that you can but to get the least expensive care that the doctor will authorize. Your doctor should carefully explain to the insurance company why you need additional therapy and why a home exercise program by itself will not improve your medical condition that the extent that you can return to your regular work. Therapy and other passive treatments are beneficial at reducing disability and returning workers back to their normal activities, including work, as long as they are given the opportunity to succeed. Constantly delaying or questioning treatment is not helpful to anyone but the insurance company. You or your doctor can appeal the insurer’s decision to the Workers’ Compensation Department.

You can also talk to an attorney who understands workers’ compensation law and can help you get the treatment that you need.


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