The workers’ compensation insurance company is required by Iowa law to pay all reasonable and necessary medical care for a work-related injury — but too often Iowa workers’ compensation refuses to pay. There are many reasons why the insurance company may be refusing to pay for your medical care. Let’s discuss some of the most common reasons your medical care for a work injury may be refused, and what you can do about it.
Let’s start with the authorization defense. For Iowa workers’ compensation, if you are injured on the job, the employer’s workmans’ comp insurance company must to pay for the medical care—but they get to pick the doctors. In other words, the care has to be “authorized.” If you decide to seek medical care that the insurance company doesn’t authorize, there can be consequences:
There may be some valid reasons to seek medical treatment on your own—like if the work comp insurance company has refused to pay for care. You should ask an Iowa workers’ compensation attorney whether it is appropriate to seek care on your own outside of the work comp system.
Let’s move onto the next defense insurance companies sometimes use—that the care you are asking for isn’t necessary. You may believe that there is an alternate form of medical care that could help you, but the insurance company isn’t paying for it. If that’s the case, your workers’ compensation attorney should get a written opinion from the doctor recommending the care. This opinion should state that the care is reasonable and will be beneficial.
Once that is done, you can petition the Iowa Workers’ Compensation Agency to force the insurance company to pay for the care you want. It’s called a petition for alternate medical care.
Your employer’s insurance company may decide that the care a doctor is recommending is not related to your work injury—that it was caused by something else, like a pre-existing condition.
If your employer’s worker’s compensation insurance company says your injury is not work related, don’t take their word for it. Another doctor may have a different opinion. When workers’ compensation refuses to pay, you may need to hire an independent medical expert. This expert will offer an opinion about whether the injury you have, and the care you need for that injury, was caused by work related activities.
If the workers’ compensation insurance company is refusing to pay your bills after a work-related injury, contact one of our work comp attorneys at 1-800-433-0283. We can help you get the compensation you deserve.
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