Medical Treatment in Charleston Workers’ Compensation Cases

There are many injuries that can lead to workers’ compensation claims in Charleston. These range from neck injuries, lower back injuries, shoulders, wrists, arms, knees, hips, feet, and hands, just to name a few. It is important that any individual that has been injured receive medical treatment in their Charleston workers’ compensation case. A record of this treatment will be incredibly beneficial when making a claim for damages. To understand the importance of this treatment, it is crucial to contact an experienced Charleston workers’ compensation attorney as soon as possible.

Types of Injuries

The Workers’ Compensation Act has a list of numerous body parts that can be claimed, as well as a section that allows for any other type of injury that was not contemplated by the act to still be addressed with medical benefits and compensation.

These injuries include brain injuries, incomplete quadriplegia, and tetraplegia cases whether it be an internal organ, an occupational disease, or just broken bones, tendon injuries, or muscle injuries. Any part of the human anatomy or body system that is injured is covered by the Workers’ Compensation Act.

Seeking Medical Treatment

Under the state Workers’ Compensation Act in South Carolina, the insurance company gets to choose the medical provider. Since the insurance company is picking the doctor, they try to pick somebody that they hope will be favorable to the insurance company and not the injured worker. Most medical doctors are very patient-oriented and good to their patient. Therefore, many times, the authorized treating physician that is provided by the insurance company is somebody that is easy to work with, but not always.

In those instances where the injured worker is not getting fair treatment from the authorized medical physician, lawyers may send their clients for an independent medical evaluation with the proper expert, whether it be an orthopedic specialist, a neurosurgeon, neurologist, or urologist. Whichever specialist is appropriate for the condition will be contacted.

Getting the individual to the correct medical treatment following their Charleston workers’ compensation case is crucial in terms of determining the cause of the injury or medical condition. It is critical to understand the extent of the injury, any work restrictions, and whatever else is essential for the case. Many times, an attorney can use that independent analysis to seek and obtain greater benefits medically and money-wise for the injured worker.

Role of the Insurance Company

In state workers’ compensation cases, the insurance company by law is allowed to dictate where the injured worker goes for their medical treatment, but that is only to some extent. The insurance company chooses a medical provider that they are willing to pay for. The injured worker can seek medical treatment on their own in their Charleston workers’ compensation case. This can be a good thing, but can also create some problems in the case.

An experienced lawyer can help direct a person toward the appropriate medical treatment and help them work with the authorized treating physician to get opinions from the medical provider that can be attained. A lawyer can help an individual find an Independent Medical Evaluation and, if necessary, treatment from a recognized and credible provider that the commission will give proper weight to in terms of making a decision about the case.

Likelihood of Insufficient Treatment

Many clients often feel like the medical treatment is inadequate. As a threshold matter, many employers will try to send the injured worker to an in-house nurse or an in-house medical clinic that will many times ignore the injuries or undertreat the injuries.

The next level is that the insurance company many times picks a company doctor who is a general practitioner and generally under-reports the injuries or does not provide adequate medical treatment. Whenever the injury occurs, one of the first things an attorney should do on behalf of their potential client is to seek medical treatment from the correct medical specialist for whatever the injury may be.

This would include the injured worker getting an orthopedic specialist or a neurosurgeon immediately. It is important to receive the proper imaging with an MRI, CT scan so that the injury can be properly diagnosed and treated by an expert and the subspecialty field for the type of injury the injured worker has sustained.

Getting an Independent Medical Evaluation

There are a couple of available options for when a person feels the treatment has been insufficient.  The easiest option is to get an Independent Medical Evaluation with the appropriate medical expert regarding the injury. If there is a good cause that can be shown as to why the authorized treating physician should be removed, there is an opportunity under the law to remove that expert and have one replaced. Sometimes, it is chosen by the claimant; sometimes by a workers’ compensation commissioner or sometimes by agreement with the insurance company if there truly is good cause to change medical providers.

If someone is hurt, working for a medical provider and then the insurance company chooses a doctor that works for the same employer, obviously, there is a conflict of interest there. That would be a situation where there is a good reason to change the provider to a different doctor that has no nexus or connection with the employer and therefore remove any potential negative bias that may come from the medical opinions that are given for the injured worker.

 

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