Medical Benefits, under Workers’ Compensation, are a variety of aid or assistance to which an injured worker may be entitled. Any work-related injury, compensable hernia or occupational illness is covered. Diagnostic, medical, surgical, nursing, and/or pharmaceutical services must be made available to the claimant. Employers must shoulder the injured employee’s medical expenses when he suffers a work-related injury or illness— whether it is physical or mental.
It will not be surprising for employers and their insurance companies to try to evade liabilities which is why it is also important for you to talk to a lawyer.
Do not sit on your rights
If you are sick or injured because of your work environment or the nature of your work, the State of Louisiana assures you that you are entitled to reasonable and necessary medical treatment to be shouldered by your employer. If your employer refuses to arrange and subsidize your medical care, you can get treated on your own but your employer will still be held liable. He has a responsibility to you according to the law. You must fight for your entitlements. That is where an attorney comes in. Do not sit on your rights. Fight for what is for you.
Do not delay in getting medical attention right away because this could be used against you. You must be evaluated right away. Although you have rights that are protected by the law, you must also exercise due diligence in asserting these rights. We strongly suggest that you call us right away. Talk to us and we will guide you on what steps to take that would protect your best interests.
Get treated right away, choose your own doctor
You are entitled to be treated by a doctor you are most comfortable with. Your health should be handled by persons you trust. If your employer recommends you a doctor, you are not obliged to agree. Contact us at Workers’ Compensation LLC and we will make sure that you get the medical treatment that you want for yourself. Remember, do not sit on your rights. You do not have to sign the Choice of Physician form given to you.
Your employer will still have to fund your treatment even if you do not choose the doctor that they recommend. The right to choose a physician is yours as enshrined in the Workers’ Compensation Act.
If you do not have a doctor, let us know. We can recommend you doctors. The very reason why it is not advisable that you agree to the recommended physician of your employer is that your employer wouldn’t want you to have a claim. It is in their best interests to downplay your condition. We, on the other hand, as your counsels, will have your best interests in mind. We want you to get what you deserve and definitely not less than that. Protect your rights. Get the most out of your claim.
If you need to see more than one physician, your employer and their insurance company must agree. You must also have a compelling reason. That is why, choose your physician carefully. It is highly unlikely that your employer and their insurers will allow paying multiple physicians. It is in their best interests to keep payouts at a minimum. Talk to us, though. We might be able to work our way through it and get you what you truly deserve– even if that means getting you more than one doctor.
Second Medical Opinion (SMO) and Independent Medical Examination (IME)
Depending on the circumstances, your employer may require you to be evaluated by a physician of their choice known as Second Medical Opinion (SMO) or they may ask the Office of Workers’ Compensation for an Independent Medical Examination (IME)
During the course of your claim, you may not only be treated by your choice of physician, but you may also be evaluated by Employer’s choice of physician for a Second Medical Opinion (SMO) or by an Office of Workers’ Compensation’s choice of physician for an Independent Medical Examination (IME).
Now in SMOs and IMEs, you won’t get any treatment. Again, it’s just evaluation to make sure that you are indeed suffering as you claim so. This is to eliminate bias. The law is fair. Even though employers have a responsibility to their employees, they must also be protected and should not be abused. Meaning, you will need an attorney if in case they assert that you are claiming more than you should. We have to work together to make the courts believe that you are claims are truthful.
Usually, IMEs are conducted if in case there is a disagreement between the finding of your physician and the physician of your employers. It means that there is an inconsistency between what you allege and the results of the SMO.
When subjected to IME, you will first receive a letter of notice from the Louisiana Workers’ Compensation Medical Services Division or from one of the Workers’ Compensation Courts of the state. Talk to us before you allow yourself to be examined. You must be wise and protective of your rights. The findings of the IME will be directly sent to the Louisiana Office of Workers’ Compensation Medical Services Division if requested by them or to the Judge of the Workers’ Compensation court who asked for an IME to be conducted.
The results of the IME can still be contested. The court, treating the IME results as prima facie evidence, can use it to make a decision, but, it can also be refuted by an even more compelling evidence. A judge must not limit himself to the results of the IME. It could be a really stressful process which is why we are very much willing to help you out because we handle Workers’ Compensation claims on a daily basis and we know what we are doing. The process is very familiar to us. We will make sure that if you take us as your attorneys, you won’t be in the dark.
Once you are awarded by the state of Louisiana your Medical Benefits, you can choose the doctor who will treat you. Regardless of the kind of medical care and attention you choose to undergo, as long as it is germane to your work-related injury or illness, the employer must shoulder these expenses. Even if traveling for treatment is allowed and must be paid for if you feel that the best treatment will be in some other place. The Medical Director of the Office of Workers’ Compensation Administration will decide if your proposed medical treatment is reasonable and within the guidelines. A judicial review may be filed if in case you want to appeal the Medical Director’s decision. This appeal and judicial review shall also be shouldered by the employer.
What if your employer does not give you the money for treatment then? Get treated on your own, call a lawyer, and ask your employer for reimbursement. They have the duty to do so.
If the employee’s injury or illness requires surgery or admission, the doctor’s office will usually cooperate with the Louisiana Workers’ Compensation insurance company. An investigation will ensue right away. If this is denied, employee may file Disputed Claim for Compensation to the courts. Don’t let this happen. You don’t have to end up disputing in court. We can help you right from the very start so you can get treatment ASAP. Call us at 504-608-6776 today.