Medical Treatment in Rock Hill Workers’ Compensation Cases
Medical treatment is one of the most important benefits available in Rock Hill workers’ compensation cases. Injured workers may qualify to have all of their medical expenses paid for, but insurance companies are often reluctant to cover certain treatments. If you are struggling to receive the benefits you need, consider seeking help from a qualified workers’ comp attorney.
Common Injuries and Treatment in Rock Hill
The kinds of injuries that can lead to a valid workers’ compensation claim vary depending on the type of work an individual does. In Rock Hill, most injuries involve lifting, twisting, bending, stooping, falling, and tripping. Workplace accidents can cause injury to the brain, back, shoulder, or joints. Some injuries do not occur in one distinct accident but rather accumulate over time due to repetitive work. These are known as repetitive-trauma cases, and they can also be covered under workers’ compensation.
Unfortunately, insurance companies have almost complete control in workers’ compensation cases. They get to decide which medical providers they will authorize, and the worker has to follow the recommendations of the treating physician. Many times, the companies want a second opinion if they do not agree with what the doctor recommends or do not want to pay for it. They will try to send the individual to another doctor and recommend what treatment they need.
There is an emergency exception, however. For example, if the individual is involved in a car wreck while working and transported to the hospital by ambulance, the insurance company will cover it.
Challenging the Insurance Company’s Recommendations
If the injured employee does not agree with the insurance company’s decision or recommendations, they can request a second opinion. If the insurance company does not approve of the doctor the individual wants to see, the individual can ask the South Carolina Workers’ Compensation Commission to order the insurance company to authorize the visit.
In some cases, injured workers feel that their medical treatment has been insufficient. For example, the doctor may have been persuaded by a nurse case manager, and the worker may not feel like the doctor is on their side. In those situations, the individual’s lawyer will often ask the insurance company to recommend a different physician.
What is Maximum Medical Improvement?
Maximum medical improvement is when someone has reached a point in their treatment at which their condition is unlikely to improve further. No additional medical treatment is recommended by the doctor that will lessen their disability. At this point, the individual’s physician assigns an impairment rating based on American Medical Association (AMA) guildeines.
The impairment rating is used to determine their disability rating, which reflects the person’s ability to work. In South Carolina, the injured worker could be entitled to additional disability compensation based on their disability rating. If they cannot return to their previous job but can work in some capacity, they could receive permanent partial disability benefits. If they are completely unable to work, they could receive permanent total disability.
Let a Rock Hill Attorney Help You Seek Medical Treatment
If you were hurt in a Rock Hill workplace accident, you may be entitled to all necessary medical treatment under your employer’s workers’ compensation insurance policy. Unfortunately, insurance companies can become difficult to work with over time, and you may find your claim denied. For help pursuing the benefits you need, call Schiller & Hamilton today.