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Insurance Company Crisis: What Workers’ Comp Will (and WON’T) Cover

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You recently received your first workers’ compensation payment in the mail. It’s not much, but it will allow you to pay rent and buy groceries while you wait for your upcoming doctor’s visit. At least insurance will pay for that appointment, right?

Maybe not. Many injured employees in California face a number of workers’ comp insurance issues as they struggle to overcome their injuries, largely because the insurance system is allowed to dictate what care they receive.

Here are a few California health care systems that make it more difficult for injured workers to get much-needed treatment:

  • Multiple Provider Networks – Doctors in these networks are paid directly by insurance companies, creating a considerable conflict of interest when it comes to patient health. While many of these doctors are good health care providers, they are working for their bosses and not for you.
  • American College of Occupational and Environmental Medicine Guides – Since most diagnostic testing is expensive, health care professionals are encouraged to turn down testing requests if there could possibly be another explanation for suffering.
  • Utilization Review – Doctors in multiple provider networks may be reprimanded or even fired if they order too many tests for a patient, or acknowledge that the injuries may require further treatment.
  • Independent Medical Reviews – Even if you do voice your concerns about your medical treatment, any disputes you bring forward will take weeks or even months to be heard (and even longer to resolve).

At the Ledgerwood Law Group, we have experience in sorting out workers’ comp insurance issues and getting our clients the care they deserve. Call us today at 888-761-7383 to find out how we can help you, or click the link on this page to get a FREE copy of our book, The Northern California Workers’ Compensation Survival Manual.

Category: Worker's Compensation


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