Butler Viadro, LLP
Call now: Your first consultation is free
Local: 510-907-9577
Toll free: 888-353-2158
Comprehensive Legal Help After An Injury

Workers' Compensation Carriers Continue to Inject Unnecessary Costs Into the System

California workers' compensation carriers' policies routinely lead to the knee jerk denial and delay or care prescribed by physicians from within their own network or doctors. The result? Unnecessary costs are added to the system and injured workers don't get the care they need.

By way of example, a client of ours has recently received a prescription for one session of physical therapy by a doctor within the workers' compensation carrier's medical network. This single session of therapy would have cost less than $100. The treating physician had requested just one single session of physical therapy to first see whether the injured worker would benefit from same. The insurance company put the request through their internal review process and denied the request (and thereby incurred the cost of doing so). The injured worker's recourse was to appeal the matter to another doctor through a process known in the system as "Independent Medical Review" or IMR. While the exact costs of IMR in this instance is not known, it is expected to be in the neighborhood of $600. Thus, the carrier was willing to spend $600 to try and save $100.

Several months after the application for IMR, the insurance denial was overturned and the injured worker was allowed to get the single session of physical therapy. As a result, the workers' compensation carrier unnecessarily expended monies for the initial review and then paid for the IMR.

For the worker, the delay in physical therapy has had a deleterious effect upon him. Sadly, such an approach to medical treatment in the workers' compensation system is becoming more and more commonplace all the detriment of the system, employers who pay premiums and the injured workers of the state.

No Comments

Leave a comment
Comment Information

Start Your Recovery Today

Bold labels are required.

Contact Information
disclaimer.

The use of the Internet or this form for communication with the firm or any individual member of the firm does not establish an attorney-client relationship. Confidential or time-sensitive information should not be sent through this form.

close

Privacy Policy

email us for a response

Office Location

Butler Viadro, LLP
414 13th Street, 7th Floor
Oakland, CA 94612

Toll Free: 888-353-2158
Phone: 510-907-9577
Fax: 510-287-2401
Oakland Law Office Map