Blog Post

Combating Unfair Independent Medical Reviews

lemaster • September 11, 2015

Workplace injuries can have a long lasting effect even after workers’ comp is paid out. Part of the problem is that worker’s compensation might not give the injured party adequate medical coverage. Often it is recommended that cheaper procedures be utilized over ones more expensive such as surgeries and MRIs. At one time it was easy to fight for better treatment by seeking a doctor’s evaluation, however since 2013, this process has become much more arduous.

Since 2013, the Independent Medical Review (IMR) adjudicates all medical disputes and the right to the Workers’ Compensation Appeals Board has been stripped. Using confusing processes and tight deadlines, it is highly unlikely that an injured worker can rightfully obtain the treatment they deserve. Often the injured party waits until their treatment is denied before consulting with an attorney. By that time it is often too late to start the litigation process. However, if an attorney is brought on early enough in the process there are strategies that can be utilized to get the injured party the proper medical attention they deserve and is often necessary to lead a normal healthy life once again.

Combating the Procedure

With an attorney from the start, there is a much greater chance for success in the appeals process as long as the injured party sustained more than minor damage. The Independent Medical Review will prolong treatments for important procedures such as MRIs and surgery as long as possible so it is important that the injured party act fast in the case of serious injuries. The IMR will inevitably deny these expensive treatments, which allows the attorney to forward this denial to independent doctors to review. The doctors will subscribe their recommended treatment and subsequently will be submitted to the Utilization Review. If the treatment is challenged by the Utilization Review, then the case can be taken to court.

After the court case – if victorious – the client is given the full treatment they required. Without an attorney this procedure is nearly impossible to accomplish due to ambiguous tight deadlines and non-intuitive procedures. With the right attorney – such as Nicholas Sheedy – there is a much greater chance of the injured party receiving the treatment that they need as long as the attorney is brought on from the very beginning.

If you or a loved one has experienced a debilitating injury at work, call the Law Office of Nicholas Sheedy today at 916-604-4291.

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