When you get injured at work, your employer’s workers’ compensation insurance will pay for your treatment, including surgery, if necessary. That means that your employer’s insurance has the final decision about which doctors treat you. If you disagree with the workers’ compensation doctor, challenging the doctor’s decision or getting your case reassigned to a different physician can be a challenge. It can be incredibly frustrating when you are still having symptoms, but the workers’ compensation doctors insist that you are cured and do not need any more treatment. If you need help challenging the decision of the workers’ compensation doctors about whether you need more treatment, contact a South Florida workers’ compensation lawyer.
Details of Teresita de Jesus Abreu’s Case
At the time of her injury, Teresita de Jesus Abreu was working at Riverland Elementary School in Fort Lauderdale. She suffered a shoulder injury while at work in 2015, and she saw a doctor chosen by her employer’s workers’ compensation insurance, who diagnosed her with a partial rotator cuff tear. The doctor referred her to an orthopedic surgeon who performed the surgery to repair her rotator cuff, and the workers’ compensation insurance paid for the surgery.
After the surgery, Abreu continued to experience pain. She visited an orthopedic surgeon of her own choosing, who recommended that she undergo a second surgery. The workers’ compensation refused to cover the second surgery, because the employer-appointed physician did not think that it was necessary. Abreu filed a lawsuit against Riverland and the Broward County School Board; the judge of compensation claims appointed an expert medical adviser who had not previously been involved with the case to review Abreu’s medical records and determine whether another surgery was necessary. The expert medical adviser, agreeing with the workers’ compensation doctors, decided that the second surgery was not necessary. Therefore, the judge ruled that workers’ compensation should not pay for Abreu to have the new surgery.
Abreu’s attorneys filed an appeal. Their arguments for reversing the trial court’s decision dealt with some issues related to the procedure of workers’ compensation cases. For example, they argued that the weight the law grants to expert medical advisers’ opinions constitutes a violation of due process. Nonetheless, the appeals court affirmed the trial court’s decision and refused to cover Abreu’s second surgery. Abreu intends to take the case to the Florida Supreme Court.
You Know Your Symptoms Best
Workers’ compensation insurance companies, like other kinds of insurance companies that deal with medical treatment, are in the business of paying injured people as little as possible. Don’t be surprised if the doctors appointed to your case act like your injuries are less serious than they are or require less treatment than they do. You have the right to challenge these denials of coverage; a lawyer can help you do this.
Let Us Help You Today
A workers’ compensation lawyer will stand up for you if your employer’s workers’ compensation insurance refuses to give you the treatment you need. Contact a Sunrise workers’ compensation lawyer at the Law Offices of David M. Benenfeld for help today.
Resources:
news.wgcu.org/2019-07-10/workers-comp-case-goes-to-supreme-court
www.wlrn.org/post/workers-comp-law-upheld-appeals-court#stream/0
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