What Happens If You Seek Treatment on Your Own Because the Workers’ Compensation System Kept You Waiting Too Long?

Having health insurance that will pay for your treatment is nice, but all the bureaucratic red tape that goes with it is not.  Many employees choose the employer-provided health insurance option that gives them the greatest flexibility regarding which doctors they can visit, even if it costs more.  When you are sick or injured and waiting for a diagnosis or treatment, having to wait weeks or months for a doctor’s appointment can be incredibly frustrating.  The frustration of waiting and jumping through bureaucratic hoops is a normal part of getting treatment for work-related injuries.  Sometimes the fact that your employer’s workers’ compensation insurance is paying for everything makes it easier to be patient, but some people find that they cannot tolerate their symptoms for as long as it would take to see a workers’ compensation doctor, and they seek treatment at their own expense with a doctor who will see them sooner.  Doing so makes your workers’ compensation case more complicated, but it does not take away the right to have workers’ compensation cover your work injuries.  If you are getting frustrated with workers’ compensation referrals taking a long time, contact a South Florida workers’ compensation lawyer.

Brian and the Unbearably Long Wait

Brian, a police officer, injured both of his quadriceps tendons while at work in 2007.  He filed a workers’ compensation claim, and the workers’ compensation doctors prescribed anti-inflammatory medications.  Since these medications have stomach irritation as a side effect, the workers’ compensation doctor also prescribed Zantac to help manage the side effects of the other medications.  Brian subsequently developed gynecomastia (an over-development of the male mammary glands) as a side effect of the medications.

In 2009, Brian filed a claim requesting treatment of his gynecomastia, and the workers’ compensation doctor who examined him determined that the drugs prescribed for his work injury were not the cause of the condition.  Therefore, his employer denied the claim.  Brian requested to have an expert medical advisor (EMA) assigned to his case to determine the cause of his gynecomastia, and it took until September 2010 to find a doctor willing to take on the task and until January 2011 for Brian to get an appointment.  Brian missed his appointment, and the judge of compensation claims (JCC) scheduled a status conference for his case.  At the conference in February 2011, Brian submitted medical records from his own doctor, who had corrected Brian’s gynecomastia with surgery.  The JCC then decided that all of Brian’s claims were moot, since he had already undergone treatment.  Brian appealed the ruling, and the appeals court ruled to reopen his case.  This left the door open for Brian to get his employer to pay for treatment, but it would require a lot of hassle.

Contact Us Today for Help

A Sunrise workers’ compensation lawyer will help you if your employer has paid for your treatment but now refuses to pay to enable you to manage the side effects of that treatment.  Contact the Law Offices of David M. Benenfeld for help with your case.

Resource:

scholar.google.com/scholar_case?case=15252483252653802253&q=judge+of+compensation+claims+Palm+Beach&hl=en&as_sdt=4,10&as_ylo=2010&as_yhi=2020