If you’ve been injured at work, one of your first concerns is getting the medical treatment you need. Unfortunately, many injured workers are surprised to learn that Missouri workers’ compensation rules can affect where they receive treatment and which doctor they see.
Understanding your rights regarding medical care is important because the treatment you receive can impact both your recovery and your workers’ compensation claim. Here’s what you need to know about medical treatment in a Missouri workers’ compensation case.
Who Pays for Medical Treatment After a Work Injury?
Under Missouri workers’ compensation law, employers are generally responsible for providing medical treatment that is reasonably required to cure and relieve the effects of a work-related injury.
This can include:
- Emergency medical treatment
- Doctor visits
- Hospital care
- Diagnostic testing such as MRIs and X-rays
- Physical therapy
- Prescription medications
- Surgery
- Specialist referrals
- Follow-up medical care
When treatment is authorized and related to your workplace injury, the workers’ compensation insurance carrier should pay the medical expenses directly.
Medical benefits are often one of the most valuable parts of a workers’ compensation claim because they can cover treatment costs that would otherwise create a significant financial burden for injured workers and their families.
What Should You Do Immediately After a Workplace Injury?
The steps you take after an injury can affect both your health and your workers’ compensation claim.
If you’re injured at work:
- Report the injury to your employer as soon as possible.
- Seek emergency medical treatment if necessary.
- Follow your employer’s instructions regarding medical care.
- Attend all scheduled medical appointments.
- Keep records of your symptoms, restrictions, and treatment.
- Follow your doctor’s recommendations whenever possible.
Prompt reporting and treatment can help establish a clear connection between your injury and your job duties.
Can I Choose My Own Doctor?
One of the most common questions we hear is, “Can I see my own doctor?”
In Missouri, the employer and its workers’ compensation insurance company generally have the right to select the authorized treating physician. This means they choose the doctor who will provide treatment for your work injury.
While many authorized physicians provide quality care, injured workers are often frustrated to learn they cannot simply schedule treatment with their family doctor and expect workers’ compensation to cover the cost.
If you seek treatment from a doctor who is not authorized by the employer or insurance company, there is a risk that those medical expenses may not be covered.
Because every case is different, it is important to understand your rights before seeking treatment outside the authorized workers’ compensation system.
What Is an Authorized Treating Physician?
An authorized treating physician is the doctor selected by the employer or workers’ compensation insurance carrier to manage your medical care.
This physician may:
- Diagnose your injury
- Recommend treatment plans
- Prescribe medications
- Refer you to specialists
- Determine work restrictions
- Evaluate your ability to return to work
- Assess whether you have reached maximum medical improvement (MMI)
The opinions of the authorized treating physician often play a major role in workers’ compensation claims. Medical records, treatment recommendations, and work restrictions can all impact the benefits available to an injured worker.
What If I Need a Specialist?
Many workplace injuries require treatment beyond a primary physician.
Depending on your injury, you may need care from:
- Orthopedic surgeons
- Neurologists
- Pain management specialists
- Physical therapists
- Occupational medicine physicians
- Hand specialists
- Neurosurgeons
In most cases, referrals to specialists must be authorized through the workers’ compensation system. Delays in obtaining specialist care can slow recovery and prolong time away from work.
If a specialist referral is denied, an attorney may be able to help evaluate your options.
What Happens If Treatment Is Delayed or Denied?
Unfortunately, disputes over medical treatment can arise during a workers’ compensation claim.
Some common issues include:
- Delays in scheduling appointments
- Refusal to authorize specialist referrals
- Denial of recommended surgeries
- Disputes regarding diagnostic testing
- Refusal to approve medications
- Termination of treatment before recovery is complete
When treatment is delayed or denied, injured workers may experience ongoing pain, worsening symptoms, and uncertainty about their future.
If you believe necessary medical care is being withheld, it may be beneficial to speak with a Missouri workers’ compensation attorney about your situation.
Can I Change Doctors During My Claim?
Changing doctors in a Missouri workers’ compensation case can be challenging because the employer generally controls the selection of authorized medical providers.
However, concerns sometimes arise regarding the quality of treatment being provided. Injured workers may feel their symptoms are being minimized, necessary testing is not being ordered, or recommended treatment is being delayed.
When these situations occur, legal guidance can help injured workers understand their rights and determine whether additional medical opinions or legal remedies may be available.
What Happens if I Miss a Medical Appointment?
Missing appointments can create problems for both your recovery and your claim.
Insurance companies may argue that missed appointments demonstrate a lack of cooperation with treatment recommendations. In some cases, missed visits can delay benefits or create disputes regarding the severity of the injury.
If you cannot attend an appointment, notify the medical provider as soon as possible and reschedule promptly.
Will Workers’ Compensation Pay for Surgery?
If surgery is considered medically necessary to treat a work-related injury, workers’ compensation may cover the procedure.
However, surgery recommendations are often reviewed by insurance companies before authorization is granted. Disputes can occur when insurers question whether a procedure is necessary or related to the workplace injury.
These disagreements can delay treatment and may require legal intervention.
Can Workers’ Compensation Cover Physical Therapy?
Yes. Physical therapy is commonly provided as part of a workers’ compensation treatment plan.
Therapy may help injured workers:
- Improve mobility
- Reduce pain
- Rebuild strength
- Return to work safely
- Avoid more invasive procedures
As with other forms of treatment, physical therapy generally must be authorized through the workers’ compensation system.
How an Attorney Can Help Protect Your Medical Care
Medical treatment is often the foundation of a workers’ compensation claim. Without proper care, injured workers may struggle to recover physically and financially.
An experienced workers’ compensation attorney can help:
- Address treatment delays
- Challenge denied medical care
- Evaluate disputes involving authorized physicians
- Protect your right to benefits
- Ensure your claim is handled properly
At The Hines & Wilson Law Firm, we help injured workers throughout Missouri navigate the workers’ compensation system and pursue the medical care and benefits they deserve.
Call or text today for a Free Consultation.
If you’ve been injured on the job and have questions about medical treatment, denied care, or your workers’ compensation claim, contact The Hines & Wilson Law Firm today.
Our team can review your case, explain your options, and help you understand the next steps available to protect your health, your recovery, and your future.
