Medical Treatment: How Important Is It For A Workers’ Compensation Claim?

The Importance of Medical Treatment for a Workers’ Comp Claim

Welcome back to the Inland Empire Workers Compensation Lawyer live stream and podcast. My name is Attorney Alexander Napolin. I’m joined by my co-host, Attorney Jorge Ibuado. Every week we discuss a new topic in workers’ compensation law and employment rights. That’s meant to help you if you’ve been injured at work. So in this episode, episode number 30, we’re discussing the importance of medical treatment for your workers’ compensation claim. So if you’re a worker, and you’ve been injured at work, and you need medical treatment, we’re going to discuss why that treatment is so important that you have it and follow through with it. And maybe some circumstances where you might not follow through with it and what the consequences will be. So with that said, George, what’s the importance of medical treatment for a workers’ compensation claim?

Medical Treatment Strengthens a Workers’ Comp Claim

I think it’s one of the most important things right, a lot of people worry about their benefits, are they going to be paid while they’re off of work. But I think the medical treatment’s more important, for two reasons. First, you want to get back in that workforce as much as possible, you want to be able to get better and get back to work. And the medical treatments going to help you do that, if something’s recommended by your doctor, you should definitely follow that advice, because it’s gonna get you to the end line faster. But second of all, is, is going to kind of reduce whatever secondary effects you might experience in the future, if you can nip those in the bud and you get the proper treatment, you might not have to undergo further medical treatment for the same type of issue in the future. Not to mention, as you know, if you don’t get medical treatment, not only are you gonna feel worse, but it decreases the value of your claim, because now you’re telling the doctors, you’re telling the insurance company, you’re telling everyone, “I don’t really need to treat for this claim,” even if you do even if you feel horrible, but you don’t want to go, the message is, “I really don’t need the treatment because I’m not getting it. And I’m not following it.”

Medical Treatment Proves your Injuries

Right. So you hear that people if you’ve been injured at work, one of the main components of your workers’ compensation claim is to get the medical treatment that you need to get better, and get back to work. And if you don’t get that treatment, you’re not going to get better. And also people like your employer, the insurance adjuster, they may not believe that you’re really injured, because you do need medical treatment to prove your injuries, especially with injuries that aren’t visible on the outside. Like back injuries, internal derangement of the knee, shoulder injuries and things like that. So it’s very important that if you’ve been injured at work, you go get that medical treatment, not only to get better, get back to work, but also to take advantage of those rights and prove your injuries.

A Trusted Doctor will Help Secure your Benefits

Right. And I always tell my clients, Alex, that the doctor is your trusted partner in this journey. Okay. And what I mean by that, I don’t mean that he’s going to say whatever you want him to say that’s not his job. But his role is to listen to you. Take your complaints, make sure they’re verifiable either through objective reports or subjective accounts. But make sure that there’s something there, make sure you tell them what’s going on, so that they can interpret that and then put it on the medical report, which we will get, the insurance company will get, ultimately maybe a neutral doctor might get, but they are your trusted partner in this journey, in that they are supposed to be doing what’s best for you now, is that always the case? Alex, are the doctors always looking out for your best interest?

Introduction to the Industrial Medical Clinic

The answer is definitely no, they’re not always acting in your best interest. Now, that doesn’t mean they’re acting against you, right. But it may mean that they don’t have your best interest at heart. They’re just trying to get you, because these industrial clinics, the way that it’s set up, is that workers’ compensation is for injured workers and injured workers are supposed to get better and go back to work. So the industrial clinic and the doctors that you’re sent to by your employer are going to be pushing for that. That’s what we discussed on our very first episode. We’re now on episode number 30, our first episode of Inland Empire was on treatment at the medical clinic. So, I do advise, we’ll put a link up right here to our first video. And you can check that out. Maybe they don’t have your best interests at hear right? And that’s why maybe you need to consult with a lawyer. Jorge, what can a lawyer do to help advance your medical treatment within workers compensation?

Experienced Workers’ Comp Lawyers Help With Choosing Your Doctor

Well, as you know, Alex, we work with many of the very best doctors here in Southern California. We’ve worked with them for a long time. So we know that they’re skilled, we know that they have great bedside manner, we know that they’re the ones that are going to be able to assess your injuries properly, correctly, truthfully, and be able to put it in a report that’s going to be substantial medical evidence. So because we do work with these doctors, and by work, I mean, send them clients and make sure that they take care of those clients, we’ll be able to find a doctor in your area that can best look after your best interests.

Introduction to the MPN (Medical Provider Network)

So, if you’re out there, and you’re concerned that you’re at the industrial clinic, you’re watching this video because you’re concerned about the importance of Medical Treatment in workers’ compensation, your employer has a medical provider network, and you have access to a much larger list of doctors than wherever your employer is sent you. That’s what Jorge is discussing. Our knowledge of these lists, we can get the list, we can look through the list and help you make a decision on who will be your primary treating physician. That’s gonna help you get more medical treatment, hopefully, get reports that will substantiate your injuries and then also write you off of work, give you work restrictions that are real work restrictions, not like whatever the industrial clinic just decides to give you. But actually, the doctor listens to you, and then gives you restrictions that are appropriate for your injury. And I think we should touch base on the importance of following up with medical care that’s provided to you. Jorge, what’s the importance of following up with medical treatment that the insurance company is authorizing?

Don’t Outright Deny Treatment During a Workers’ Comp Claim

Their job during a workers’ compensation claim is to get medical treatment, and then not only get the medical treatment, listen to your doctor’s advice, listen to your attorneys advice, and follow through with whatever they’re recommending, especially if it’s already approved. That’s something they should definitely do. I don’t know why people ask, “Do I have to go to this appointment?” “Do I have to go to this physical therapy appointment?” My answer is always yes. I mean, unless you somehow are in an emergency and you can’t go, you can always call and reschedule. But don’t just miss a doctor’s appointment, because you don’t want to go. You know, if it’s raining outside and you want to go in the rain, that’s not a good enough reason, you have to go to your doctor’s appointments. That’s your number one job. Your second job, there’s a little sidebar here, is obviously don’t do things that will disprove and discredit your claim. As we discussed in one of our episodes, Sub Rosa can be very real, it’s definitely real, but can happen to you. So they could be videotaping you. So if your doctor recommends that you don’t lift above a certain weight, if you don’t do a certain thing, don’t go out there and just do it everywhere. Don’t just always be going against your doctor’s recommendations, because once again, that’ll discredit your claim. And that’ll lower the value of your claim.

A Note on Sub Rosa Evidence

Sub Rosa evidence is surveillance evidence that your employer will send someone out into the world to videotape you, and then go show that to your primary treating physician to the qualified medical evaluator, which is your second opinion doctor or to the judge, ultimately, to discredit you, basically say you’re lying, and hurt the value of your case significantly. But what about surgery, Jorge? What about when someone says, you know, you say you should go get a physical therapy, you can’t miss it. But is surgery potentially an exception to this rule is there maybe a situation where someone would not go get that surgery?

Denying Treatment could Hurt Your Workers’ Comp Claim

I’m very glad you brought that up, Alex, it’s something that happens very often. I mean, all too often is maybe a doctor, whether it’s your PTP or a panel doctor is recommending surgery, and you might have already gotten it approved by the insurance company. Now, this is a very good situation to be in. I mean, the insurance company sometimes lollygags on surgery and approvals. But if you got it approved, that means that they authorized for you to go through with that surgery. Now, you might not want to go through with that surgery, it could be a plethora of different reasons why you might not want to go through with that surgery. Maybe, you don’t want to do it now, you’d rather do it later. Maybe you’re scared of the surgery, maybe you don’t trust the doctor that you had the surgery scheduled with. Whatever the case is, my recommendation to my clients, Alex, is never never say you don’t want to do the surgery. If they tell you that you need surgery, and it gets approved, great. Speak to your attorney and say “I would rather not have the surgery,” then you and your attorney can discuss your options. It might be your best option to have the surgery and your attorney will say “You know what, I understand you don’t want to have the surgery. But these doctors, these experts, these specialists are recommending for you to have the surgery, if you want to continue with a better quality of life. I recommend you have it.” Okay, that’s that’s one discussion. Another discussion is, maybe this approval of surgery is going to help you with the value of your claim. You can throw that on into the future medical and say, “Well, you know, my client is authorized for surgery. They want to have it at a later date.” But that adds that value of the surgery to your claim if you want to settle your claim via compromise and release which we discussed. So there’s a lot of options for you if you have a surgery approved or even recommended. Never say you don’t want surgery, speak to your attorney about it. You can let them know you don’t want surgery. And then they can give you your best options and you don’t have to have surgery, but never outright say that you don’t want a certain medical treatment.

How an Experienced Workers’ Compensation Lawyer Can Help

Well put. I think that there’s a lot of people out there who just have a knee jerk reaction against surgery. “Oh, I would never have that” or “I don’t want anybody cutting myself open.” I think that every individual injured worker has to assess that situation before speaking the words “No, I would never have it.” What’s the seriousness of the injury? Are you going to have work restrictions when you go back to work that’s going to displace you If you don’t have the surgery? In other words, not having the surgery might lead you to being given permanent work restrictions, because you didn’t get better enough, and now you can’t go back to work, right? And also, if you’re at a qualified medical evaluation, if you’re at a second opinion doctor, and you tell that doctor, “I would never have surgery” that might cue to that doctor that might lead that doctor to say that you’re not surgical at all right? Which then you’re not going to get that in your future medical care, the insurance company’s not going to consider that as a real exposure to the claim. Although it’s questionable whether or not that would be the ultimate decision by the judge to not give you the surgery. If your primary treating physician saying you need it, maybe you would get it. But the value of your claim could be damaged. If you just knee jerk reaction, say, “Oh, I’d never have surgery,” when doctors actually are saying you potentially need it. Right. So I think that covers everything we want to discuss on the importance of medical treatment for injured workers. You should be aware of the industrial medical clinic, you should be aware that you have other options for treatment, you should go to your treatments, they’re very important. And surgery: saying no as a knee jerk reaction, it’s probably not a good idea for the overall situation of your claim. Now a lot of injured workers, they have denied claims. So if you’re out there and your employer is not giving you any medical treatment at all, it’s time to call a lawyer. If you are maybe potentially getting surgery, or you’re concerned about ongoing medical care, time to call a lawyer. That’s why you dial the Injury Helpline: 844-984-8414.

Remember that discussions we have here on the Inland Empire workers’ compensation Lawyer livestream podcast are general in nature only. They’re entertainment, they’re educational. They’re meant to help you broaden your perspective, understand your situation better, but it’s not legal advice. If you need legal advice, you need to reach out to us by dialing 844-984-8414.

Learn more about your rights as an employee in California: www.workerscomplawyerie.com