According to South Carolina law, injured employees are entitled to all medical treatment that “tends to lessen their degree of disability.” In other words, your employer’s insurance company must pay for all medical care that helps you heal after an on-the-job accident. Because the workers' compensation insurance company is paying for your treatment, they often attempt to control which doctors you see. While insurers have a right to participate in the selection of your doctors, this right is not absolute. Furthermore, treating physicians rather than insurance adjusters, should decide which tests, therapies, and procedures are necessary for your health. All medical treatment that an authorized treating physician declares necessary to lessen your degree of disability, must ultimately be approved and paid for through workers' comp.
Taking Your Case Before the SC Workers' Compensation Commission
Nonetheless, insurance carriers often disagree with doctor’s findings and refuse to authorize necessary medical care. When this occurs, we file for a hearing before the SC Workers’ Compensation Commission. If the insurance company continues to dispute the need for treatment, we will present the medical evidence along with your testimony at the hearing. A judge will then decide whether the test or procedure should be approved. The process of filing for a hearing, having it placed on the docket, appearing before the Commission, and having treatment ordered, can take months. During that time, your injury might worsen. In the long run, delaying necessary medical care often increases the amount of money an insurance company will have to pay you.
Understanding "maximum medical improvement"
When a doctor finds that additional medical treatment will do nothing to improve your condition, she will declare that you have reached “maximum medical improvement” (MMI). Reaching MMI does not mean future medical care is unnecessary. Instead, it is an indication that such care cannot relieve you of permanent impairment.
When an injured worker achieves MMI, the treating physician will issue findings pertaining to an impairment rating and the need for future treatment. If certain tests, medications, therapies, or operations beyond the date of MMI would “lessen the period of disability,” the insurance company must pay for such them. In other words, the law gives injured employees the right to all treatment that makes them better and keeps them well.
Contact My Office Today
As an attorney, I have dedicated myself to injured workers’ health and recovery. Everyday my firm works to ensure our workers’ compensation clients receive the treatment they need from doctors they trust. When insurance companies refuse to follow the law, we are prepared to hold them accountable. For answers to your questions, and to find out how we can help, call my Columbia, SC office today at 803-790-2800. Consider requesting my free book, Your Guide to South Carolina Personal Injury & Workers' Compensation, for even more helpful information.