Two Times An Employer Can Interfere With Employees' Medical Treatment
Employees who are injured on the job are entitled to receive appropriate medical care from qualified healthcare providers and have the cost paid by the workers' comp insurance program. Generally, employers don't have a say in how this care if provided, but here are two special circumstances when the type of care hurt employees receive is decided by the companies they work for.
The Employer is Self-Insured
Almost all states require employers to carry workers' comp insurance to cover employees who get hurt while working. However, one way companies can get around this obligation is by self-insuring. In this scenario, the company would responsible for paying the costs associated with employee injuries.
Although this may be a little more convenient for employees—since they only have to deal with their HR departments or equivalent—it can be highly problematic for them in a number of ways. Specifically, the employer can dictate where employees can go to get medical care and can approve or deny treatment as it sees fit. As you can imagine, this can lead to employees having to jump through hoops to get the care they need or suffering wrongful denials.
Unfortunately, there isn't much employees can do about this particular situation except fight back if they feel like they're being treated unfairly. This is why it's important to hire a workers' compensation attorney who can help you push back against an employer who may be trying to save money by denying treatment without adequate justification.
The Employer Belongs to an MCO
Another way employers can limit workers' medical option is if they're part of an MCO or managed care organization. An MCO is a private organization designed specifically to handle the medical needs of injured employees. When a person is hurt on the job, the employer can require the individual seek out treatment only from healthcare providers who are a part of the MCO network; otherwise, the employee would have to pay out of pocket for care from an out-of-network provider.
Although they're supposed to operate independently of their member companies and workers' compensation, their close relationship with both can lead to employees receiving poor care or unfair treatment decisions. Luckily, though, since these organizations are private, employees have a little more power in that they can often appeal denials to a higher authority if they feel the decision in their cases was unwarranted.
Still, though, it's best to connect with a workers' compensation attorney who is knowledgeable about these types of alternate insurance options. He or she can provide you with advice on and assistance with getting the best care possible after your accident. For more information about these or other workers' comp issues, contact a lawyer in your area.
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