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Who decides what treatment you need under workers’ compensation?

On Behalf of | May 18, 2021 | Workers' Compensation

The quality of medical care that you receive after a workplace injury will directly influence how well you recover. Workers suffering from a traumatic injury or a repetitive stress injury often require weeks of time away from work or altered job responsibilities to allow an injured body part to heal. Physical therapy, medication or even surgery can also help a worker recover.

It can cost thousands to get the necessary care and much more in missed wages for a worker to recover from an injury suffered due to their employment. Who determines the care that a worker receives when they make a claim for medical coverage under the Ohio workers’ compensation program?

The Managed Care Organization establishes what care is necessary

Ohio employers have to contract a Managed Care Organization (MCO) to oversee workers’ compensation claims. They report the claims, review records from individual claims and make payments for necessary treatment.

An MCO effectively has control over what care an injured worker receives through workers’ compensation. Typically, an MCO will approve care recommended by a physician for the treatment of a work-related medical condition. However, it may be possible that the MCO overseeing your claim disagrees with you or your doctor about the care necessary.

What happens during disputes about workers’ compensation care?

An MCO, like your employer, will have an incentive to keep expenses with a claim as low as possible. Low costs don’t always translate to adequate care for injured workers. If your MCO won’t approve care that you need to fully recover, you don’t have to suffer without the treatment you need to get back to work.

When there is a disagreement about the care necessary for a worker’s recovery, a workers’ compensation attorney can help resolve the conflict. Your lawyer can advise you of your rights and help you obtain any further necessary medical treatment.

Knowing how to advocate for yourself during a workers’ compensation claim requires that you first understand your rights. It can be hard to get the medical care and support you need after a workplace injury, but partnering with an experienced workers’ compensation attorney can protect you from unfair treatment during a workers’ compensation claim.