hollywoodyed Wrote:Was injured at work severe abd and low back pain went to authorized urgent care was seen by PA x3 and PT x2 pain worsening. Only 1 regular xray done no follow-up PT continues manipulation PA basically says suck it up. Pain is excrutiating meds not helping PT manipulation worsens pain can I go to ER?
In some states if you have designated a treating physician after your initial claim, the comp carrier will deny any other ER visit if it fails to meet the statutory definition of an emergency. In many jurisdictions the Legislatures, through the lobbying efforts of the insurance industry have defined "emeregency" as the a situation which poses a life threatening condition. They will deny it due to the fact that the carrier will state in the denial you have already designated a treating physician.
If you have not designated an initial treating physician you can go to the ER and be sure to give to the ER staff a medical history of the work related injury which brought about the onse of your condiition, so they can document it in the medical records, so that at the time the medical records get in the hands of an adjuster for the insurance company they can see the medical notation ot the work relarted injury describing the event which brought the onset of pain.
If your state allows the employer to designate medical care and you go to the ER without written authorization do so, the insuranc company will deny the bill due to the provider was not authorized to provide you treatment, due to the employer may not have authorized you to seek medical treatment from the medical provider who provided the ER services rendered for your medical condition.
Further, if you are not represented by an attorney many states have what is called an Ombudsman's Department, which will assist injured workers in filing their claim, who are not represented by attorneys, and will walk you through the maze of the process of workers compenasation which your state's Legislature had seen fit to codify into law, commonly known as the comp statutes.
Each state has a Department of Workers Compensation it is within this department where you will fine the Ombudsman's Office.
I hope this helps. I wish you the best of luck.
Sincerely,
Comp8301
If not and the pain is truly severe, go to the Emergency Room