Often times this is not the case.\u00a0 While the injured worker believes they are now in the clear with an accepted claim the\u00a0insurer is just getting started on shutting the claim down with little or no compensation.\u00a0 They will be obtaining any and all potentially relevant medical records. They may be speaking to or writing to your doctor about your prior medical history without your knowledge.\u00a0 They may be setting up an appointment for a mandatory \u201cIndependent Medical Exam\u201d\u00a0to aid closure or denial of the claim.\u00a0 Again, this can all be happening in the background without any notice to you until the denial or closure is issued.<\/p>\n
What many injured workers fail to understand is that the insurance company may authorize medical treatment for quite some time\u00a0without accepting full responsibility\u00a0for a work injury.\u00a0 All the while they are building their case and creating a plan to shut down your claim.\u00a0 If your claim is only accepted for a strain or sprain then your claim could easily be closed or denied with\u00a0just a letter\u00a0or two from the insurer to your doctor.\u00a0 Even if your doctor supports you and wants to help they may be completely unable to do anything if your claim is under accepted.<\/p>\n
There are\u00a0two main ways\u00a0that an insurer will shut down an accepted claim.\u00a0 First, they may push for a closure without an award for permanent impairment. \u00a0The closure will affect your right to compensation and\u00a0will limit your rights\u00a0to continuing medical care. The other way a claim can be quickly shut down is with a\u00a0\u201ccombined condition denial\u201d.\u00a0 This kind of denial is used when a pre-existing medical condition is diagnosed and the insurer takes the position that the current need for medical treatment is due to the pre-existing condition and not the work injury.<\/p>\n
One less common way for a claim to end is with what is called a\u00a0\u201cback-up denial\u201d.\u00a0\u00a0The insurer can deny the claim after acceptance if they can prove that an injured worker obtained benefits through fraud or misrepresentation.\u00a0 If a back-up denial is issued, the injured worker will\u00a0become\u00a0responsible for the bills\u00a0that the insurer has paid for medical services on the claim.\u00a0 This is very infrequently used and claim closure and combined condition denials are far more frequently used by the insurer to end a claim.<\/p>\n
<\/p>\n","protected":false},"excerpt":{"rendered":"
Often times this is not the case.\u00a0 While the injured worker believes they are now in the clear with an accepted claim the\u00a0insurer is just getting started on shutting the claim down with little or no compensation.\u00a0 They will be obtaining any and all potentially relevant medical records. They may be speaking to or writing […]<\/p>\n","protected":false},"author":2,"featured_media":0,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"_angie_page":false,"page_builder":"","footnotes":""},"categories":[53],"tags":[],"class_list":["post-13794","post","type-post","status-publish","format-standard","hentry","category-workers-compensation"],"yoast_head":"\n