If your surgery was denied by the workers’ compensation insurance company after a work injury, you are not alone. Even when a doctor clearly recommends surgery, insurance companies often deny approval. A denial does not mean the decision is right, and many surgery denials can be challenged and reversed with the help of an experienced workers’ compensation lawyer.
Here are three important steps to take if workers’ comp will not authorize your surgery:
1. Get copies of all your medical records
Workers’ compensation insurance companies often deny surgery by claiming they do not have enough medical information. This includes saying records are missing, incomplete, or unclear.
Request copies of all medical records related to your work injury. This includes doctor visit notes, imaging reports, and treatment history. Having complete records helps remove one of the most common reasons surgery is denied.
2. Get a clear written recommendation from your doctor
Meet with your treating doctor and ask for a written statement explaining why surgery is medically necessary. The recommendation should clearly connect the need for surgery to your work injury and explain why other treatments are no longer effective.
Your doctor should also explain what risks come with delaying surgery. A clear written medical opinion is critical when challenging a workers’ compensation surgery denial.
3. Talk with a workers’ compensation lawyer
When surgery is denied, a hearing is often required to force the insurance company to approve treatment. Hearings involve medical evidence, legal standards, and strict deadlines.
Speaking with an experienced workers’ compensation lawyer early can help protect your rights and avoid unnecessary delays.
Call Donahoe Kearney Today
If workers’ compensation denied surgery after a work injury, getting legal guidance early matters. Delays in treatment can slow recovery and make injuries worse.
Call 202-393-3320 or book your free consultation here: Book Free Consultation.