Insurance Companies Playing Doctor

By: Kevin Kampschror, Esq.

If you are injured at work, you will have to deal directly with an insurance company through an adjuster. However, if you retain an attorney, you will never have to deal with adjuster unless there are extremely extenuating circumstances as your attorney will be the contact point for you. Either way, you may encounter an adjuster attempting to use the medical degree or the medical training that they do not have. The final outcome of this is that you may not get the treatment you need and are entitled to, and you may be leaving thousands of dollars on the table.

Being represented by an attorney is very important for this very reason. You may not know that the doctor is ordering testing such as EMGs or MRIs, only to have the adjuster make an arbitrary decision to deny the treatment, citing whatever reason they see fit on their determination letter. Alarmingly, this does not only happen when there are competing doctor’s opinions on what the treatment should entail under the claim. In fact, there could be a consensus amongst multiple doctors that you require certain treatment and the adjuster still has the power to deny the treatment. The only remedy the injured worker has is to file an appeal, wait to go to court, and then wait for a decision (that the insurer will then have thirty-three (33) days to comply with).

Does that sound unfair? It is.

To speak with a Las Vegas workers’ compensation attorney about your case, please contact us today.


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