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Michael J. Doyle, Attorney At Law Michael J. Doyle, Attorney At Law
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What is Medical Treatment Authorization for Worker's Compensation?


If you are injured on the job, you can receive compensation through your employer’s workers’ compensation insurance, right? While that is the theory behind the program, getting the medical treatment that you need may not always be that simple. After a claim has been approved, an insurance company may refuse to authorize needed treatment, leaving victims to pay for costs out-of-pocket.

Why Is My Claim Being Denied?

At the end of the day, an insurance company is a business which watches its bottom line. Insurance adjusters may be looking for any evidence which allows the company to minimize costs. Even after your claim has been approved, each medical procedure may be subjected to intense scrutiny and its necessity contested. A specific treatment may be contested if you did not seek medical care immediately or a doctor did not accurately note the full extent of your injuries.

The degree to which a victim is able to accurately communicate and document injuries can greatly impact the overall success of the claims process. For example, assume you go to the doctor for a back injury and mention that your neck also hurts. The doctor focuses on the back injury and acknowledges your additional complaints without taking any notes. Later the pain in your neck worsens and it is discovered that there is damage to a disk. However, because your doctor did not initially make a note, the insurance company argues against approving procedures to treat that injury.

Tips for strengthening a worker’s compensation claim include:

  • Report the injury to your employer and file a claim as soon as possible
  • Take pictures, videos, and record witness testimony to document your injuries
  • Seek medical treatment in a timely manner; ensure doctors document your injuries
  • Secure copies and review all medical records for accuracy and to resolve misunderstandings
  • Contact an experienced workers’ compensation injury claims attorney

The inability to get the care you need due to a lack of insurance authorization can be tremendously frustrating. While following the steps above can help to see your medical treatments are approved, you may be left to fight for the benefits you need. If you believe that you are being unfairly treated during any step of the workers’ compensation insurance process, it may be time to get an attorney involved.

Fight for Your Claim

In the wake of a workplace accident, the last thing you need to worry about is that your medical treatment may be denied to an administrative technicality. At Michael J. Doyle, Attorney at Law, our legal team believes that all injured workers deserve fair access to medical treatment. Our Albuquerque personal injury attorney possesses more than a decade of legal experience and can help you to ensure that your voice is heard. If you’re health lies in the balance, let us fight for the medical care that you deserve.

Call (505) 219-2176 to request a FREE case evaluation and discuss your claim with an attorney.