If there is one thing I wish every injured Illinois worker would know, it’s that insurance companies will play games. One way or another, they are looking for a way to minimize what they pay you, even when it seems like they are doing everything right. A common tactic is to not actually deny care, but say they can’t approve it yet because they don’t have the necessary documentation. Here is a recent email from an injured worker that shows this clearly:
I was hurt at work a few months ago. Workers comp has been cooperating until now. I saw my dr on and he said he wanted to get a cervical spine mri and he has me off work until next Tuesday 7 when he can review the mri with me. When my workers comp case manager was informed she called and told me that they wouldn’t pay for the mri or the days off bc I hadn’t been getting any cervical treatment, she said she looked and couldn’t find anything in the papers. I have all the report forms from my appointments and my therapy orders where it is mentioned numerous times. I’m not looking for any more compensation than what I deserve. I have done everything they have asked me to do and I feel this is mistreatment. Do you think you can help me?
First off, I doubt that they don’t have the records that they need. If the insurance really wanted to get the records, they could do so with a simple phone call. News flash, doctors want to get paid for their care. So if the case manager just called the doctor’s office and asked for supporting documentation, it would be provided ASAP.
But their goal isn’t to find the truth. Their goal certainly isn’t to get you healthy. Their goal is to save money. So many injured workers just throw in the towel because these games frustrate them. It works enough that it’s worth it to these greedy insurance companies to mess with you even when they don’t really have a legal leg to stand on.
The good news usually is that we can help in these situations. Having an attorney does stop some of the game playing, although certainly not all of it. We aren’t asking insurance companies to just give money away. What we want is for them to follow the law and really not to lie. You’d get punished if you were caught lying about your injury. The same should happen to them when they don’t tell the truth about “needing records” or anything else related to your care.
For them, a win is saving some money. They don’t look at it from the standpoint that their “win” could cause you a lifetime of pain due to delayed care. The truth is that while insurance companies do have real defenses to some cases, not approving treatment because they lack records or information is almost always b.s. and a huge red flag that they are playing games.
As always, if you want to speak to a lawyer for free about your case, fill out our contact form or call us at 312-346-5578.