Residents of Jefferson Parish who have workers' compensation claims need to know a lot about why their medical treatment takes so long to get approved through workers' compensation.
Approximately 10 years ago, the state of Louisiana revised its medical treatment procedures for workman's compensation cases. One of the changes was to make all medical treatment uniformed for particular diagnosis so that one doctor would not give a patient totally different treatment for the same diagnosis that another doctor would give different treatment for. In essence, the objective was to make treatment uniform.
In all the years that have passed, it has now evolved to a paperwork system with a Form 1010 that is used by the state that requires a doctor's office to complete and submit, and the insurance company has five working days to approve. Many times, doctors' offices do not have proper staff to complete the forms, and that causes an enormous amount of delays in the worker's compensation system.
Additionally, the insurance companies will use utilization review companies to review the paperwork that the doctor submits. Many times, the paperwork that the doctor submits does not have the complete physical findings of the doctor, and they will reject treatment if it is not documented in the chart what the findings are. This is something called objective-based medical treatment. The purpose is to not have doctors perform treatment on subjective complaints, but on actual physical findings.
If the insurance company still does not approve treatment timely, a form 1009 must be filed with the state, and the state has to review the medical treatment and the medical reports to see if the doctor has complied with all the requirements and the insurance company has delayed things needlessly. This process obviously requires a lawyer sometimes because sometimes the doctors won't timely file the appeals on medical treatment, and the insurance companies may deny certain body parts from the medical treatment that the doctor is proposing. Lawyers can assist you because we routinely see these issues every day, and our skills can help you get the proper medical treatment that you need to get on recovery and your right to work.