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What if an injured worker doesn’t agree with their treatment plan?

When a worker gets hurt on the job in Missouri, they can usually file a claim for workers’ compensation benefits. Those benefits can cover their medical treatment expenses and help replace their wages. However, the worker will need to abide by several rules to continue receiving benefits.

For example, they will need to undergo treatment provided by the physician selected either by their employer or the insurance company managing their care. The only exception to this rule is when someone requires emergency care and cannot wait for a recommendation from their employer or insurance company. For ongoing care, they will have to defer to the wishes of their employer or the insurance company.

They will also need to follow the physician’s instructions and abide by the treatment plan. Failure to do so might leave a worker ineligible for future benefits. Sometimes workers become medically non-compliant because they do not agree with the recommended course of treatment suggested by a physician. Instead of ignoring “doctor’s orders” outright, it’s important that a worker responds to a dispute about what treatment is appropriate in specific ways.

They can request a second opinion

Technically, the workers’ compensation program in Missouri does not require insurance or employer payments for second opinions. However, when someone has a valid reason for challenging a physician’s recommended plan of care, the insurance company may sometimes agree to pay for an appointment with another physician. A second opinion that leads to less invasive treatment could save the business money, making it a savvy choice to approve the request

Even if the company will not pay for a second opinion, hurt workers may find it worthwhile to cover the cost of an outside medical evaluation on their own. They could then use the report from that appointment when negotiating with their physician or the insurance company about the proposed treatment plan.

Particularly in scenarios in which a worker asserts that they have not improved enough to return to work or where they don’t want to undergo invasive treatments, like surgery, a second opinion could make a massive difference to their situation. Ultimately, learning more about the rules that govern workers’ compensation benefits in Missouri may help those in need of coverage better assert their rights.