When Will Worker’s Compensation Approve Physical Therapy?
When Will Worker’s Comp Pay for Physical Therapy?
The short answer is when an authorized doctor orders it. However, insurance companies frequently delay issuing a decision on the physical therapy order. In the alternative, an insurance company may partially approve physical therapy while claiming the amount of physical therapy ordered is not medically necessary – essentially, denying it.
Physical therapy used to be routine treatment in a worker’s comp case. Doctors frequently order physical therapy to help the injured worker heal, gain back strength, and get back on the job. However, insurance companies’ growing concern for the bottom line in recent years has left injured workers waiting unreasonably long for a decision to approve physical therapy, or having the physical therapy partially denied, or having physical therapy denied altogether.
What Your Worker’s Comp Lawyer Can Do to Get Your Physical Therapy Approved
If you’ve contacted your physical therapist’s office to ask when your first appointment is and it has not been scheduled, ask why. If you find out that the insurance company has denied, partially approved, or has not yet responded to your doctor’s order for physical therapy, you should contact your workers compensation attorney right away.
Do not delay in reaching out to your workers’ comp attorney because delay in receiving physical therapy can have a negative impact on your recovery from your injury. Don’t trust your long-term health and wellness to the hands of the insurance company!
Your workers comp lawyer can and will do any of the following immediately to get you the physical therapy you need as soon as possible:
- File a motion with the court or a Form WC-PMT to expedite approval of the order for physical therapy;
- Ask the authorized doctor’s office to file a Form WC-205 requesting approval of the order for physical therapy;
- Request a hearing before a workers’ comp judge to get an order for approval.
Why Do You Need Physical Therapy after a Work-Related Injury?
Doctors frequently prescribe physical therapy after an injury at work or after surgery resulting from a work accident. The reason physical therapy is necessary is that an injured worker, or one recovering from surgery, must be led through and taught the exercises and stretches that will help heal the injury and help the worker gain strength after the injury or following surgery.
A worker’s comp-authorized doctor may also prescribe occupational therapy. Occupational therapy is a more specific form of physical therapy that helps a worker move and use his or her body more effectively on the job to avoid similar injuries or overuse problems at work in the future.
Why Do Insurance Companies Deny Physical Therapy in Workers Comp
Insurance companies only make money when they don’t pay claims, and this is their incentive to deny or only partially-approve an order for physical therapy. An insurance company will often delay issuing a decision whether to approve or deny physical therapy, which gives them the time value of the money they would pay your physical therapist.
It’s a nasty business, and while the insurance companies are watching their bottom line, your recovery is delayed and perhaps compromised by that delay.
How the Insurance Companies Deny Physical Therapy for a Work-Related Injury
Insurance companies delay issuing a decision regarding physical therapy
Again, this delay allows the insurance company to hold onto the money they would use to pay your physical therapist. When you consider that they are employing this tactic nation-wide, think of the hundreds and probably thousands of delayed claims that are earning interest for the insurance company. All while you and countless others wait for the physical therapy you need to recover.
Insurance companies frequently partially approve an order for physical therapy.
Put another way, insurance companies will deny part of the physical therapy your doctor ordered as medically necessary for your recovery.
Insurance companies frequently deny physical therapy outright.
The insurance company may simply deny physical therapy as not medically necessary, in which case you will need to litigate the claim to get the care you need to recover.
Call Your Workers Compensation Lawyer if Your Physical Therapy Order was Delayed, only Partially-Approved, or Denied.
Our firm has helped workers comp clients get paid sooner and often more in benefits than they would have received otherwise. Workers comp attorneys usually are paid 10% of your recovery, and we only get paid when you do. You don’t have to face the big national insurance companies and their team of lawyers alone. Call us today to schedule your free consultation and let us help you get paid!