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Iowa Work Comp: What to do when the adjuster refuses medical treatment


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9/25/2013
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Question: The workers’ comp insurance adjuster refuses to pay for physical therapy after my surgery, can I do anything about this?

Question Detail: I was injured on the job in April 2013, had surgery in August, and then went to physical therapy for 3 weeks. Now workers comp is saying no more PT. Also doctor wants to start a set of Supartz shot, also turned down. Now what?

Answer: It appears you have an injury to your knee. The Supartz Joint Fluid Therapy is to treat knee pain. Supartz is the trade name for highly purified sodium hyaluronate used as a lubricant in the treatment of knee dysfunction. You can learn more about the treatment and the side effects by following this link. But first let us get back to answering your question about how to deal with the activist adjuster who thinks he or she is a doctor.

There are a lot of activist insurance adjusters ruining the way the Iowa workers’ compensation system works.

You will need to hire a lawyer and let me explain why. The workers' compensation adjuster does not have a license to practice medicine. In Iowa the adjuster is permitted to select the doctors not make medical decisions. Micromanaging the medical care is not part of the selection process; it is a part of practicing medicine. Once selected it is the doctor who determines the course of treatment - not the insurance company. If the insurance adjuster keeps interfering with the medical treatment your lawyer should know how to file a Petition for Alt. Medical Care and allow a Deputy from the Iowa Industrial Commission to order the adjuster to stop interfering with the medical care, by ordering the treatment. It's unfortunate that more decisions aren't made to set the insurance industry on notice about practicing medicine without a license. There are a lot of activist insurance adjusters ruining the way the Iowa workers’ compensation system works. 



Category: Workers' Compensation & Employee Rights


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