You are Injured on the job and your claim is allowed for the injury. Then your doctor of record requests authorization for medical treatment, specialist consults, and you get a denial from your MCO. (Medical Care Organization). What do you do?
It is unbelievable that with all of President Obama’s talk about health care, Ohio’s Injured Workers who have allowed claims cannot get the treatment they need and deserve. This isn’t even an issue of no coverage – there is plenty of coverage – the claim IS allowed.
Most people don’t know that the MCO makes its money by the amount of medical treatment it denies (saving the Ohio Bureau of Workers’ Compensation tons of money). So, is it any surprise that such a high percentage of medical requests are denied?
What has to be done is the filing of an appeal to the denial of treatment. In today’s climate at the OhioBWC, it too denies a majority of the medical treatment requests. However, there is redress to The Industrial Commission of Ohio, which is the administrative law judge division.
The bottom line. If your medical authorization is denied, file an appeal to the OhioBWC. Make sure you inform your lawyer that your medical treatment request has been denied. More often than not, with the right legal representation, the Industrial Commission will grant the medical treatment requested. But this requires attendance at an administrative law hearing.
The BWC has its lawyers, the employer has its lawyers. You, the injured worker, better have your own lawyer too. And, make certain that your lawyer is well versed in BWC law.
If you need representation in your Ohio Workers’ Compensation Claim, call Mike Gruhin at Gruhin & Gruhin. He is a Board Certified Workers’ Compensation Specialist Attorney. Let Gruhin & Gruhin fight for you and the benefits you deserve!