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+--- Forum: Injured Worker Forum (/forumdisplay.php?fid=4)
+--- Thread: seeing another doctor (/showthread.php?tid=2279)
seeing another doctor - cristabell - 11-15-2007 01:00 PM
i ended up in the er last night for pain.i have a right knee injury .ive been seeing a gp doctor and have been doing pt for 4 weeks now a cortisone shot.i had an mri which showed small tearss in the postier horn of meniscus.now doctor thinks i have brusitis and tendonitis.been in imobilizer for 5 weeks doctor wants me to take it off and start walking on knee.well i did this yesterday and had so much pain i had to go to er.the doctor there refered me to see ortopedic surgon.i made an appointment with him. my question is will wc pay for this visit,and what if he thinks i need surgey what then? any help would be greatly apprecieted
RE: seeing another doctor - katicabogar - 11-15-2007 01:51 PM
I am dealing with L@i since 2004 and I know you have to have an attending physician on file with them whom they approve. If this physician request a surgery, utrasound, mri etc. needs to be authorized by the department. If not, they will not pay.
I know, my surgeon had to request authorization for ultrasounds, nerve conducting tests, x-rays and had to explain, why.
RE: seeing another doctor - AQA - 11-15-2007 01:57 PM
I believe that question to be state specific. You may want to call the ic and ask the question. In texas, when I went to a new Dr.. That was fine. Some minor medical work was fine also. But anything that cost over $1000.00 needed to be pre-approved.
RE: seeing another doctor - 1171 - 11-15-2007 08:01 PM
Since it's a referal from your doctor their visit and treatment should be covered. The employer/carrier is also entitled to a second opinion.
You can find out more about south dakota's work comp by starting here
http://www.state.sd.us/dol/workerscomp/Employee-Q&A.htm
RE: seeing another doctor - cristabell - 11-15-2007 08:14 PM
nope not a referal from my doctor.if u would have read my post it said a referal from er doctor. my doctor doesnt think i need to see a orthopedic doc[/i]
RE: seeing another doctor - 1171 - 11-16-2007 11:56 AM
as the link explains if it's not their choice then you have to get prior permission/authorization if you want them to pay.