Work injuries can happen to anyone in any industry. Occupational illnesses can develop due to unsafe work environments or chronic exposure to toxins. Carpal tunnel syndrome, tendonitis, bursitis, and other repetitive strain injuries can be caused by repetitive activities at work. Sudden accidents like falling or being struck by an object can lead to traumatic brain injuries, neck and back injuries, broken bones, and other painful injuries.
If you or a loved one were injured or fell ill because of your job, you may be entitled to workers’ compensation. Unfortunately, getting compensation for medical expenses and lost income is often a drawn out, complex process. If the employer requests a utilization review, this can further complicate the workers’ compensation case.
The Purpose of a Utilization Review
When a worker is injured, he or she understandably wants the best medical care possible. The employer and insurance company wants the most cost-effective option. This can lead to disagreements about the type of medical care a worker receives.
The employer may request a utilization review to determine if the worker is receiving appropriate care for his or her injury or condition. Ultimately, the employer wants to ensure that the worker is not receiving unnecessary treatment. During a utilization review, a medical professional will assess the type of medical care the worker is receiving and whether that care is needed to address the worker’s medical concerns.
A prospective utilization review considers the necessity of the recommended medical treatment. A current review is used to evaluate the treatment the worker is currently undergoing. Retrospective reviews assess treatment that has already taken place.
How a Utilization Review Can Impact Your Case
Employers and workers’ compensation insurance companies want to reduce their financial losses as much as possible. Sometimes, utilization reviews are used a tool for this purpose. If you or a loved one were hurt at work, it is important to have a legal advocate on your side who can help you fight for the full compensation you need.
Contact a McHenry County Workers’ Compensation Lawyer
The Crystal Lake workers’ compensation attorneys at Botto Gilbert Lancaster, PC understand the complexities and challenges of workers’ compensation cases and how to meet these challenges head on. If you or a loved one were hurt in a work accident or you developed medical problems due to the nature of your work, we can help you pursue compensation. Call our office at 815-338-3838 for a free consultation today.
Source:
https://www.ilga.gov/legislation/ilcs/fulltext.asp?DocName=082003050K8.7