What can I do if my workers’ comp surgery has been denied?
There are many reasons that a surgery is denied.
In most cases the Carrier is not accepting the Extent of Injury for which the surgery is being requested. Other times the denial is due to the fact your doctor was not available for a peer to peer conversation when the Carrier doctor called or the request was faulty in some way.
You should look closely at the Utilization Review denial and ask your doctor to either resubmit or appeal the denial. You should also seriously consider having legal representation as the case is now complicated.
In most cases the Carrier is not accepting the Extent of Injury for which the surgery is being requested. Other times the denial is due to the fact your doctor was not available for a peer to peer conversation when the Carrier doctor called or the request was faulty in some way.
You should look closely at the Utilization Review denial and ask your doctor to either resubmit or appeal the denial. You should also seriously consider having legal representation as the case is now complicated.
If you still have any questions, feel free to contact us. We are happy to assist you by phone, text, or email.