Q: What is the legal consequence when workers compensation fails to provide necessary medical care in IN?
Going on two years post ORIF. Failed to provide treatment for post op DVT (basically left me for dead), failed to provide any care for my related nerve damage or problematic hardware. Finally got them to send me to a new specialist who agrees there are all kinds of problems and ordered mri and emg. Work comp will not give auth info to hospital billing. My meds are over $2,000/mo.
I want a hearing but I doubt my attorney will want to schedule one. Monon will tell me what consequence I can hold over their heads to get any sort of care! I’m a RN who fell at a hospice patient’s house- there is zero question if this is a work comp case.
Shame on you! You are a healthcare professional. There is no reason why you could not have worked with Worker's Compensation to coordinate any needed care. Indiana's Worker's Compensation board is not set up as a traditional, adversarial system. In Indiana, the employer has exclusive control over your medical care and cannot be compelled to pay for any care that is not preauthorized unless said care was provided, literally, to prevent death (think profuse bleeding). Unrepresented plaintiffs can often get any question answered by the Board's ombudsman who are both knowledgeable and helpful. Moreover, if you are registered nurse, you almost certainly had group health insurance. Any medical care that was not immediately authorized through Worker's Compensation should have been secured through your group health insurance. Your group plan can fight with Worker's Compensation later but you would get the care when you need it.
You also mention an ongoing situation where you are taking $2000 worth of prescription medicine per month but you do not tell us why. If that medication is related to your injury or sequela from that injury, then Worker's Compensation is responsible for it. Again, as a healthcare professional, you are much better able to appreciate whether there is a nexus between your medication and your injury than the vast majority of people. If the medication is related, you should explain to the nurse case manager or to the adjuster why it is related and your lawyer should have told you from the day he met you that it was imperative that you make your doctor write everything down. If it's not written down, it didn't happen. If the doctor writes in your chart note that he or she is prescribing a medication to treat DVT that was secondary to your work-related ankle injury, I guarantee it will be covered. If the doctor fails to make such an entry, I guarantee that it will not be covered. It is that simple. If your attorney never bothered to explain this dynamic, it is that hard because, as you know, a doctor cannot meaningfully amend a chart note. Whatever the doctor inadvertently omitted from a chart note needs to be entered as a separate note or needs to be added to your next chart note, provided that you are still seeing the doctor.
The short answer to your question is that there is no real legal consequence. Self-help doctrine is king.
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