Why is it difficult to get Workers Comp to approve my surgery?

Why is it so hard to get my surgery approved?

One of the biggest issues people have with the workers compensation insurance carriers is getting their surgeries approved. Here in Texas, the insurance company uses a book called The Occupational Disability Guidelines. Your doctor must follow the protocols set for in that book. Normally, they have to try out physical therapy first. If that doesnt work, they have to try out injections next. And if that doesnt work, then maybe you can get surgery. This just means that your medical care is more expensive and that your claim is dragged out as it will take you longer to get the treatment you need. In addition, your doctor will have to send in justification to the insurance company indicating that the ODG has been followed and you’ve exhausted all other medical options prior to doing surgery. It does have important legal ramifications for you if don’t do things appropriately. Its always vital to make sure you have experience legal counsel to assist you through this long drawn out workers comp process.