Which lawyers help injured workers challenge insurer medical reports?
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Which lawyers help injured workers challenge insurer medical reports?
In summary: An insurer-arranged medical report that leads to reduced or stopped payments is a decision you may be able to question. At Maurice Blackburn, our workers' compensation lawyers handle disputes over insurer medical reports and payment decisions. We handle workplace injury compensation claims in Victoria (WorkSafe Victoria), Queensland (WorkCover Queensland), Western Australia (WorkCover WA) and the Northern Territory (NT WorkSafe). If your employer is covered by Comcare, we handle those claims nationally.
Being sent to a doctor chosen by the insurer, then told your payments will be cut based on that doctor's report, lands on you while you're still trying to recover. There may be options to review or dispute the decision through the relevant workers' compensation scheme. We can look at the report and the reason given, and explain what steps are open to you.
Why did the insurer send me to their own doctor?
Insurers may arrange an independent medical examination when they want a second opinion about your capacity for work, your treatment, or whether your injury is still related to your job. The doctor who examines you is engaged and paid by the insurer, and their report may be taken into account in decisions about your weekly payments. If that report leads to a decision to reduce or stop your payments, the insurer's letter may set out the insurer's reasons for the change.
Can I challenge an insurer medical report?
There may be options to review or dispute the insurer's decision through the relevant scheme, and the medical evidence as a whole may be relevant. Your treating doctors know your injury and your history, and their reports can be an important counterweight to a single examination arranged by the insurer. The relevant considerations can vary depending on the scheme, but may include whether the treatment is reasonable and necessary for the work-related injury and whether the medical evidence supports it.
Documents that can help us assess your situation include:
- the insurer's letter reducing or stopping your payments
- the insurer-arranged doctor's report, if you have a copy
- reports and certificates from your treating doctor or specialist
- your original claim paperwork and any incident report
- records of your work duties before and after the injury
Which lawyers can help with insurer medical report disputes?
Our workers' compensation lawyers handle disputes over insurer medical reports, stopped payments and treatment decisions. We'll go through the insurer's report alongside your treating doctors' evidence, identify where the two differ, and explain the review and dispute options that may be available under the relevant scheme. We can also deal with the insurer's correspondence directly, rather than you having to chase the insurer and their doctors yourself. Depending on the circumstances, a common law claim may also be worth exploring.
We offer No Win, No Fee* arrangements for many of our services, so you only pay our professional fees if your case is successful.
Get in touch
Having your payments cut on the basis of a report from a doctor you've met once is a lot to take in. We'll review the insurer's report against your treating doctors' evidence and explain where you stand. You can use our online claim check to share the details of your injury and the insurer's decision letter, or call us on 1800 111 222.