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Two-Hour Driving Limit for Workers’ Compensation Medical Exams

iStock_000003102026Medium1-683x1024Imagine having to travel four hours or more to a medical examination. Now imagine that you cannot sit for more than an hour because of pain caused by a work injury. Imagine also that you have no choice but to endure the long car ride or risk losing your workers’ compensation benefits. This was the case for many of our clients until recently. Under Vermont law, injured workers must allow themselves to be examined by a doctor chosen by the insurance company. If a worker refuses, they can lose their workers’ compensation benefits. Since the Vermont Department of Labor placed no mileage or distance restrictions on these examinations, despite requests to do so by our law firm, insurance adjusters often required injured workers to travel unreasonable distances. In some cases, workers have had to travel to Boston, or even further, if that is where the adjuster told them to go. This placed an unnecessary burden on injured workers, many of whom have a difficult and painful time riding in a car for any period of time. It also encouraged “doctor shopping” by the adjuster, who could then send all Vermont workers to the same biased doctor who might be willing to help the insurance company with their report. This past year Biggam, Fox & Skinner worked with the Vermont Association for Justice to change this policy. As a result, the Vermont Legislature addressed the issue and amended the statute. Now, most examinations must occur “within a two-hour driving radius of the residence of the injured employee.” Although we still feel this is too far to travel for many of our clients, it is a start in the right direction. The statue does provide an exception to this “two-hour” rule. For example, at the discretion of the Commissioner of Labor, the worker may have to travel a greater distance if their injury is unique and requires examination by a specialist not available within the two-hour driving distance. We hope this will be the rare exception for injured workers.

New Law Accelerates Medical Treatment for Injured Workers

Pre-authorization law accelerates medical treatment for injured workersUnder a new Vermont law, injured workers with an accepted workers’ compensation claim can now get quick pre-approval for necessary medical procedures. Workers’ compensation insurers must now respond to a request for medical pre-authorization from a medical provider within 14 days, as long as the claim has been accepted and medical records support the request. In the past, insurers had no obligation to pre-approve any medical procedure or treatment for injured workers in Vermont. Often, the injured worker was unable to get necessary medical help because the insurance company simply ignored requests for authorization, and medical providers could not move forward with treatment options without a guarantee of payment. As a result, many people were unable to have necessary surgery, physical therapy, or medication to treat their injuries. That is now changed.

My Workers’ Compensation Claim was Accepted. Do I Still Need a Lawyer?

The simple answer is that it depends on your situation. If you don’t know exactly what you are entitled to receive, you may want to contact a lawyer to help you.

Many insurance company agents don’t tell injured people about all the benefits they may be entitled to receive under workers’ compensation. For example, did you know you can select your own physician or vocational rehabilitation specialist, instead of being forced to treat with a provider selected by the insurance adjuster? It makes sense to contact a lawyer for a consultation, even if your claim is accepted, to be sure you are getting these benefits and your claim is being handled properly. We can make sure our clients’ injuries are rated by the most qualified physicians, and not just by the doctors hired by the insurance agent. And a higher rating results in a larger award.

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Edward Shattuck, St. Johnsbury, VT

"I have been around a lot of attorney's offices; never been treated as well as Biggam, Fox & Skinner. Phone calls answered fast!"

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