Legal Question in Workers Comp in South Carolina

Dt. won't give referral for treatment

I injured my back muscles at work over six months ago. I have had a lot of difficulty getting the doctors to provide me any treatment other than pain killers and muscle relaxers. The only specialist involved is an orthopedic dr. and I asked for a referral to a neuromuscular therapy center and he would not refer me (I think it's because it wasn't an office that fell under his hospital "network"). Another dr. told me that he couldn't give me a referral unless he knew the insurance company would cover it. The ins. co. won't even review until they have a referral. My question: does my doctor have the right to refuse this referral just because he doesn't know if the ins. co. will cover it? If this doesn't work, my dr. wants to do some very invasive, costly, and risky procedures. In my opinion, they aren't using common sense with my condition and they are playing a lot of very frustrating games. Under W/C is there any recourse I can take and how can I find out my rights? I tried checking out the W/C info. on the internet for my state but no answers to these kind of questions. Thanks.

Asked on 5/15/00, 9:50 am

1 Answer from Attorneys

William O'Neil O'Neil Law Firm

Re: Dt. won't give referral for treatment

My friend...why are you trying to handle this on your own? You go to a doctor when you need medical need a lawyer, at a minimum for advice and probably representation. Call my office in Myrtle Beach and ask that we send you a free workers' compensation brochure packet that may help answer your questions. 843-448-0920 If the insurance company is going to pay for the treatment, they get to pick the doctor(s). They pay, but they control. It all boils down to money.

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Answered on 7/04/00, 12:44 pm

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