The Unseemly Relationship Between Workers Compensation Insurance Carriers and Medical Providers

How Are Medical Providers for Workers Compensation Cases “chosen”

I attended a recent workers compensation related golf outing.  Almost every hole had a vendor who provides services to the workers compensation community.  One of the vendors was a large medical provider of services to many injured workers in Indiana.  I started talking with one of the medical provider employees who provides sales services to employers and insurance carriers throughout Indiana. He encourages employers and insurance carriers to send their injured workers to this facility.

Think about it, employers and insurance companies are being “sold” to use this provider’s services.  This is not unusual.  It happens every day, all day. 

The Deck Is Stacked Against Injured Employees

Large medical facilities that provide services to injured workers often have one, two, or three “closers”. They are people who are used by the insurance company to bring your medical treatment to an end and to assign you a very low, if not 0%, PPI.  A PPI is the main determining factor of the value of your settlement.

What Motivates Providers to Assign Low PPIs?

Think about it another way – what if these providers, after promoting themselves and their services to employer and insurance companies – assigned generous, fair, reasonable PPI’s?  Do you think their services would be in demand over the long term? NO. The providers only continue to get patients referred to them if they assign low PPIs on a regular basis.

Injured Workers Get the Raw End of The Deal

The victim in this arrangement between insurance companies and medical providers is the injured worker. Sadly, this “I’ll scratch your back if you scratch mine” system occurs regularly.

Experienced Workers Compensation Attorneys Know How To Uncover These Unfair Practices

I’ve practiced workers compensation law for almost 30 years.  It is as bad as ever.  There is an epidemic of workers compensation physicians who assign very low PPI’s in order to keep the referrals coming.  High PPI’s would sway insurance companies and employers from using these providers and other medical providers.  To make the playing field level, please give us a call and we can talk to you about your case.