In some cases, pursuing one’s dental workers’ compensation claim may not be that straightforward. Even with a doctor’s recommendation, certain insurance companies may delay the approval of the treatment. This means that the patient cannot proceed with his or her treatment at the selected dental practice. These individuals may then need to consider out-of-pocket expenses to expedite the treatment process. Cardinal Law Partners is here to assure you that we will solve the hold-up in as little time as possible so that you can receive the necessary dental treatment.
What is Workers’ Compensation?
Workers’ compensation policies are designed to pay out monetary benefits to workers who sustained injuries or became disabled in the course of their employment. The North Carolina system requires most employers to carry workers’ compensation insurance if they have three or more employees. Insurance carriers pay medical costs incurred from treating injuries that were a direct result of employment. For example, a construction worker can pursue damages if scaffolding equipment fell on their head at the job site.
When Do You Need To Visit Dentists and Dental Practices?
Some forms of trauma that impact an employee from the neck up typically involves a dental injury. Oftentimes, dental trauma may occur as a result of falling objects, workplace slips and falls, construction accidents, workplace violence, and more. Oral maxillofacial surgeons, endodontists, and periodontists are some of the common dental specialists who are engaged to treat injured workers with workers’ compensation coverage.
With that in mind, dentists who participate in a specialized workers’ compensation network perform prospective oral evaluations and will develop an injury-related dental care plan. After determining what is billable in relation to a workplace injury, dental professionals will proceed to seek the approval of nurse case managers and claims adjusters.
Common Problems Encountered During Workers’ Compensation Claims Processes
If your dental treatment has not been approved after a week or two, your workers’ compensation insurance carrier may be delaying or denying the claims process. Below is a quick look at some of the common scenarios:
- Insurance companies denying one’s request for treatment by filing a Form WC-3 Notice
- Insurance companies simply not approving the treatment without denying the request
- Insurance companies delaying the approval process by getting a second opinion from the treatment specialist or by utilization review documents
- Insurance companies partially approve a doctor’s recommendations
How Cardinal Law Partners Can Help
Few workers are familiar with the measures that they can take to get their treatments approved. They can file a motion if the carrier hesitates to provide necessary dental treatment. If that does not work, it is time to bring out the big guns. Cardinal Law Partners will schedule a court hearing to expedite your workers’ compensation claims process. With over 50 years of collective legal experience, our team has been providing legal services for a wide variety of workers throughout Raleigh, Greensboro, Charlotte, and Belmont.
Cardinal Law Partners’ lawyers for dentists and dental practices include Attorney Kristin Henriksen, Attorney Justin Wraight, Attorney John Landry, and Attorney Megan Callahan. You can enjoy peace of mind that they are also board-certified specialists in North Carolina workers’ compensation law.
If you wish to learn more about Cardinal Law Partners’ stellar expertise in healthcare providers such as dentists and dental practices, do not hesitate to schedule a free, initial consultation with us today!