Workers’ Compensation law requires employers and their workers’ comp carriers to provide medical treatment to injured workers for their industrial injuries. Workers’ comp law requires the doctors to request medical treatment on a Request For Authorization (RFA) form. The doctors must use the RFA form in order to properly request medical treatment for the injured worker’s on the job injury. If the RFA form is not used, the workers’ comp carrier has no obligation to authorize the medical treatment. Injured workers should make sure their doctors are using the RFA form for all medical treatment requests for their industrial injuries.
The doctors also must submit written reports with the RFA form. The report needs to set forth the medical treatment requested. The doctor needs to cite the workers’ comp medical treatment guidelines for industrial injuries such as the Medical Treatment Utilization Schedule (MTUS) and Official Disability Guidelines (ODG) that support the medical treatment. Most important, the doctor needs to explain why the treatment for his injured worker patient meets the requirements of the guidelines. If the doctor does these things, it will go a long way to get the workers’ comp carrier to authorize the medical treatment for the injured worker.
Stay tuned for the next step: Utilization Review
