Physicians of course want to rule out internal derangement before they start the patient on a treatment path. Early physical therapy could do more damage than good should internal derangement be present.
The flip side to that statement is if the objective indicators are not present, and the testing is completed, it can validate the “injury” in the mind of the claimant.
Adjusters Are Often Put In Tough Position to Approve Testing
Adjusters are often put in a tough position on whether or not to approve testing just after an injury. The claim is new, the adjuster has limited info, and doctors are usually not helpful in putting the pieces of the puzzle together.
Patients are also are very demanding. The presence of medical websites can impact a claim, and injured workers are not stupid. They know what to tell the doctor in order to get what they want. This is especially true in states where the carrier cannot direct care and the worker is free to treat with any doctor they choose. The doctor chosen is likely their primary care doc, who they have known for years, and can probably request whatever they want and usually get it from them.
Take the normal everyday back strain injury. The worker lifts up a box and feels pain in their lower back. Upon examination, the patient has tenderness, pain, and limited range of motion. They complain of acute pain, and they are demanding an MRI be completed.
This is the proverbial fork in the road. If the patient has delayed reflex, subjective radicular pain in the legs, and subjective numbness, the doctor at times will be quick to grant the request of an MRI.
Why Is Conservative Treatment Not Applied First?
I do not agree with this stance. If the injury just happened, why is conservative treatment not applied first? Medication, work restrictions, and maybe conservative physical therapy should be completed first prior to any diagnostic testing being completed except the normal X-Rays. Continue reading Early Diagnostic Testing Can Extend Claim Life and Cost