In a workers comp claim, an Industrial Commission hearing is worth pursuing if the carrier will not voluntarily pay for treatment where chronic pain is contributing to the depression.
Mental health professionals estimate that at least 50% of chronic pain patients suffer from depression. While everyone feels “blue” occasionally, depression is different. When you are depressed you feel sad much of the time. You lose interest in doing normal activities, or it takes a lot of effort just to do routine chores. You may have insomnia or feel like sleeping much of the day. Some people lose their appetite; others overeat. Concentration can be affected, such that making simple decisions is difficult. Of course, depression affects relationships with spouses, other family members and friends.
Treatment is available that helps the majority of patients suffering from depression. This generally consists of counseling and medications. What can be done to try to ensure that the insurance carrier will pay for this?
The injured worker should start by discussing his feelings of depression with his primary treating doctor and asking for a referral to a mental health professional. Most doctors are receptive to this.
However, even if the attending physician agrees to make this referral, the insurance carrier may not authorize payment for this. Insurance carriers are generally resistant to paying for treatment for conditions whose symptoms are not “objective”; i.e., where the medical condition cannot be seen on an x-ray. So the carrier often will either deny authorization or defer authorization pending an examination by a psychiatrist or psychologist it chooses.
At that point it may be necessary to request a hearing so that an administrative law judge at the Industrial Commission can rule on whether the carrier must pay for treatment by a qualified mental health professional. While this process can take a number of months, it is worth pursuing if the carrier will not voluntarily assume responsibility for paying for treatment for depression where chronic pain is significantly contributing to the depression, as so often happens.
Contact the Law Office of Stephen L. Weiss today if you or a loved one suffers from work injury related chronic injury or depression.
