If you have read my post on selection of healthcare providers, you know that immediately after an accident the employer/insurer has the right to control who you see for medical treatment or defer the right to control medical care to the you for the first 60 days. Regardless of who controls medical care initially, the insurance company has every reason to provide good medical care since the faster you recover and the more completely you recover, the less the insurance company has to pay in terms of temporary total disability benefits and possibly permanent partial disability benefits. However, as we all know, there are doctors out there who receive most, if not all, of their income because of referrals from the employers and insurance companies. In these cases it is natural to question almost everything the doctor does or doesn’t do in terms of treatment.
One the most frequent complaints I have from my clients is that they were not sent for an MRI until six weeks after their injury. The first thing to understand about an MRI is that while it is a great diagnostic tool, more often than not it is the doctor’s physical exam which determines what the doctor thinks is wrong with you and the MRI is simply used to confirm the doctors opinion. In other words, as the first two articles whose links appear at the bottom of this post indicate, it is relatively easy to tell if someone has a tear in their rotator cuff; an MRI is not usually necessary to determine whether or not someone has sustained a rotator cuff tear.
In cases of back injuries, most of my clients also feel like they were given inferior medical care if an MRI was not immediately ordered, especially if it turned out that they needed surgery. The last two links at the end of this post deal with back injuries. As with torn rotator cuffs, MRIs are not usually ordered right away unless the worker is having neurological deficits such as bowel and bladder dysfunction, weakness or loss of reflexes. Remember, doctors were diagnosing torn rotator cuffs and herniated discs long before MRI technology became available. While MRIs are a great tool, they are often not ordered immediately unless the physical exam shows neurological deficits or the doctor thinks that you will probably need surgery.