Every so often, a medical provider will send my office a form asking for my “authorization” before they treat one of my injury clients on a lien basis. Sometimes it’s framed as a courtesy. Other times it’s treated like a requirement.
Let me be clear: there is no legal reason a healthcare provider needs my authorization to provide treatment when they’re treating you for your injuries related to your injury claim.
This never happens when the client is using health insurance and is almost exclusively something that happens in doctor’s office when they are unfamiliar with, or fundamentally misunderstand, liens on personal injury cases.
What a Medical Lien Really Is
When a provider agrees to treat someone on a lien, what they’re really doing is this:
The health care provider is planning on perfecting their lien according to statute, after they offer treatment without up-front payment by the patient/client, thereby waiting for payment in the hopes of getting the bill satisfied from potential future settlement proceed.
This arrangement is a calculated risk taken on by both the provider and the client: The provider’s risk is that they may not get paid, or may get paid less than they are billing. The client’s risk is that they may end up personally responsible for the bill.
Notice that no where in that explanation of this arrangement is any medical decision-making capacity transferred to the plaintiff’s personal injury attorney. That’s not a thing.
The patient is the one receiving medical care. And absent some health care power of attorney or general power of attorney, their medical decisions remain their own.
I Don’t Practice Medicine and I Don’t Want To
I’m a lawyer. I don’t diagnose. I don’t prescribe. And I don’t decide what treatment is “authorized.”
If a provider believes treatment is medically appropriate, that decision is between the provider and the patient. Asking me to “authorize” care blurs ethical lines and suggests a level of control that I simply don’t—and shouldn’t—have.
In fact, I prefer not to be in that position. Attorneys should not be influencing medical treatment decisions, even indirectly.
What I Think the Providers Are Asking
IWhen I’m asked, “Do you authorize this epidural steroid injection?” it’s hard to read anything into that question except a request that I take over medical care decisions for my client, or even crazier, agree to pay for said medical care. But what I think providers are getting at, sometimes, by asking this question is that they are looking for reassurance that they are likely to get paid.
Generally speaking, I try not to be involved in cases that I don’t think have value, so I would like to say there’s a great chance all cases are going to work out, meaning there’s going to be at least some money to go around, even though it’s hard at any given point, especially before treatment is done, to have a firm idea as to how much we’d be talking about. I simply can’t say if there’s going to be a settlement, or enough of a settlement, for some or all of any given bill to get paid. And I certainly can’t sign any letters of protection (don’t get me started on that).
What I can promise to do is this:
- I’ll address all validly perfected liens out of settlement proceeds within the rules set out by statute and competing liens.
- I’ll communicate honestly about the status of the case
The Bottom Line
Healthcare providers don’t need my permission to treat injured patients. They need the patient’s consent and that’s it.
If healthcare providers have questions/concerns about getting paid, I can offer some general information about the case, but I can’t do anything that approaches promising to pay their bill. I can only promise to follow the law when addressing validly perfected liens.
My job is to protect my client’s interests; It’s not to practice medicine, approve treatment plans, or guarantee payment to providers.
When everyone stays in their lane, cases resolve more smoothly—and nobody is surprised at the end.
If you’ve been injured and have questions about medical liens or treatment issues, call me at 919-929-2992
🖥️ jeffreyhowardlaw.com







