Common Questions About Workers’ Comp Medical Benefits

Workplace injuries happen all the time, and when they do, they can have devastating effects on the injured party. The workers’ compensation insurance system was implemented to mitigate the financial impacts of being injured on the job, but it doesn’t always work as intended. 

Injured workers who are having trouble accessing the benefits to which they are entitled should take the time to educate themselves and secure the help of a workers’ compensation attorney. Get started by reading through the answers to some of Claimants’ most frequently asked questions about workers’ compensation medical benefits below.

What Injuries Are Covered By Workers’ Comp?

Workers’ compensation insurance is designed to cover expenses associated with workplace injuries. If the claimant was injured on the job or became ill due to working conditions, they’re entitled to coverage of medical expenses as well as help replacing lost wages and paying for ongoing care.

What Injuries Are Not Covered By Workers’ Comp?

The laws precluding eligibility to receive benefits vary by state. In most cases, though, workers’ compensation insurance won’t cover injuries sustained due to a worker’s intoxication, physical altercations started by the employee, or intentional acts which cause injury. With the exception of first responders diagnosed with PTSD as a result of their lines of work, emotional injuries aren’t covered unless they are accompanied by physical trauma.

What Should Injured Workers Do to Get Medical Benefits?

The first thing workers should do if they are injured on the job is to report the incident to their supervisors. Make sure a report gets filed that includes the date and time of the injury and the circumstances surrounding it. In the case of job-related illnesses, employees should file reports as soon as they learn that the diagnosis is related to their jobs.

From there, the employer is supposed to make sure the injured worker gets proper medical treatment and file a workers’ compensation claim with the insurance company as soon as possible. Employers that fail to file a First Report of Injury in a timely manner can be fined.

What Kinds of Medical Treatment Can Injured Workers Get?

Injured workers should be able to get all forms of necessary medical care paid for by workers’ compensation insurance. That includes visits to emergency rooms, clinics, or doctors, prescriptions related to the injury, surgical costs if applicable, and any ongoing care required to facilitate a full recovery. Anyone denied necessary medical treatment can contact medical benefits lawyers to discuss their options.

What Should Injured Employees Do If They Receive Medical Bills?

Injured employees should not be asked to pay any medical bills related to their care. Instead, all authorized bills should be submitted directly to the employer’s insurance company. If medical providers are sending bills to patients or the insurance company is refusing to pay for authorized treatments, affected workers should not pay the bills. In fact, medical providers who persist in billing an injured Claimant directly for medical expenses which are payable under workers’ compensation may actually be subjecting themselves to claims brought pursuant to the Fair Debt Collection Practices Act. Injured workers’ who are getting medical bills for their treatment should contact our workplace injury lawyers in Bradenton and Sarasota right away.

Will Workers’ Comp Pay for Employment-Related Illnesses?

In Florida, work injury compensation should also pay for care related to illnesses incurred as a result of working conditions. However, it can be more difficult to have these claims approved. Workers who are seriously ill or have suffered disabilities not related to acute injuries may want to contact a lawyer for help with filing their claims.

Can Workers File Appeals if Their Claims Are Denied?

All eligible workers are entitled to medical benefits through the workers’ compensation insurance program. Those who are denied benefits should schedule consultations with a personal injury lawyer right away to get help with filing appeals. There are time limits in effect that need to be followed, so don’t put it off.

Who Can Administer Medical Care to Injured Workers?

Injured workers usually have the right to choose their own doctors, hospitals, and pharmacies for long-term care. However, not all of them participate in the state’s workers’ compensation program. What that means is that, although the law prohibits employers and insurance companies from interfering with an injured worker’s right to receive care from the providers of their choice, there may still be some limitations regarding where to go for care.

Still Have Questions?

Do you still have questions about workers’ compensation benefits? Our team of attorneys has nearly 100 years of combined experience in helping clients understand their legal options following workplace injuries and get the compensation they need to focus on healing instead of on how to pay the bills. Contact Legler, Murphy & Battaglia to schedule a free consultation.