What Medical Benefits are Available for Injured Workers ?

Read­ing Time: 9 min­utes

Last Updat­ed on June 29, 2023 

Med­ical Ben­e­fits are rights of work­ers injured while on job. Work­ers’ com­pen­sa­tion is a type of insur­ance that pro­vides ben­e­fits to employ­ees who are injured or become ill as a result of their job. These ben­e­fits can include med­ical expens­es, lost wages, and death ben­e­fits. If you have ques­tions about Med­ical Ben­e­fits, give us a call at 844–682‑0999 to pro­tect your med­ical claims and get your bills paid.

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• Report your injury to your employ­er as soon as possible.
• Get med­ical atten­tion as soon as possible.
• Keep all med­ical records relat­ed to your injury.
• File a claim with your employ­er’s work­ers’ com­pen­sa­tion insur­ance company.
• Be per­sis­tent. It may take some time to get the ben­e­fits you are enti­tled to.

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Injured at Work? Get Your Medical Benefits and Bills Paid

It’s essen­tial to con­sult with your employ­er, insur­ance provider, or a legal pro­fes­sion­al to under­stand the pre­cise process and eli­gi­bil­i­ty cri­te­ria for obtain­ing cov­er­age for med­ical ben­e­fits under work­ers’ compensation.

Con­sult­ing with your employ­er, insur­ance provider, or a legal pro­fes­sion­al is the best course of action to obtain accu­rate and up-to-date infor­ma­tion regard­ing work­ers’ com­pen­sa­tion and med­ical ben­e­fits. They will have the spe­cif­ic knowl­edge and exper­tise to guide you through the process and pro­vide infor­ma­tion regard­ing eli­gi­bil­i­ty cri­te­ria based on the insur­ance laws applic­a­ble in your state.

Work­ers’ com­pen­sa­tion laws and poli­cies can dif­fer from state to state, and it’s cru­cial to under­stand the spe­cif­ic reg­u­la­tions and require­ments that apply to your sit­u­a­tion. By con­sult­ing the appro­pri­ate pro­fes­sion­als, you can ensure that you receive accu­rate infor­ma­tion tai­lored to your cir­cum­stances, enabling you to nav­i­gate the work­ers’ com­pen­sa­tion sys­tem effec­tive­ly and deter­mine your eli­gi­bil­i­ty for med­ical benefits.

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Categories of Medical Expenses covered by Workers’ Comp

• Emer­gency Med­ical Care: Cov­er­age for emer­gency med­ical treat­ment required imme­di­ate­ly fol­low­ing a work-relat­ed injury or illness.
• Pre­scrip­tions and Med­ica­tions are usu­al­ly cov­ered by work­ers’ com­pen­sa­tion insur­ance. You will need to get a pre­scrip­tion from your doc­tor and then have the pre­scrip­tion filled at a phar­ma­cy that is approved by your employ­er’s work­ers’ com­pen­sa­tion insur­ance company.
• Doc­tor vis­its are usu­al­ly cov­ered by work­ers’ com­pen­sa­tion insur­ance. You can go to any doc­tor who is will­ing to accept work­ers’ com­pen­sa­tion payments.
• Hos­pi­tal stays are also usu­al­ly cov­ered by work­ers’ com­pen­sa­tion insur­ance. You will need to go to a hos­pi­tal that is approved by your employ­er’s work­ers’ com­pen­sa­tion insur­ance company.
• Spe­cial­ist Con­sul­ta­tions: Cov­er­age for con­sul­ta­tions with med­ical spe­cial­ists, such as ortho­pe­dic sur­geons, neu­rol­o­gists, or oth­er experts, when required for the prop­er diag­no­sis and treat­ment of the work-relat­ed injury or illness.
• Diag­nos­tic Tests: Cov­er­age for diag­nos­tic tests, includ­ing X‑rays, MRIs, CT scans, blood tests, and oth­er nec­es­sary med­ical tests to assess the extent of the injury or illness.
• Pain Man­age­ment: Cov­er­age for pain man­age­ment treat­ments, includ­ing med­ica­tion, injec­tions, or alter­na­tive ther­a­pies, for man­ag­ing pain result­ing from the work-relat­ed injury or illness.
• Assis­tive Devices and Med­ical equip­ment is some­times cov­ered by work­ers’ com­pen­sa­tion insur­ance. You will need to get a pre­scrip­tion from your doc­tor and then have the equip­ment ordered from a sup­pli­er that is approved by your employ­er’s work­ers’ com­pen­sa­tion insur­ance com­pa­ny. Cov­er­age for assis­tive devices and pros­thet­ics, includ­ing crutch­es, wheel­chairs, arti­fi­cial limbs, hear­ing aids, and oth­er devices need­ed for mobil­i­ty or func­tion­al improvement.
• Reha­bil­i­ta­tion and Phys­i­cal ther­a­py is a type of reha­bil­i­ta­tion that helps peo­ple recov­er from injuries or ill­ness­es that affect their move­ment. Phys­i­cal ther­a­pists use a vari­ety of tech­niques, such as exer­cise, mas­sage, and heat ther­a­py, to help peo­ple improve their range of motion, strength, and flexibility.
• Occu­pa­tion­al ther­a­py is a type of reha­bil­i­ta­tion that helps peo­ple who have dif­fi­cul­ty with every­day tasks due to an injury or ill­ness. Occu­pa­tion­al ther­a­pists use a vari­ety of tech­niques, such as teach­ing new skills, mod­i­fy­ing the envi­ron­ment, and pro­vid­ing assis­tive devices, to help peo­ple regain their independence.
• Men­tal Health Ser­vices and Psy­cho­log­i­cal coun­sel­ing is a type of ther­a­py that helps peo­ple cope with the emo­tion­al and psy­cho­log­i­cal effects of an injury or ill­ness. Psy­cho­log­i­cal coun­selors use a vari­ety of tech­niques, such as talk ther­a­py, cog­ni­tive-behav­ioral ther­a­py, and stress man­age­ment, to help peo­ple improve their men­tal health and well-being.
• Trans­porta­tion Costs: Cov­er­age for rea­son­able trans­porta­tion costs to and from med­ical appoint­ments, includ­ing mileage reim­burse­ment or trans­porta­tion ser­vices, if required.
• Home Health­care: Cov­er­age for home health­care ser­vices, if med­ical­ly nec­es­sary, includ­ing nurs­ing care, med­ical mon­i­tor­ing, or ther­a­py at the injured work­er’s residence.
• Med­ical Trav­el Expens­es: Cov­er­age for trav­el expens­es, such as lodg­ing and meals, when the injured work­er needs to trav­el a sig­nif­i­cant dis­tance for med­ical treatment.

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Doctor visits and consultations under Workers’ Comp

In gen­er­al, if you sus­tain an injury while per­form­ing your job duties, work­ers’ com­pen­sa­tion insur­ance typ­i­cal­ly cov­ers med­ical expens­es relat­ed to the injury. These med­ical expens­es can include doc­tor vis­its, hos­pi­tal stays, surg­eries, pre­scrip­tion med­ica­tions, phys­i­cal ther­a­py, med­ical tests, and nec­es­sary med­ical equipment.

Work­ers’ com­pen­sa­tion is designed to pro­vide ben­e­fits to employ­ees who are injured or become ill due to work-relat­ed activ­i­ties. The cov­er­age aims to ensure that employ­ees receive appro­pri­ate med­ical treat­ment and care with­out incur­ring out-of-pock­et expenses.

When seek­ing med­ical treat­ment, includ­ing a hos­pi­tal stay, for a work-relat­ed injury, it is advis­able to fol­low the guide­lines and pro­ce­dures out­lined by your employ­er’s work­ers’ com­pen­sa­tion insur­ance com­pa­ny. They may have a net­work or list of approved hos­pi­tals or health­care providers that you should vis­it to ensure cov­er­age and to com­ply with the require­ments of the insur­ance policy.

By going to a hos­pi­tal approved by your employ­er’s work­ers’ com­pen­sa­tion insur­ance com­pa­ny, you can help ensure that the med­ical expens­es incurred dur­ing your hos­pi­tal stay will be eli­gi­ble for cov­er­age under the work­ers’ com­pen­sa­tion insur­ance policy.

It’s impor­tant to note that the spe­cif­ic cov­er­age and require­ments can vary based on the laws of the state where the injury occurred and the work­ers’ com­pen­sa­tion pol­i­cy pro­vid­ed by your employ­er. It is rec­om­mend­ed to con­sult with your employ­er or their work­ers’ com­pen­sa­tion insur­ance provider to under­stand the pre­cise details of the cov­er­age and the process for fil­ing a claim for med­ical expenses.

Here are some tips for finding a doctor who accepts workers’ compensation payments:

• Ask your employ­er for a list of doc­tors who accept work­ers’ com­pen­sa­tion payments.
• Con­tact your state’s work­ers’ com­pen­sa­tion insur­ance agency. They may be able to pro­vide you with a list of doc­tors who accept work­ers’ com­pen­sa­tion pay­ments in your area.
• Search online for doc­tors who accept work­ers’ com­pen­sa­tion pay­ments. There are a num­ber of web­sites that can help you find doc­tors who accept work­ers’ com­pen­sa­tion pay­ments in your area.

Once you have found a doc­tor who accepts work­ers’ com­pen­sa­tion pay­ments, you will need to pro­vide the doc­tor with a copy of your work­ers’ com­pen­sa­tion claim form. The doc­tor will then bill your employ­er’s work­ers’ com­pen­sa­tion insur­ance com­pa­ny directly.

If you have any ques­tions about work­ers’ com­pen­sa­tion or med­ical expens­es, you should con­tact your employ­er’s work­ers’ com­pen­sa­tion insur­ance com­pa­ny. They will be able to answer any ques­tions you have and help you file a claim.

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Hospital stays and surgeries and Workers’ Comp

Here are some tips for finding a hospital that is approved by your employer’s workers’ compensation insurance company:

• Ask your employ­er for a list of hos­pi­tals that are approved by their work­ers’ com­pen­sa­tion insur­ance company.
• Con­tact your state’s work­ers’ com­pen­sa­tion insur­ance agency. They may be able to pro­vide you with a list of hos­pi­tals that are approved by work­ers’ com­pen­sa­tion insur­ance com­pa­nies in your area.
• Search online for hos­pi­tals that are approved by work­ers’ com­pen­sa­tion insur­ance com­pa­nies. There are a num­ber of web­sites that can help you find hos­pi­tals that are approved by work­ers’ com­pen­sa­tion insur­ance com­pa­nies in your area.

Once you have found a hos­pi­tal that is approved by your employ­er’s work­ers’ com­pen­sa­tion insur­ance com­pa­ny, you will need to pro­vide the hos­pi­tal with a copy of your work­ers’ com­pen­sa­tion claim form. The hos­pi­tal will then bill your employ­er’s work­ers’ com­pen­sa­tion insur­ance com­pa­ny directly.

If you have any ques­tions about work­ers’ com­pen­sa­tion or med­ical expens­es, you should con­tact your employ­er’s work­ers’ com­pen­sa­tion insur­ance com­pa­ny. They will be able to answer any ques­tions you have and help you file a claim.

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Prescription medications

To ensure cov­er­age for your med­ica­tions, it is impor­tant to fol­low the prop­er pro­ce­dures and guide­lines set forth by your employ­er’s work­ers’ com­pen­sa­tion insur­ance company.

The process usu­al­ly involves the fol­low­ing steps:

1. Vis­it a doc­tor: Seek med­ical atten­tion from a health­care provider, such as a doc­tor or spe­cial­ist, who will eval­u­ate your con­di­tion and pre­scribe the nec­es­sary medications.
2. Obtain a pre­scrip­tion: The doc­tor will pro­vide you with a writ­ten pre­scrip­tion detail­ing the med­ica­tions need­ed for your treat­ment. Make sure to com­mu­ni­cate that your injury or ill­ness is work-relat­ed to ensure prop­er documentation.
3. Approved phar­ma­cy: Your employ­er’s work­ers’ com­pen­sa­tion insur­ance com­pa­ny may have a list of approved phar­ma­cies that you should use to have your pre­scrip­tion filled. These phar­ma­cies have estab­lished rela­tion­ships with the insur­ance com­pa­ny and can bill them directly.
4. Sub­mit doc­u­men­ta­tion: Pro­vide the phar­ma­cy with the nec­es­sary doc­u­men­ta­tion, includ­ing your work­ers’ com­pen­sa­tion claim infor­ma­tion, to ensure that the med­ica­tion expens­es are billed direct­ly to the insur­ance company.

It’s cru­cial to com­mu­ni­cate with your employ­er or the work­ers’ com­pen­sa­tion insur­ance provider to under­stand the spe­cif­ic pro­ce­dures, require­ments, and approved phar­ma­cies for obtain­ing med­ica­tion cov­er­age under your work­ers’ com­pen­sa­tion insur­ance. They will be able to guide you through the process and address any ques­tions or con­cerns you may have.

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Medical Equipment

To ensure cov­er­age for med­ical equip­ment under work­ers’ com­pen­sa­tion insur­ance, the fol­low­ing steps are typ­i­cal­ly involved:

1. Con­sul­ta­tion with a doc­tor: Seek med­ical advice from a health­care provider who can eval­u­ate your con­di­tion and deter­mine the need for spe­cif­ic med­ical equipment.
2. Obtain a pre­scrip­tion: If the doc­tor deems med­ical equip­ment nec­es­sary for your treat­ment, they will pro­vide you with a writ­ten pre­scrip­tion spec­i­fy­ing the type of equip­ment required.
3. Approved sup­pli­er: Your employ­er’s work­ers’ com­pen­sa­tion insur­ance com­pa­ny may have a list of approved sup­pli­ers or durable med­ical equip­ment providers. It is advis­able to choose a sup­pli­er from this approved list to ensure prop­er cov­er­age and billing.
4. Order place­ment: Con­tact the approved sup­pli­er, pro­vide them with the pre­scrip­tion, and fol­low their pro­ce­dures for order­ing the rec­om­mend­ed med­ical equip­ment. They will often han­dle the billing direct­ly with the work­ers’ com­pen­sa­tion insur­ance company.

By fol­low­ing these steps and work­ing with an approved sup­pli­er, you increase the like­li­hood of hav­ing the med­ical equip­ment expens­es cov­ered under your work­ers’ com­pen­sa­tion insurance.

It is cru­cial to com­mu­ni­cate with your employ­er or the work­ers’ com­pen­sa­tion insur­ance provider to under­stand the spe­cif­ic process­es, guide­lines, and approved sup­pli­ers for obtain­ing cov­er­age for med­ical equip­ment. They will pro­vide you with the nec­es­sary infor­ma­tion and assist you in nav­i­gat­ing the process smoothly.

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Type of Medical Services by each Type of Injury

Physical Therapy

Physical therapy can help you recover from a variety of injuries, including:

• Back injuries
• Neck injuries
• Shoul­der injuries
• Knee injuries
• Hip injuries
• Carpal tun­nel syndrome
• Sports injuries

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Occupational therapy

Occupational therapy can help you with a variety of tasks, such as:

• Dress­ing
• Bathing
• Eat­ing
• Cook­ing
• Clean­ing
• Shop­ping
• Dri­ving
• Using pub­lic transportation

Occupational therapy can also help you with:

• Return­ing to work
• Going back to school
• Par­tic­i­pat­ing in social activities

Psychological counseling and Mental health services related to the work-related injury or illness

Psychological counseling can help you with a variety of emotional and psychological issues, such as:

• Anx­i­ety
• Depres­sion
• Stress
• Grief
• Anger
• Pain

Psychological counseling can also help you:

• Cope with the changes in your life due to an injury or illness
• Devel­op cop­ing mechanisms
• Improve your self-esteem
• Build rela­tion­ships

If you are injured on the job, you should seek med­ical atten­tion imme­di­ate­ly. Your employ­er’s work­ers’ com­pen­sa­tion insur­ance should cov­er the cost of your med­ical care, includ­ing phys­i­cal ther­a­py, occu­pa­tion­al ther­a­py, and psy­cho­log­i­cal counseling.

All of these ser­vices may be cov­ered by work­ers’ com­pen­sa­tion if they are deemed nec­es­sary to help you recov­er from a work-relat­ed injury or ill­ness. To find out if your spe­cif­ic treat­ment is cov­ered, you should con­tact your employ­er’s work­ers’ com­pen­sa­tion insur­ance company.

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Frequently Asked Questions

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A Work­ers’ Comp Lawyer’s rep­re­sen­ta­tion, depend­ing on the sit­u­a­tion may include the following:

• File a claim peti­tion: A Work­ers’ Comp Lawyer can file a claim peti­tion on your behalf to get you all the ben­e­fits you are enti­tled to. This includes wage replace­ment, med­ical expens­es, and oth­er benefits.
• Block employer’s insur­ance company’s attempt to ter­mi­nate or sus­pend your wage / comp ben­e­fits: If your employ­er’s insur­ance com­pa­ny tries to ter­mi­nate or sus­pend your ben­e­fits, a Work­ers’ Comp Lawyer can help you fight back.
• Ensure your work relat­ed injury med­ical bills are paid: A Work­ers’ Comp Lawyer can make sure that your work-relat­ed med­ical bills are paid by your employ­er’s insur­ance company.
• Pre­pare and present your case in court, if nec­es­sary: If your case goes to court, a Work­ers’ Comp Lawyer can pre­pare and present your case for you.
• Sup­port your med­ical claims through your doc­tor, if nec­es­sary: A Work­ers’ Comp Lawyer can work with your doc­tor to sup­port your med­ical claims and make sure that you are get­ting the treat­ment you need for your work­place injury.
• Cross-exam­ine insur­ance med­ical expert dur­ing tri­al, if nec­es­sary: If your case goes to tri­al, a Work­ers’ Comp Lawyer can cross-exam­ine the insur­ance com­pa­ny’s med­ical expert.
• Set­tle your Work­ers Com­pen­sa­tion claim for a lump sum amount, in con­sul­ta­tion with you: A Work­ers’ Comp Lawyer can nego­ti­ate a set­tle­ment for your Work­ers’ Com­pen­sa­tion claim, and they can help you under­stand all of your options.

Injured at Work? Get Legal Help & Protect Your Rights, Benefits & Compensation — Call 844–682‑0999.

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