Medical Workers’ Compensation Benefits

Workers’ Compensation

medical benefits

The insurance company must pay for all medical care, medicines, and supplies that are “reasonable and necessary” to treat your work injury. This may include doctor visits, hospital care, physical therapy, chiropractic treatment, medication, acupuncture, prescriptions, or counseling. It also covers over-the-counter treatments and medical equipment or devices. The insurance company is obligated to pay medical bills for your work injury for the rest of your life, even after you have reached a medical endpoint.

Often the insurance company will require you to pursue “conservative” treatment options such as physical therapy before it will pay for invasive treatment such as surgery. This is normal.

You have the right to see your own doctor, in addition to or instead of the doctor your employer uses.
Sometimes your doctor will recommend treatment that the insurance company does not want to pay for. The insurance company can require you to attend an IME with their own doctor and can use the IME report to try to deny payment for the treatment. (See “FAQ What is an IME? Do I have to go to it”) However, a difference in medical opinion between two reasonable treatment options is not a legitimate basis to refuse to pay for treatment.

See also Guide to Denied Medical Payments and “Why aren’t they paying my bills?”