Five Hidden Workers’ Comp Medical Benefits

Most people know about the workers’ compensation medical benefit. But many people don’t know how extensive this benefit is. In a nutshell, workers’ comp covers all reasonably necessary medical bills. The list of reasonably necessary injury or illness-related bills doesn’t end with direct medical care expenses, or even begin with them.

In a perfect world, insurance companies would voluntarily issue checks for these hidden medical payment benefits. But we don’t live in a perfect world. So, a Tampa workers’ compensation lawyer must get involved and force insurance companies to follow through on their legal obligations. People with job-related illnesses or injuries are also entitled to lost wage replacement and other important workers’ comp benefits.

Exclusive Payment

Workers’ comp is the exclusive remedy for job-related illnesses and injuries. Workers’ comp is also the exclusive payment source for medical bills.

Frequently, medical providers send gap bills to victims. For example, if the agreed-upon insurance price for Tony’s $1,000 MRI is $250, the provider sends Tony a $750 bill.

In the provider’s defense, such gap billing is often unintentional. Most hospitals and other providers have separate treatment and billing departments. Frequently, these departments don’t communicate well with each other.

However, intentional or not, such gap billing is against the law. If a provider sends a job injury or illness victim a medical bill, severe penalties could apply under state and federal laws.

Rehabilitation

The law recently changed on this point. Today, medical payment, lost wage replacement, and other benefits last up to 104 weeks (two years). The extended time period usually allows victims to complete physical therapy before their benefits expire.

Extended physical therapy is sometimes a two-edged sword. If progress plateaus, as it often does in long-term physical therapy, many insurance companies try to pull the financial plug. A Tampa workers’ compensation lawyer advocates for these victims and ensures that the financial spigot remains open.

Transportation

In many cases, especially if a victim requires helicopter transportation, initial transportation costs could be almost as high as hospital bills. Workers’ comp benefits begin at the moment of injury or illness diagnosis.

The reasonably necessary requirement may be an issue in this area. Many insurance adjusters argue that the next step down was reasonably necessary. For example, if Mandy rode an ambulance to the hospital, the insurance company only pays for the cost of an Uber.

Specialist Visits

Workers’ comp usually pays for medical specialists, if the victim’s primary workers’ comp doctor referred the patient to the specialist. This benefit is tricky in Florida because, in most cases, job injury and illness victims must see company doctors.

Prescription Drugs

Most people pay insurance-subsidized prices for their prescription drugs. Most health insurance policies exclude injury-related costs. So, when a job injury victim picks up a prescription at the store, the victim could be in for a shock.

Workers’ compensation pays 100 percent of reasonably necessary ancillary costs, such as prescription drugs, medical devices, and essential transportation. This benefit eases the financial stress these families undergo, allowing victims to better focus on their recoveries.

Count on a Hard-Working Hillsborough County Lawyer 

Injury victims are entitled to important financial benefits. For a confidential consultation with an experienced workers’ compensation lawyer in Tampa, contact Kobal Law. The sooner you reach out to us, the sooner we start working for you.

Source:

myfloridacfo.com/division/wc/employee/benefits-available-to-injured-workers