The FDCPA and Workers’ Comp

Most people know the Fair Debt Collection Practices Act for its limitation on debt collectors. But the FDCPA is also meaningful for job injury victims. It protects them from financial responsibility for unpaid medical debts. Or, more specifically, it protects them from financial responsibility for gap amounts.

Most people know there’s a significant difference between the private pay cost and insurance reimbursement cost for medical services. Frequently, hospitals try to bill individuals for the difference. This practice is semi-legal in many situations, depending on the wording in the health insurance policy. But it’s always illegal in workers’ compensation situations.

For a Tampa workers’ compensation lawyer, standing up for your rights is a two-step process. First, an attorney must be aware of your rights, and any limitations on those rights. Second, a Tampa workers’ compensation lawyer must aggressively stand up for these rights in court. Usually, FDCPA violations are separate from workers’ compensation claims.

Covered Expenses

Quite simply, all reasonably necessary medical expenses are covered by workers’ compensation. This list includes:

• Transportation: These expenses are usually only reimbursable in fall and other workplace trauma injury claims. Ambulance rides to hospitals are quite expensive. Helicopter rides could easily cost ten times as much. This critical coverage ensures that victims get help ASAP.
• Emergency Care: Many job injury victims are so badly hurt that doctors can’t correct all their medical problems in one procedure. Instead, they must spread this treatment over multiple procedures. That act increases the cost of medical treatment, something that insurance adjusters usually never understand.
• Follow-Up Care: Emergency care usually isn’t a one-and-done procedure. Later, stitches, metal plates, and other treatment aids must be removed. Furthermore, these victims require constant monitoring to ensure they don’t relapse.
• Physical Therapy: PT is part of follow-up care. After job injury victims recover from their injuries, they must rebuild their strength before they can return to work. Not everyone responds to physical therapy equally. So, the boilerplate tables most adjusters use (e.g. three PT sessions for a broken arm) are often inapplicable.

FDCPA/workers’ compensation violations are especially common if doctors must perform duplicate procedures. Diagnostic tests are a good example. Frequently, a doctor orders an MRI to confirm X-ray results. Many hospitals bill workers’ compensation for one procedure and the victim for the other one.

Willful blindness is also an issue for a Tampa workers’ compensation lawyer. The workers’ comp billing department is usually separate from the standard billing department., Frequently, these two entities don’t communicate very well.

Damages Available

Hospitals and other entities that violate the FDCPA face stiff penalties. In addition to compensatory damages, the hospital or other entity must pay $1,000 per violation. Each letter, phone call, or other collection attempt is a separate violation.

These damages are in addition to the workers’ compensation benefits available, such as medical bill payment, as outlined above, and lost wage replacement. Most job injury victims receive two-thirds of their AWW (average weekly wage) for the duration of their temporary or permanent work-related disabilities.

Usually, a Tampa worker’ compensation lawyer partners with an accountant or other outside professional to determine a fair amount of lost wages if the victim is disabled (cannot work again, or at least cannot work full-speed again).

 Contact a Diligent Hillsborough County Lawyer 

Injury victims are entitled to important financial benefits. For a confidential consultation with an experienced personal injury lawyer in Tampa, contact Kobal Law. Virtual, home, and hospital visits are available.

Source:

federalreserve.gov/boarddocs/supmanual/cch/fairdebt.pdf