The Three Faces of Medical Bills in a Job Injury Claim

The average injury-related medical bill in Florida usually exceeds $40,000. The average cost of medical treatment is like the average cost of a motor vehicle. New vehicles vary so much in terms of size, options, and other features that the “average” cost is almost meaningless. A minivan costs a lot more than a motorcycle. Medical treatment costs vary almost as much. Yet many insurance companies insist that a motorcycle is always appropriate, regardless of the patient’s needs.

A Tampa workers’ compensation lawyer works hard to ensure that job injury victims get the medical treatment they need and not the medical treatment an insurance adjuster is willing to pay for. Job injury benefits are also entitled to lost wage replacement and other economic benefits. Some victims may file legal claims outside the workers’ compensation system and obtain even more compensation for their serious injuries.

Transportation

Florida law requires workers’ compensation insurance companies to pay all reasonably necessary medical bills. This requirement might be an issue before the victim arrives at a hospital.

If emergency responders believe the victim has a life-threatening injury and/or the injury occurred at a remote location, like an isolated factory, emergency responders often summon medical helicopters. Medevac might not be reasonably necessary, at least according to a workers’ compensation insurance company lawyer.

But to a Tampa workers’ compensation lawyer, an emergency responder’s decision at the scene has more weight than an insurance company adjuster’s decision who knows nothing about the facts.

Surface ambulance trips might be controversial as well. Frequently, insurance company lawyers argue that an Uber would have been just as good.

But Uber drivers cannot go into emergency mode (lights flashing and siren screaming) to avoid unexpected traffic backups and other unanticipated delays. Furthermore, Uber drivers cannot help victims if their conditions suddenly and unexpectedly deteriorate.

Emergency Care

Once again, insurance company adjusters believe they can second-guess medical professionals, in terms of what care is reasonably necessary.

Frequently, adjusters use boilerplate charts to determine what bills are reasonably necessary in a certain situation. For example, a char might dictate that if a victim lives in A location and sustains B injury, C amount of medical bills are reasonably necessary.

Alas, medical treatment for serious injuries isn’t as easy as ABC. Not all injury victims are good candidates for all surgical procedures. Other victims have pre-existing medical conditions that limit treatment options. In these situations, doctors must use a backup plan. These backup plans are generally costlier, but the costlier plan is clearly reasonably necessary based on the facts.

Generally, a Tampa workers’ compensation lawyer asks an independent doctor to review medical treatment and verify that the approach was reasonably necessary under the circumstances.

Follow-Up Care

Medical treatment isn’t over after victims recover from emergency surgery. In fact, in most cases, medical treatment is just beginning.

Physical therapy is often longer and costlier than emergency care. Brain injury physical therapy is a good example. Delicate brain surgery prevents these injuries from getting worse. But the injury itself is irreversible. Thus, a physical therapist must painstakingly train uninjured parts of the brain to assume lost functions.

Progress is measured in fits and starts instead of a straight line. Patients might have breakthroughs after progress has seemingly stopped.

During these plateaus, insurance company lawyers often try to pull the financial plug. A Tampa workers’ compensation lawyer advocates for victims so the money keeps coming and victims keep getting better.

Thanks to a new law, workers’ compensation medical benefits continue for up to five years. This extension helps victims fully recover and get back to work, which is usually what everyone wants in the end.

 Connect With a Savvy Hillsborough County Attorney

Injury victims are entitled to important financial benefits. For a free consultation with an experienced workers’ compensation lawyer in Tampa, contact Kobal Law. We do not charge upfront legal fees in these matters.

Source:

pubmed.ncbi.nlm.nih.gov/31888976/