What Are ‘Reasonably Necessary’ Medical Bills?
This question is a little harder to answer in Florida than in some other states. Job injury victims don’t have the right to choose their own doctor in the Sunshine State. An insurance company or employer-provided doctor often has a much different view about what’s reasonably necessary than an independent physician. More on that below.
However, several things are definitely true. Job injury victims have the right to get a second opinion from an independent doctor. And, job injury victims are not financially responsible for any reasonably necessary medical bills. A Tampa fair debt lawyer makes a big difference in both areas. Attorneys connect victims with doctors who don’t charge any upfront money. And, attorneys advocate for victims to ensure that greedy medical companies don’t make them pay for covered medical services.
Frequently, when it comes to hospital transportation, insurance adjusters use the “one step lower” approach.
Generally, a work-related trauma injury victim has three transportation options: private transportation, like a ride from a friend or an Uber, ambulance, and helicopter medevac. Adjusters often only offer to pay for the next step lower. For example, if an ambulance took Jim to a hospital, an adjuster might say that an Uber would’ve been just as good.
That’s especially true if the victim died at the hospital, and the adjuster can say “see, a few minutes didn’t matter.” That’s a very callous argument, but one that our Tampa workers’ compensation lawyers regularly hear.
Most trauma injury victims are, at most, semi-conscious during the transportation phase. They’re in no position to question the mode of transportation. Even if they are fully conscious and alert, they understandably defer to the opinion of an emergency responder.
This next area usually applies to initial emergency care treatment and subsequent physical therapy.
Most of us know that insurance adjusters love actuarial tables. These tables often determine what’s “reasonable” in this area, as far as an adjuster is concerned. For example, multiple broken bones in X Zip code requires Y surgical technique and Z days of rehabilitation.
Not all work-related injuries are created equally, and not all victims respond to treatment and therapy the same way. That’s especially true if the victim has a pre-existing medical condition that limits treatment and/or therapy options.
The pre-existing condition wildcard usually applies to prescription drugs as well. These conditions, especially something like a medication allergy, take certain drugs off the table.
Furthermore, the cheapest drug is not always the most effective drug. In fact, the opposite is normally true. The cheapest drug is usually the least effective one. Job injury victims don’t get back to work as quickly if they have limited prescription drug options. An attorney, often in partnership with an independent doctor, helps ensure that these victims get the prescription drugs they need, and not the medicine an insurance adjuster is willing to pay for.
Work With a Diligent 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. The sooner you reach out to us, the sooner we start fighting for you.