What Medical Expenses Does Workers’ Compensation Pay?

By law, workers’ compensation insurance companies must pay all reasonably necessary medical expenses. This subjective term means different things to different people. Many insurance adjusters believe that “reasonably necessary” means “cheapest available.” The cheapest available treatment is usually not the best available treatment, mostly because many workplace injuries such as head injuries, are difficult to diagnose and treat.

A Tampa workers’ compensation lawyer works hard to ensure that job injury and illness victims get the medical treatment they need when they need it, as opposed to the medical treatment an insurance adjuster is willing to pay for. This commitment is difficult to keep in states like Florida that force job injury victims to see company doctors. So, a Tampa workers’ compensation lawyer must work extra hard to obtain evidence in these cases and, if necessary, partner with an independent physician.

Transportation Expenses

Most people know that hospital bills are very high in Florida. Sometimes, transportation to a hospital could approach these expenses.

Usually, emergency treatment requires ambulance transportation. Even if victims can get a ride with someone else or take an Uber, an ambulance is usually a better idea. Ambulance-transported victims usually go to the top of the list in terms of treatment priority.

Many insurance adjusters don’t see things this way. They believe that an Uber and an ambulance are basically the same. Since Uber is a lot cheaper, the adjuster agrees to pay the Uber cost and states that the remainder was unreasonable.

Frequently, a Tampa workers’ compensation lawyer points out that, because of the aforementioned treatment priority, ambulance transportation saved the insurance company money. At that point, an attorney is speaking a language the adjuster understands.

Emergency Care

Work-related injury stays are usually longer than non-work-related injury hospital stays. For example, surgery to correct a broken shoulder may only require one procedure in many cases. But injury victims usually aren’t strong enough to undergo complex surgery.

Therefore, doctors must break up one procedure into two or three shorter ones. This approach is best for the victim but it significantly drives up emergency treatment costs. Generally, workers’ compensation insurance adjusters use generic tables to calculate reasonably necessary expenses. If a treatment bill is higher than the chart dictates, the adjuster immediately assumes the expense is unreasonable and therefore uncovered.

Follow-Up Care

Corrective surgery is a bit like weight loss. Pam might lose thirty or forty pounds, but unless she watches what she eats and exercises regularly, she’ll probably gain that weight back. A doctor could surgically correct Pam’s internal injuries, but without medical supervision, that correction is just a temporary fix.

Attorneys help ensure that doctors do not abandon patients after surgery. Continued aggressive treatment is the best way for an injury victim to get back to work quickly. In the end, that’s what everyone wants.

Physical Therapy

Post-work injury physical therapy, especially brain injury physical therapy, is unusually long, difficult, and expensive. Additionally, progress comes in fits and starts. Once again, insurance adjusters usually pay “standard” costs instead of actual costs. Furthermore, if progress flatlines, most adjusters try to pull the plug.

Attorneys help ensure that insurance companies don’t pull the financial pug prematurely, so improvement continues.

Ancillary Expenses

These expenses usually include prescription drugs and medical devices. Job injury victims need top-of-the-line meds and devices, not cheap alternatives.

Count on a Dedicated  Hillsborough County Attorney

Injury victims need and deserve substantial compensation. For a confidential consultation with an experienced workers’ compensation lawyer in Tampa, contact Kobal Law. We routinely handle matters throughout the Sunshine State.

Source:

leg.state.fl.us/statutes/index.cfm?App_mode=Display_Statute&URL=0400-0499/0440/Sections/0440.09.html