Medical Treatment for Orlando Workers’ Compensation Cases
Trust Van Dingenen Law Can Help You Get Medical Treatment
One of the most important aspects of your claim is getting medical treatment for your injury. Under Florida Law, the insurance company gets to pick your doctors and they have to “authorize” your treatment before you receive it. Don’t wait any longer for the insurance company — our attorneys can file a claim on your behalf to get the medical treatment you need.
If you have been injured on the job, your employer’s workers’ compensation insurance should provide you with medical care.
Types of medical treatment that may be covered by workers’ compensation include:
- Diagnostic tests – This usually includes tests such as MRIs, CT scans, and X-rays to determine your level of injury.
- Medical equipment – Items such as wheelchairs, crutches, and other necessary medical supplies.
- Doctor visits – Including referrals to specialist such as orthopedics, neurosurgeons, and pain management specialists.
- Unpaid medical bills – You should not be responsible for paying any medical treatment related to your work injury.
- Physical therapy – Licensed physical therapists, massage therapists, and other certified therapists.
- Surgical procedures – Any necessary surgeries related to your injury.
- Hospital stay – Required stay in the hospital for your injuries.
- Emergency room care – Treatment received in the ER due to a work-related injury.
- Prescriptions – Necessary medications used to treat your injury or work-related illness.
- Travel reimbursement – You can be reimbursed for your mileage driving to and from your authorized doctor’s appointments (including pharmacies).
Is There a Cap to Medical Treatment Coverage?
Medical benefits under workers’ compensation do not have a cap. As long as the treatments are necessary for you to recover from a job-related accident and injury, you should have to pay nothing from your own pocket to receive them. Even if your treatments range into hundreds of thousands of dollars or more, the insurance company has to foot the bill.
Also, miscellaneous costs of medical treatment should be fully covered, like copays and deductibles. If you are being required to pay such costs, then it is time to talk to one of our Orlando workers’ comp attorneys.
Can Medical Treatment Coverage Be Denied?
There are two ways that insurers often try to deny medical treatment coverage:
- Elective treatments: Workers’ compensation insurance only covers the above treatments when they are deemed “necessary” to help the worker recover and return to work. Insurance companies sometimes like to deny medical treatments by arguing that they are not necessary but merely elective. An elective medical treatment is suggested by a doctor or requested by a patient, but that is not required for them to reach their maximum medical improvement (MMI). Countering an insurance company’s argument that your treatments are elective can be tricky if your medical provider has not been thorough with their notetaking.
- Incorrect aftercare: After you are released from the hospital to continue treatments at home, you should be given a set of aftercare instructions. Commonly, aftercare will tell you to get a certain number of hours of bedrest each day, take prescription medicines as needed, exercise or stretch affected limbs, and so on. Insurance companies can try to deny future medical treatment coverage if you do not follow aftercare instructions correctly, though. They can make the argument that your conditions have worsened because of your intentional neglect, and, therefore, they should not be liable for any new treatments needed to make up for your mistakes.
Can You Ever Choose Your Own Workers’ Comp Doctor?
Florida has some of the tightest restrictions regarding what doctors can treat an injured worker after a workplace accident. The law clearly states that an employee must see a medical provider that has been approved by the employer or the insurance company. If another doctor treats an injured worker, then the insurance company can and most likely will deny coverage entirely.
There is one exception, though: emergencies. When a worker has been severely injured and needs medical attention immediately, and there is no time to check with an employer to find which emergency room is in-network, the worker can be taken to the nearest emergency room or hospital. The treatments rendered there should be covered by the workers’ compensation plan. In such cases, it is common for the worker to be transferred to an approved medical clinic or provider once they are stabilized.
We Will Travel to You if You Can't Come to Us
At Van Dingenen Law, our workers’ compensation attorneys in Central Florida are dedicated to helping you. In fact, because we only focus on workers' compensation law, you can trust that we have the experience and knowledge to help you. After you've been injured, we are ready to help you, whether you can come to our office or if we need to visit you at home or in the hospital.
Call (407) 967-5377 to see if you are entitled to compensation. We offer free consultations.
Q:Do I need to cover any medical expenses on my own?
A:No. Any authorized medical bills related to your treatment can and should be submitted to your insurance provider once the claim is approved.
Q:Will I still have to pay co-pays on medical treatments and visits?
A:No, you will not need to pay your usual co-payments for doctor’s visits and treatments related to your work injury. Once your doctor determines that you reach “maximum medical improvement,” your additional treatments will carry a $10.00 co-pay.
Q:Is my transportation to the doctor covered under workers’ comp?
A:Yes, your transportation to and from the doctor’s office should be covered under the workers’ compensation program. Either your employer or the insurance provider should take responsibility for helping you arrange and cover transportation to your appointments.
Q:What medical treatments are covered under workers’ compensation insurance?
A:Any medical treatments that are deemed necessary for your specific injury should be covered, as long as your authorized doctor has approved them.
Q:What can I do about issues with my pharmacy for workers’ comp prescriptions?
A:Under Florida law, you’re permitted to pick your own pharmacy or pharmacist for filling workers’ comp prescriptions. Unfortunately, not all pharmacies will fill a prescription for the workers’ compensation program. If that happens, you should choose a different one.