The cost of medical treatment in America is at an all-time high. One injury or illness has the potential to bankrupt a family – and it does not even need to be that serious of an injury. Fortunately, medical care after a work-related accident and for work-related health conditions is 100 percent compensable by workers’ compensation. If you suffer injuries on the job, you do not have to concern yourself with how you are going to cover the medical bills; your employer’s workers’ compensation insurer should pay for it.
When do my workers’ compensation medical benefits kick in?
So long as you are eligible for workers’ compensation, all medical treatment from the moment of injury is covered. This is a good thing, because medical bills can be astronomical. In 2014, workers’ compensation insurers shelled out $220,084,601 just for medical bills (not including lost wages) for injured workers in Georgia, according to the State Board of Workers’ Compensation (SBWC).
In order to be covered, all of your treatments must be reasonable, necessary, and authorized by your workers’ compensation doctor. Types of treatments that are covered include the following.
- Diagnostic tests
- Emergency room and hospital bills
- Follow-up appointments
- Approved treatments with specialists
- Prescriptions and surgeries
- Second opinions (Independent Medical Exams or IMEs)
- Physical therapy
- Necessary travel expenses
When do the medical benefits stop?
Prior to July 1, 2013, injured workers in Georgia were entitled to medical benefits for as long as their injury required. This is no longer the case.
Georgia recently changed its laws regarding the duration of medical benefits for injured workers. If your injury occurred on or after July 1, 2013, your medical treatment benefits will be limited to a maximum period of 400 weeks from the date of injury. The only exception is if the insurer deems your injury catastrophic in nature. In this case, you may be entitled to lifetime medical benefits.
Can I choose my own doctor for my medical treatment?
In short, no. You must choose a company-approved doctor. Your employer is obligated to have a Panel of Physicians posted in a prominent location on the worksite. Employers usually post the panel somewhere you pass by every day, such as on a bulletin board, in the break room, or near by the clock-in station.
Panels will include the name and contact information for at least six physicians. You may choose any doctor on the list for your work injury-related care. If you are unhappy with that doctor, you can opt to change to another doctor on the list without your employer’s approval one time during the course of your treatment.
If you are still not satisfied or believe your doctor is pushing you to go back to work before you are physically able, you can request a second opinion and additional diagnostic tests from an independent physician at the expense of your employer. However, there is a time limit on and a procedure for obtaining a second opinion. Your attorney can advise you accordingly.
Will workers’ compensation reimburse me for gas mileage for my medical treatment?
Yes, your gas mileage to and from your medical appointments is reimbursable, too. The reimbursement rate for 2015 is 57.5 cents per mile. Unfortunately, many people on workers’ compensation do not fully capitalize on this benefit.
First, many people do not even know that travel expenses are reimbursable or how to accurately track them. Second, many people do not know that you have to submit a specific request for gas mileage reimbursement, and that you must submit your request within a year or forfeit your right to reimbursement.
Finally, a lot of workers are just unaware of all the types of trips that are compensable by workers’ compensation. It is not just trips to the doctor and hospital, but also trips to the pharmacy to pick up your medicine and trips that you have to make while participating in a vocational rehabilitation plan.
Granted, 57.5 cents might not seem like a lot, but it adds up over time, and it is money that you do not have to spend. The best way to handle medical treatment gas mileage reimbursement is to work with your lawyer to track your expenses. Once you submit your request, the insurer will reimburse you within 15 days.
What if I use my own health insurance to pay for medical treatment?
If the insurer disputes or denies your claim, you are in the midst of an appeal, or it is taking a long time to reach a resolution, you can opt to use your own health insurance in the interim until your case resolves.
However, be forewarned that your health insurance company will likely want to be reimbursed when you get your workers’ compensation settlement. This is known as subrogation.
For questions about workers’ compensation or your medical treatment benefits, call the Bader Law Firm in Savannah. You can schedule a free, no-obligation consultation with our work injury attorneys anytime by calling 678-562-5595.