Workers’ Compensation and Medical Bills
If you suffered an on-the-job injury and require medical care or rehabilitation, your employer is likely required to provide workers’ compensation benefits for the costs of treatment. Workers’ compensation laws require most employers and their workers’ comp insurers to pay 100 percent of all reasonable and necessary medical bills incurred by a qualifying employee.
However, injured employees sometimes struggle with disputes from their employer or insurer over the reasonableness or necessity of medical treatment. Some also face questions of whether the treatment is related to the employee’s work injury. In other cases, employers or insurers may deny payment of medical bills altogether.
Is your employer or its workers’ comp insurer refusing to pay medical bills for your on-the-job injury? It’s time to seek help from a workers’ compensation lawyer. Turn to Trollinger Law LLC. For years, injured workers across southern Maryland and Washington D.C. have trusted us for help with their workers’ compensation disputes. We can determine whether you are getting the fair treatment that you deserve.
Our law firm focuses solely on injury cases, giving us the in-depth experience and resources needed to advocate for your rights and interests thoroughly. Let us push for the medical care you need to get back to work.
We’ve got answers if you have questions about what is covered by workers’ compensation. Call or fill out our online contact form for a free case review.
What Are My Rights If I’m Injured at Work?
Workers’ compensation laws in Maryland and Washington D.C. protect you if you are hurt in the course and scope of your employment. You have the right to:
- File a workers’ compensation claim to obtain payment of your medical expenses due to the job injury
- Receive medical treatment and financial benefits if you miss time from work
- Choose your doctors
- Hire a workers’ compensation attorney to help you file a claim and represent you during the claims process
In addition, your employer cannot retaliate against you for by your employer for filing for workers’ comp. including not being demoted, suffering a pay rate cut, or being laid off or fired.
Does Workers’ Comp Cover All Medical Bills?
Workers’ compensation requires an employer or its insurer to pay for all reasonable and necessary medical treatment and rehabilitation for an employee’s work injury or occupational illness. This gives the employer some latitude on what costs they will pay. If a worker requests or receives treatment that the employer or its insurer deems unreasonable, they may refuse to pay for that course of treatment.
In addition, an employer or its insurer may decline to cover medical bills for treatment that they determine was not related to the employee’s work injury or occupational illness. For example, suppose you suffer a shoulder injury at work and also receive physical therapy to treat back pain. In that case, your employer may conclude that the treatment was not related to your compensable work injury.
Does Workers’ Comp Cover All Work-Related Injuries?
Not all injuries that occur in the course and scope of your employment may be covered by workers’ compensation. You could be ineligible for workers’ comp if you got hurt at work while:
- Drinking or using illicit drugs
- Engaging in horseplay
- Starting a fight
- Committing a crime or violating your employer’s policies
- Attempting to injure yourself intentionally
Do I Have to Be Injured at My Workplace to Be Covered by Workers’ Comp?
No. An injury should be covered by workers’ compensation so long as it occurred in the course and scope of your employment. If your job duties take you away from your regular workplace or your employer’s facilities, you can still receive workers’ comp if you are hurt while performing those duties. This might apply if you get injured in a car accident while on business or while visiting a client’s site to fulfill your job duties.
But not all injuries that occur at your workplace will be covered by workers’ comp. For example, injuries that occur while walking into your workplace at the start of the day may not be covered because you weren’t performing job duties at the time of the accident.
What Happens to Medical Bills When Workers’ Comp Is Denied?
In some cases, an employer or its insurer may decline to pay your medical bills even though you believe the course of treatment was reasonable and related to treating your job injury or illness.
In Maryland and Washington D.C., you can choose your own medical providers for treatment. For this reason, it’s critical to let your providers know that your job caused your injury so they can prepare documentation to obtain payment from workers’ comp.
You should also provide your health insurance information to your treating providers. If workers’ comp denies payment on a medical bill, your health insurer may be obligated to provide coverage for that bill.
Can I Appeal a Denial of Medical Payment?
Your employer’s workers’ comp insurer may have a process to allow you to appeal the denial of medical bills. However, you also have the option of filing a formal workers’ compensation claim with the Workers’ Compensation Commission (Maryland) or Department of Employment Services (Washington, D.C.).
While you pursue a formal workers’ comp claim, your treating provider may refrain from demanding payment on their bill and instead await the outcome of your claim. Or if your health insurer paid the provider already, they may place a lien on your workers’ comp claim securing their right to reimbursement later.
Contact Our Workers’ Compensation Lawyer After a Workplace Accident
Employers have obligations to pay reasonable medical expenses for eligible workers who suffer on-the-job injuries or live with an occupational disease. If you have trouble getting your medical bills paid, Trollinger Law LLC can help. Call or contact us today for a free consultation with a highly qualified workers’ compensation lawyer.