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Will Work Comp Pay Any Medical Procedure?

Workers’ compensation is supposed to provide you with full payment for medical treatments. However, this does not necessarily mean that you can get any type of medical treatment that you could ever want. ¬†Disputes may arise and workers’ comp insurers may deny coverage under certain circumstances. If this happens, it is a good idea to speak with an experienced workers’ compensation attorney for help in determining whether the insurer is acting reasonably in denying the care.

Will Work Comp Insurance Pay for All Medical Procedures?

In order for workers’ compensation to pay for a medical procedure:

  • The requested procedure must be a reasonable procedure.
  • The requested procedure must be medically necessary.
  • The requested procedure must be directly related to the work injury.

Essentially, this means that the procedure must be performed by a licensed and/or professional healthcare provider and it must be accepted within the medical community as an effective method of treating the particular condition that you have. For a back injury, for example, you likely could receive surgical treatments that have been proven to alleviate the back injury and you could also have bills paid for a chiropractor to alleviate pain and a physical therapist to strengthen back muscles. You could not, however, get payments for the bills of a faith healer who has promised to cure your back pain with positive thoughts. The first procedures are accepted as standard and reasonable treatment methods, while the treatment provided by the faith healer has not been accepted within the scientific community as a potential method of treating an injury to the back.

Disputes Over Medical Coverage

Usually, it is relatively straightforward to determine whether a medical procedure is reasonable, necessary and related to your work injury. If your treating doctor has advised that the procedure is necessary to treat the injury you developed at work, this is often enough to get the workers’ compensation insurer to pay. When disputes arise, however, then an independent medical examiner (IME) can review the situation and your medical condition and can make recommendations.

If coverage of any of your medical procedures is in dispute, it is very important that you understand your legal rights and that you know how to protect yourself and get the treatment that you need. An experienced workers’ compensation attorney can guide you through the process of working with an independent medical examiner and can assist you in all aspects of negotiating with the workers’ compensation insurance company to get your medical bills paid. Do not hesitate to contact Kohlmeyer Hagen Law Office Chtd. today so that you can get the process moving forward and make sure that you get all of the medical assistance that you require to get better from your work injury. Call 507-625-5000 .