Workers' Compensation Will Give You Unlimited Medical Care As Long As…
Posted on: 4 July 2018
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If you have been hurt on the job and you qualify for workers' compensation, then you shouldn't worry about the cost of your treatment because workers' compensation insurance will take care of them. The insurance career will pay for your medical care as long as you meet the following conditions.
The Medical Care Is Reasonable and Necessary
In all cases, you will only have unlimited medical care as long as the care is reasonable and necessary. A medical treatment is reasonable if it makes sense given the nature of your injury, and it is necessary if it may help your condition improve.
For example, if you have a burn injury, then workers' compensation may pay for massage therapy since there is medical evidence that massage therapy helps with burn injuries. However, workers' compensation may balk at paying your visits to a chiropractor if you are suffering from allergic reactions to a substance because chiropractors only deal with mechanical disorders of the musculoskeletal system.
You Haven't Realized Your Maximum Medical Improvement
If you are injured, the maximum medical improvement (MMI) is the point at which your doctor doesn't expect significant change irrespective of further treatments. You may reach the MMI point without fully recovering from your injuries. For example, a paralysis victim may reach MMI without full use of their limb if a doctor deems that the limb is permanently paralyzed, and no treatment can reverse the paralysis.
Most likely, workers' compensation will stop paying for your treatments if you have reached your MMI. This is because, in the views of your doctor and workers' compensation insurance, further treatment will not yield any positive changes for you if you have reached MMI.
You Have MCO Authorization
Lastly, workers' compensation insurance may also refuse to pay for your medical treatment if you don't have authorization from the relevant managed care organization (MCO). An MCO is the medical provider or group of medical providers offering managed care plans to specific groups of people, such as the employees of a self-insured business.
In some cases, you may be required to get authorization from an MCO before getting a specific treatment. This may be the case for treatments that seem experimental, expensive treatments or treatments that don't seem relevant to your case (but are actually relevant).
Hopefully, you won't have any complications with your treatment bills after filing a workers' compensation claim. Consult a workers' compensation attorney for help if you do experience any complication.