If you were hurt at work and are considering filing a Workers’ Compensation claim, it is important to understand how your medical care will work. There are restrictions on what can be covered, processes for getting care approved, rules for following through with recommended care, and restrictions on what physicians you can use.
Under Workers’ Compensation, all medical care tied to your injury or illness should be covered, but only if the injury or illness is work-related. Additionally, you need to get care approved before insurance will cover it, and that approval and the care itself can only be provided by doctors that your employer or their insurance provider approves. Moreover, you must follow through with recommended care and appointments or else you could risk losing your benefits.
For help with your Workers’ Compensation claim, call our Arkansas Workers’ Compensation lawyers today at (479) 316-0438.
What Medical Care Is Covered Under Workers’ Compensation in Arkansas?
If you file a claim for Workers’ Compensation, it is supposed to cover any and all medical care needed to treat a work-related injury. Of course, what is supposed to happen and what actually happens are often quite different, which is where our Arkansas Workers’ Compensation lawyers can help.
Covered Injuries
Workers’ Compensation is supposed to cover treatment for any injuries that occurred in the course of your work. That can include injuries on the line, while traveling between worksites, during training, and even potentially at required after-hours meetings or team-building sessions. This does not cover medical care for injuries you already had, but it can cover treatment for existing injuries to the extent that they were made worse by work, such as an acute injury to your preexisting “bad back.” It also does not cover injuries during your commute, but injuries should be covered while traveling between job sites.
Employers and their insurance companies often try to get medical expenses denied by claiming the injury happened outside of work and that you are trying to pass it off as a work injury.
Covered Illnesses
Similarly, Workers’ Compensation should cover any work-related illnesses or conditions. Proving that something like cancer was linked to your job conditions is often an uphill battle, but our attorneys are prepared for fights like this.
Covered Emergency Care
Whether or not you end up facing additional medical care needs beyond your initial accident, emergency treatment should be covered by your employer’s Workers’ Compensation insurance. This means that if you need to leave work in an ambulance to get treatment in the ER, your employer’s Workers’ Compensation should end up being the one to cover the bill.
How Does Workers’ Compensation Pay for Medical Care in Arkansas?
When you go to the hospital or a doctor’s office to get treatment, they ask you what your health insurance is and how you will be paying. When you go to a doctor with the intent of using Workers’ Compensation to cover your care, you merely give them the proper information and they will bill your employer’s Workers’ Compensation insurance for the costs of services.
Note that with Workers’ Compensation, you cannot just see any doctor of your choice. The insurance carrier is allowed to pick what doctors or hospitals they have approved for your care. When you do use those doctors, they will both be willing to accept Workers’ Compensation for billing and familiar with the process. Additionally, once your care plan is put in place by an approved doctor, your information should be in the system and ready to go for future appointments.
Not every doctor accepts “third-party billing” in the first place. Third-party billing refers to when a third party, such as Workers’ Compensation or another driver’s car insurance, is the one paying for your care. Since these doctors’ offices are not set up to bill Workers’ Compensation anyway, they will not treat you.
Hospitals are usually set up to do billing this way and might have an obligation to treat you under various state and federal laws. When it comes time for them to ask you about insurance, you might be able to redirect them to the Workers’ Compensation insurance carrier or else seek reimbursement later.
How Much Does Workers’ Compensation Cover for Medical Expenses in Arkansas?
Workers’ Compensation is supposed to cover all medical bills and expenses related to treatment for a work-related injury. There should not be a limit on this care, and any and all necessary medical procedures should be covered. However, whether the doctor thinks the procedure or therapy is “necessary” or not might be up for contention.
Fighting to Get Treatment Covered Under Workers’ Compensation in Arkansas
While insurance carriers usually cannot pick and choose which services to cover, they might try to deny that certain procedures are indeed necessary. For example, if you have a serious leg injury and need physical therapy, the doctor might recommend a course of 12 weeks of therapy. If you get through those 12 weeks and still do not feel like you have reached what’s known as “maximum medical improvement,” you might need more therapy.
However, your doctor – who might work for or closely with the insurance company – might reject that idea. You could go get a second opinion and seek treatment that you pay for yourself, but it is supposed to be covered! As such, our lawyers might be able to appeal decisions, seek second opinions, and challenge coverage so that more medical treatments are paid for.
Call Our Arkansas Workers’ Compensation Lawyers Today
For a free review of your case, call our Arkansas Workers’ Compensation lawyers right away at (479) 316-0438.