Workers’ comp in North Carolina will cover your medical expenses associated with your workplace injury.
In fact, one of the primary purposes of workers’ compensation insurance is to prevent injured workers from getting saddled with medical bills due to their on-the-job accidents.
With that being said, there are rules and regulations in place that you must follow to ensure you are not stuck with outstanding medical expenses.
While worker’s comp is intended to pay these costs, the coverage comes with restrictions, exceptions, and uncooperative employers. You have come to the right place if you are injured at work and wondering who pays for your medical bills.
Who Pays for Workers’ Comp Medical Bills?
An employer is responsible for maintaining worker’s compensation insurance to cover the medical bills of an injured employee. If the worker’s comp insurance carrier accepts your claim as payable, your employer will arrange to pay your medical bills.
Remember, medical treatment is only provided for the compensable injury or illness, which includes any condition that is a direct and natural consequence of the compensable injury.
For instance, a leg injury may alter how an individual walks or carries themselves. If this, in turn, causes a back injury from the shift in how they maneuver in daily life, the back condition may also be covered by workers’ comp.
What Is Considered Medical Treatment?
When you think of medical treatment for a work injury, you will probably immediately think of traditional medical services such as emergency room care and doctor visits. However, medical treatment can go far beyond that.
Any medical treatment aims to cure the injury or illness, which can encompass many forms of care.
Workers’ comp medical treatment can also include:
- Diagnostic treatment (including radiology services),
- Physical and occupational therapy,
- Prosthetics, and
- Home modifications.
Every situation is unique, and your injury may only require only minor medical intervention, while other injuries require extensive treatment.
Does Workers’ Comp Cover All Medical Bills?
Workers’ comp is intended to cover all necessary medical costs associated with a workplace injury. However, your employer can generally choose the authorized treating physicians you will see.
Authorized doctors can become a contested issue between employees, the employer, and the insurance carrier for several reasons. The injured worker may not see eye to eye with the doctor or disagree with the doctor about the extent and cause of the injury.
Authorized treating doctors are also the ones that will assign a disability rating and work restrictions, which will influence the payment of benefits. For injured employees, a lot is at stake, and having a treating physician who has your best interest in mind is imperative.
Can Injured Workers Seek Alternative Authorized Providers?
Injured workers can seek approval for a change in authorized treating physicians if the employee can show that a change is necessary to reduce pain, cure the injury, or assist in getting the employee to return to work. Employees also have the option to seek a second opinion.
Exceptions to Authorization Requirement
Generally, emergency medical treatment, such as going to the E.R. immediately following the accident, is exempt from pre-authorization requirements.
This makes sense to ensure injured workers receive life-saving and emergent medical care at the nearest hospital in the event of severe injury.
Remember, while emergency room treatment is generally an exception to authorization requirements, you can’t bypass the normal channels of care by simply going to the emergency room for any treatment.
By seeking unauthorized treatment or non-emergent emergency room care, your claims may be denied, and you may be ultimately responsible for the bills.
Contact Our North Carolina Workers’ Compensation Lawyers
With over 140 years of collective experience, our team of seasoned attorneys understands the inner workings of the North Carolina workers’ comp system. Worrying about medical bills during your recovery from a workplace injury can be stressful.
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