What Medical Bills Does Workers’ Compensation Cover?

Doctor bills and other medical expenses stabilized during the Great Recession, but they are on the rise again. Most experts predict that medical inflation will be twice the overall inflation rate for the foreseeable future. Further complicating matters, many health insurance companies do not pay work injury-related medical bills.

In Mississippi, workers’ compensation takes care of medical bills. However, to determine reimbursement, many insurance plans use predetermined coverage amounts instead of the actual medical bills. For example, the insurance company might pay $2,000 in medical expenses for a broken leg, regardless of the actual billed amount.

A Jackson workers’ compensation attorney can force the insurance company to reimburse based on actual expenses instead of theoretical amounts. Moreover, an attorney usually arranges for insurance companies to pay these expenses directly. So, many victims never see medical bills.

Transportation

Many job injuries occur in remote locations. That’s especially true of trauma injuries. Medical evacuation might cost as much as $25,000 for a fifty-mile flight. This average cost has risen much more rapidly than medical inflation in recent years.

Frequently, workers’ compensation insurance companies claim these trips are unnecessary and they refuse to pay for them. So, an attorney collects medical and other supporting evidence. Otherwise, victims could end up paying transportation bills out of their own pockets.

Emergency Care

This medical care phase often involves multiple stops. Frequently, nearby facilities stabilize trauma injury victims and then they go to larger facilities for more complete treatment. Similarly, many occupational disease victims must go to several doctors before their illnesses are properly diagnosed.

Follow up Care

Generally, most surgeons want victims to attend at least one follow-up appointment before physical therapy begins. Many victims must have stitches removed from large cuts, metal plates removed from broken bones, and so on. Additionally, many doctors want to re-evaluate patients before physical therapy begins. The cost of all these visits quickly adds up.

Many insurance companies refuse to pay for all these visits, especially if the doctor does not remove anything. But frequently, these visits set the stage for more successful physical therapy. They are essential to overall care, and the insurance company is therefore legally required to pay the complete cost.

Prescription Drugs

Frequently, medication costs approach or exceed hospitalization costs. That’s especially true if, as is commonly the case, the job injury victim needs home health care to administer and monitor the medication. On a related note, medical devices and other medical equipment can be quite costly as well.

Insurance company adjusters are not doctors. They do not have the right to dictate things like whether the victim needs generic or premium drugs. Your health is no time to take shortcuts and cut corners.

Physical/Occupational Therapy

There is a difference between physical and occupational therapy. Physical therapy helps victims return to the lives they had before their injuries. Occupational therapy helps victims develop new skills, so they can deal with their new physical limitations. Workers’ compensation does not just help victims get better. It helps them carry on with the rest of their lives. 

Reach Out to an Assertive Attorney

Insurance companies often want victims to settle for second-rate medical care. A lawyer helps ensure that doesn’t happen. For a free consultation with an experienced Jackson workers’ compensation attorney, contact Lunsford, Baskin & Priebe, PLLC. After-hours visits are available.

Resource:

bls.gov/cpi/factsheets/medical-care.htm

https://www.lunsfordbaskin.com/top-five-occupational-diseases-in-mississippi/