Workers’ Compensation Medical Care
Workers’ compensation insurance normally covers reasonable medical care costs. Medical care may include treatment by various medical professionals, including physicians, chiropractors, psychologists, or psychiatrists. You may also be reimbursed for medical supplies, generic medications (unless specifically prescribed otherwise), and roundtrip mileage to and from your medical appointments.
The injured or ill worker who is eligible for workers’ compensation will receive necessary medical care directly related to the original injury or illness and the recovery from his/her disability. The treating health care provider must often be authorized by the administrative agency responsible for overseeing the Workers’ Compensation program, except in an emergency situation.
Medical benefits available through workers’ compensation include hospital and medical expenses that are necessary to identify and treat your injury or illness. Although the details of what is covered vary in each state, workers’ compensation generally covers such things as doctor visits, medication, and surgeries. If you need equipment (such as a wheelchair or special vehicle) to help you deal with your injury, workers’ compensation will likely cover that cost as well. In some instances, workers’ compensation will also cover services like counseling, pain therapy, and acupuncture.
Determine if any injury or illness is work-related
When a patient presents at a medical office, it is very important for the physician to determine if any injury or illness is work-related. The intake information sheet and the physician’s history and physical can accomplish this. If the patient’s injury or illness is work-related, the physician’s office should determine if the employer has Workers’ Compensation coverage. If the coverage is under the Texas Workers’ Compensation system, then the physician and his or her office must follow the statute, rules, and guidelines of the state of Texas.
All reasonable expenses incurred by or on behalf of an employee in providing treatment must be paid. This includes travel costs, copying charges, costs of medical reports and, in some cases, attorney fees that are directly related to the treatment that is requested by the employee.