What to Do When Workers’ Comp Denies Your Ongoing Medical Treatment

I have continued to receive treatment from my workers’ compensation doctor, but now the insurance company is denying to pay for my further medical treatment?

This issue was address by the North Carolina Court of Appeals in Dunbar v. Acme Southern (2020).

In this case the injured employee was not entitled to any ongoing disability checks due to his injury at work, but he continued to receive medical treatment for his workers’ compensation injury.  At some point, without the knowledge of the injured employee his medical bills began to be paid by Medicare vs. his employer via the  workers’ compensation claim.  After approximately 4 years of this occurring, the injured employee was recommended to see a new doctor for medical treatment related to his work injury, but the employer denied payment for this  based on the fact that they had not paid for medical treatment in more than 2 years.

The North Carolina Court of Appeals noted that an injured employee’s entitlement to medical treatment shall terminate 2 years after the employer’s last payment for medical treatment.  The North Carolina Court of Appeals ruled that the because the last time the employer paid for medical treatment was more than 2 years that the employer was not responsible for payment for any further medical treatment due to the injured employee’s injury at work.

This case highlights the need throughout your workers’ compensation claim to stay on top of all the benefits being paid and who is paying for these benefits to assure you receive all the benefits you may be entitled to as the result of an injury at work.

Should you have any questions about this or any other issues involving your work-related injury, please feel free to reach out to one of the Board Certified Workers’ Compensation Specialists at Cardinal Law Partners for a free consultation by calling (833) 444-4127.