Health Care

Medical Benefits

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In the face of a workplace injury, filing a workers’ compensation claim is essential in order to receive your deserved monetary and medical benefits. The first question many injured workers or employees may ask, however, is what medical benefits are covered with workers’ compensation. Cardinal Law Partners is here to break down the ins and outs of workers’ compensation medical benefits as they relate to a workplace injury.

What Medical Benefits Are Included In Workers’ Compensation?

In general, workers’ compensation covers all medical expenses and hospital bills needed to diagnose, treat, and rehabilitate employees involved in a workplace injury. The North Carolina Workers’ Compensation Act defines medical compensation broadly to include all medical treatment reasonably required to effect a cure, provide the injured worker with relief, and lessen the period of disability.  Once a workers’ compensation case has been approved, the medical benefits covered include doctors’ appointments, surgeries, physical therapy, nursing care expenses, rehabilitation expenses, and medical bills. Injured workers are entitled to “sick travel” which typically means mileage to and from doctor appointments (as long as the round trip is 20 or more miles).

Additional coverage may include diagnostic tests, x-ray examinations, MRIs and other radiological tests. The cost of prescription drugs and medications are also typically covered under workers’ comp. In order to receive payment for these expenses, however, the claimant should send a North Carolina Industrial Commission Form 25P to the insurance carrier.

Medical benefits are typically unlimited with no deductible, and payments will be made until the injured employee is cured or reaches maximum medical improvement. Payments are made directly to the healthcare provider, and will continue to be made as long as the insurance company continues to authorize the medical treatment.  Insurance companies will sometimes argue that recommended treatment is not related to the workers’ compensation claim, but the injured worker has the right to request a hearing on causation issues.

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Who Can Treat My Injury For Workers’ Compensation?

The doctor or medical facility providing treatment in the event of a workplace injury is an integral part of the medical benefits afforded in a workers’ compensation case. The physician who treats an injury related to workers compensation may be able to provide crucial opinions on how much an employee receives in workers’ compensation benefits. If the insurance carrier accepts the workers’ compensation claim, they have the right to direct treatment and select the injured worker’s treating physicians.

To get an idea of what medical care provider you may be eligible to see based on where you live and where your workers’ compensation case occurred, a good reference to visit is Workers’ Compensation Doctors.

If you, a family member, or a loved one has questions about what medical benefits you deserve in the face of a workplace injury and workers’ compensation case, the team at Cardinal Law Partners can help. Our attorneys have experience handling worker’s compensation in Raleigh, Belmont, Charlotte, and Greensboro, North Carolina, and the surrounding areas. Call 833-444-4257 to contact us today!

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