The purpose of workers’ compensation insurance is to cover employees for all of the medical care they require after an accident at work leaves them injured.
Companies with more than five employees are required to carry workers’ comp insurance in every state except Texas.
This means that if you're injured at work in Kansas or Missouri, you shouldn't have to pay out of pocket for any examinations, tests, or treatments. If you're being denied payment for medical care following a workplace injury, you may need the help of a workers’ comp attorney. We provide this explanation of what should be covered so that you can protect your rights to coverage.
Medical Care That Is Covered Under Workers’ Comp
No one expects an accident to occur at work, but when it does, a worker shouldn't hesitate to report the injury to his employer and seek medical attention as soon as possible.
If the accident is sudden and serious, the employee may need an ambulance to get emergency medical treatment. Some workplace injuries are repetitive-use injuries such as carpal tunnel syndrome or back strains. These kinds of injuries are also covered by workers’ comp, but you have to report the injury to your employer before seeking treatment and follow his instructions for diagnosis and care in order for it to be covered.
When authorized by your employer, the following are covered by workers’ comp:
- Emergency services. If you require an ambulance or a trip to the emergency room (ER) following an accident at work, all charges for this care should be paid by your employer.
- Office visits. Seeing a doctor for a diagnosis or for follow-up care after an ER visit is also covered, as long as you're seeing an approved physician.
- Medical devices. If you require a wheelchair, crutches, a shoulder sling, or any other medical device, this should be paid for by your employer's worker's comp insurance.
- Prescriptions. Pain medication, anti-inflammatories, antibiotics, and any other medication prescribed by an authorized physician are covered by workers’ comp.
- Scans and tests. You'll likely need an x-ray or other scan to diagnose a broken bone or slipped disc. Chronic illnesses may require other kinds of diagnostic testing. All of these procedures should be covered.
- Hospitalization. If your injury or illness is serious enough to require hospitalization, your stay and all treatments received there will be covered.
- Surgery. Likewise, any surgical procedures—from stiches to back surgery—will be covered if authorized by your employer’s doctor.
- Physical therapy. Many injuries require ongoing physical therapy in order to get back to full health. These treatments should be covered for as long as they are medically necessary.
- Any other authorized care. Any care required as a result of a workplace injury or illness should be covered by the employer.
The Key to Coverage: You Must See an Authorized Doctor
Before seeking any kind of medical treatment for a workplace injury, you must report the injury to your employer. Your employer should have instructions for reporting workplace injuries clearly posted, and should provide a standard form for detailing the injury. You have 30 days to report an injury, or you may be denied workers’ comp insurance.
Your employer has the right to choose his own healthcare provider or treating physician. You must see this doctor in order to qualify for workers’ comp coverage. You may also see your physician, but you'll likely have to pay for this yourself. In some cases, your employer will authorize you to see a doctor of your choice, but you'll have to make a formal request.
If Your Benefits Are Denied, Call an Attorney
If you receive any bills for medical treatments that should be covered by workers’ comp, let your employer know. If he refuses to pay for authorized treatment, you may need a workers’ comp attorney to ensure you get the benefits you deserve. Call the experienced workers’ comp legal experts in our Overland Park office to learn more.