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Workers Compensation and Medical Expenses: What’s Covered and What’s Not

Lisa BabiarzNews, Personal Injury & Workers Compensation

Worker’s Compensation can provide financial assistance, medical benefits, and even rehabilitation services for those who sustain work-related injuries or illnesses. Although many things fall under this coverage umbrella, worker’s compensation lawyers will tell you that there are many things that do not.

This article delves into the topic of workers’ compensation, highlighting the common coverage and benefits. It also explores things that are not typically covered by this program while highlighting who to go to if you need expert legal assistance and dedicated worker’s compensation lawyers serving Geneva, Auburn, Ithaca, and Penn Yan, New York.

What is Worker’s Compensation?

Workers’ compensation is a system that helps employees who get injured or sick because of their job. Its main goal is to ensure that these workers get the right medical treatment promptly and receive money to support them while they recover and can’t work.

Covered Medical Expenses:

Workers’ compensation generally covers various medical expenses associated with work-related injuries or illnesses. Notable covered expenses include:

Doctor’s Visits: Expenses incurred during visits to authorized healthcare professionals, including doctors, specialists, surgeons, and other relevant practitioners directly linked to the work-related injury or illness, are typically covered. One way to ensure these expenses are covered is to consult the approved medical provider list provided by the employer or the workers’ compensation insurance company.

Hospitalization: If hospitalization becomes necessary, workers’ compensation typically covers expenses such as room charges, surgical procedures, medications, and other required treatments. You’ll want to keep up with discharge papers and hospital records for future documentation.

Diagnostic Tests: After an accident at work, you may need blood work, an x-ray, or some other test. While many people avoid these tests because they fear the cost, this can be a mistake. Worker’s compensation lawyers serving Geneva, Auburn, Ithaca, and Penn Yan, New York, stress that these are essential for assessing and diagnosing work-related injuries or illnesses.

Medications and Medical Equipment.: Prescription medications recommended by authorized healthcare providers for treating work-related conditions are typically covered under workers’ compensation. Expenses related to medical equipment, such as crutches, wheelchairs, braces, or prosthetic devices, essential for an employee’s recovery and rehabilitation, may be covered.

Home Healthcare: In some instances, workers’ compensation may cover the costs of home healthcare services if they are deemed necessary for the employee’s recovery process. This includes things like:

  • Skilled Nursing Care
  • Home Health Aides
  • Home Modifications (in some cases)

Rehabilitation Services: Rehabilitation services are an essential part of workers’ compensation. These services, like physical and occupational therapy, play a vital role in helping employees recover from injuries and return to work. The good news is that these services are often covered by the workers’ compensation program, ensuring that injured workers receive the support they need to heal and return to their job.

What’s Not Covered:

While workers’ compensation covers many medical expenses, certain situations and treatments may not be covered.

Non-Work-Related and Pre-Existing Conditions: Workers’ compensation solely applies to injuries or illnesses directly linked to employment. If an injury or illness is not work-related, it may not be covered. The same can be true for pre-existing conditions that were not caused or aggravated by work.

Experimental or Unproven Treatments: Workers’ compensation generally excludes coverage for experimental or unproven treatments that are not recognized as a standard medical practice. This includes the following:

  • Investigational Drugs
  • Experimental Surgical Procedures
  • Alternative Therapies
  • Cutting-Edge Technologies
  • Experimental Rehabilitation Programs

Self-Inflicted Injuries and Substance Abuse: Workers’ compensation generally does not cover injuries resulting from self-harm or intentional actions. Work-related injuries or illnesses resulting from an employee being under the influence of drugs or alcohol may not be covered.

This is why worker compensation law firms stress that you never take responsibility for any part in the accident, even if your employer pushes you to.

Final Thoughts

Workers’ compensation is a crucial support system for employees affected by work-related injuries or illnesses. Familiarizing oneself with the coverage of medical expenses under workers’ compensation is essential for both employees and employers.

 

By understanding the extent of coverage, individuals can ensure they receive necessary medical care and benefits in the event of a work-related injury or illness.

 

Navigating the complexities of workers’ compensation and comprehending the coverage of medical expenses can be challenging. This is why the assistance of worker’s compensation attorneys is readily available to provide legal guidance and support throughout the process.

 

If you or someone you know is grappling with a work-related injury or illness and requires legal assistance, turn to the most experienced worker’s compensation lawyers serving Geneva, Auburn, Ithaca, and Penn Yan, New York. Doing so immediately will help worker compensation attorneys Littman and Babiraz protect your rights.