Workers' Compensation Medical Benefits

The Worker’s Disability Compensation Act provides that a worker is entitled to all reasonable and necessary medical care for his work injury. This includes medical, surgical, and hospital services, dental services, crutches, hearing apparatus, chiropractic treatment and nursing care. The responsibility to provide medical care continues indefinitely so long as the need for the care is related to the industrial injury. Mileage to and from all medically related appointments and pharmacies is also covered.

During the first 28 days of treatment, the employer has the right to choose the doctor. After that the worker is free to change doctors if he desires. The worker, however, must notify the employer of the change. If the company fails to offer medical treatment during the first 28 days following the injury, the employee can treat with the doctor of his choice. The employer or its insurance company must pay for treatment by the employee’s doctor for the work injury.

Doctors and medical providers will typically send their bills directly to the employer or its insurance carrier. If the injured worker pays the doctor directly, he is entitled to be reimbursed by the employer or insurance company for that payment. Medical bills and travel allowance that remain unpaid should be submitted directly to the workers’ compensation insurance carrier by certified mail. If the employer is not disputing the claim, and if medical bills and travel allowance are not paid within thirty days after the insurance carrier or employer receives the bill by certified mail, $50.00 or the amount of the bill, whichever is less, shall be added and paid to the worker for each day over 30 days in which the medical bills or travel allowance are not paid. The maximum penalty payment is $1,500.00.