Who Pays Medical Bills
After a workplace injury, the last thing you want to worry about is medical bills.
Focusing on getting healthy should be your #1 job. Let us worry about the legal issues.
Many if not most on-the-job accidents are covered under the NC Workers’ Compensation Act. It’s an expansive statute, purposely intended to ensure workers are protected.
And a substantial part of protection is making sure you get the medical treatment you need and deserve.
Unfortunately, just because it’s in the workers compensation law, that doesn’t mean employers and their insurance carriers always proceed in good faith or even follow what’s required.
That’s where we come in. If insurance adjusters did what they’re supposed to, we wouldn’t have a job. No one would need a NC Work Comp Lawyer.Who Pays for Medical Treatment if My Comp Claim is Denied?
First and foremost, the Workmans Compensation Carrier is legally required to pay for necessary and appropriate treatment for injuries sustained as a result of and in the course of employment.
Those bills really shouldn’t even be sent to the major medical insurance carrier. Your employer is legally responsible for the accident, injuries, and even your lost wages.
They shouldn’t be able to shift liability to your insurance company or to you for that matter.
At the same time, there are instances when the Comp Carrier denies medical treatment or a course of care. That’s not supposed to happen but, if it does, having health insurance may serve as a safety net.
If the Employer or their insurance carrier denies medical care or the Worker Compensation Claim as a whole, normally your major medical insurance or “health insurance” would start paying medical bills.
That is not the case regarding lost wages, permanent injuries, or other consequential damages associated with an injury.
Health insurance would only pay for medical care for things like doctor’s visits, prescriptions, and surgical fees. That’s why it’s generally called “health insurance.”
In some instances, your major medical insurance carrier may even cover rehabilitation costs, medical devices, and appliances.What is Required to Get the Major Medical Carrier to Pay?
First, there would need to be a formal denial of coverage by your employer or their Workmans Compensation Insurance Carrier.
Thereafter, as legal counsel, a demand would be made for a formal acknowledgement, by written correspondence, confirming denial of coverage for the specific medical procedure and possibly the claim as a whole.
The key is to get healthy and back to work as soon as possible.
As lawyers, we don’t like delays in medical care and treatment. We know lapses in treatment can have substantial adverse effects.
If nothing else, pushing back the Return to Work date is something we prefer to avoid, if possible. Clearly, we don’t want you returning to work while you’re still not healthy.
Returning to work too soon could have tremendous negative consequences to your long-term well-being, health, ultimate level of recovery and claims for damages.
Given the NC Workers Compensation Laws encourage healing and returning to work, delays in getting back to work take money out of our client’s pockets.
It’s also more than a bit frustrating to be laid up at home or in the hospital, not getting better, knowing you need a medical treatment or even surgery.
Payment of your salary and wages while out of work on Comp is never in the worker’s best financial interest. Frankly, you make more money working full time than collecting a lost-wages Comp check.
It’s important to proceed forward with due haste, as obtaining the maximum level of recovery often requires swift, consistent attention and treatment.
That’s especially true in the recovery process.
Failure to act in a timely fashion can result in lost opportunities to heal. That’s just part of being human and how the human body works.
It’s also one reason both doctors and plaintiff’s lawyers (personal injury attorneys) encourage their clients to actively engage in occupational therapy, rehabilitation, and following medical advice.
We all want to you to fully recover.
Obviously, there are time when that just isn’t going to happen. Indeed, you may have suffered permanent injuries. You may never go back to work or do the same job.
Even then, it’s important to do everything you can to achieve the maximum level of medical recovery. It’s both a quality-of-life issue as well as a future employability consideration.Workers’ Compensation Lawyers – Dodge Jones Law Firm
If you’ve been injured at work and suffered damages due to the negligence of a third party, give us a ring. We’re here to help.
Kevin Jones has spent his entire legal career helping clients in coastal North Carolina. He’s from Carteret County. He lives in Morehead City.
After law school, Kevin returned to the area because he is deeply committed to helping hard working folks, protecting them from big money interests and insurance companies.
“We provide free legal consultations on Comp claims. We’ll give you straight answers to your questions.”
– Kevin Jones, Greenville Workers Compensation Lawyer
You may reach Kevin by email at: Kevin@DodgeJones.com