Medical care is expensive, and a workplace injury can cause thousands of dollars in medical expenses. Unfortunately, too many workers are told that their injury is not workplace-related, and they are therefore on the hook for paying their bills on their own. Contact Ball, Kirk & Holm, P.C. if this happens to you.
A Cedar Falls workers’ compensation lawyer can review whether you have a strong claim for benefits. Many insurance companies are becoming more aggressive about denying claims, but you deserve free medical care for any on-the-job injury. That’s the law. Speak with a member of our legal team today. We’re always available 24/7 for our clientele.
Who is Entitled to Medical Care for On the Job Injuries?
You might have health insurance as a company benefit. But any worker who is injured on the job should have their employer pay for medical treatment. Typically, employers purchase a workers’ compensation insurance policy, and this insurance carrier pays for medical benefits to treat an injury or illness picked up while working.
You should receive all reasonable and necessary treatment for an on-the-job injury or occupational illness, including:
- Transportation to the hospital
- Surgery
- Prescription medications
- Doctors’ visits
- Specialist appointments
- Diagnostic tests
- Bloodwork
- Physical therapy
- Hearing aids, crutches, wheelchairs, or other assistive devices
- Painkillers
The key issue is whether the accident happened while you were working. If so, you should be covered, because workers’ compensation is no fault in Iowa.
Who Pays if Your Workers’ Comp Claim Was Denied?
Some insurers deny claims for various reasons. They might allege you were not injured while working or that your injury was pre-existing. They might also claim you waited too long to file a workers’ comp claim.
If your claim was denied, then you might appeal. You should call our law office as soon as possible. We can address the reason for the denial and possibly get your claim approved.
Until then, however, your provider should send your medical bills to your health insurer.
What to Do if Your Workers’ Comp Claim Was Approved
Providers should send your bills to your employer’s workers’ compensation insurance carrier. They are responsible for paying the bills. You shouldn’t have to cover the cost.
Sometimes providers forget and they send a bill to you at home. Do you have to pay?
Not if your workers’ comp claim has already been approved. In that case, you should:
- Call your medical provider. Tell them to send the bill to your employer’s workers’ compensation carrier. They might not have the address.
- Follow up to ensure the bill was sent. If they haven’t sent it, then request a second time that they send it. Some providers are hesitant to send because they don’t want to be reimbursed for the rate they agreed to with the insurance provider. They might even claim they “can’t” send the bill to the insurer, but that’s rarely true.
- If they still refuse to send the bill, then forward your copy to your employer’s workers’ compensation insurance carrier.
- Your bill might be denied. The insurance carrier might claim the medical care you received was not necessary or was unreasonable. They might refuse to cover certain treatments, like massage for dealing with pain. You should receive a written notice explaining why the treatment was not covered.
- Reach out to an experienced workers’ compensation lawyer if you are still receiving bills. We can discuss options.
If the workers’ compensation carrier still refuses to pay the bill, Iowa law typically requires that your health insurer cover the bill. Iowa Code § 85.38(2) states that when an employer denies liability, then a workers’ individual or group plan shall not deny payment because liability is unresolved.
How Our Law Firm Can Help
We have represented hundreds of injured workers in these types of cases. We realize that “winning” a workers’ compensation claim is often not the end of the struggle. Some providers refuse to send bills to the insurance provider but instead demand that you pay for care. We’ve also seen employers deny that your care was necessary.
Let us review what happened. Your bill should be covered, either by the workers’ comp carrier or by your own health insurer. We can provide advice about what steps to take next.
Can You Get Bills Paid if Your Workers’ Comp Claim is Denied?
Possibly. You might have a valid personal injury lawsuit against the person or entity who injured you. Our office has a thriving personal injury practice, and we might be able to sue someone for financial compensation.
For example, you might have been struck driving home from work. That type of accident isn’t usually covered by workers’ comp, so you can’t receive benefits for health care. However, you still have a motor vehicle accident claim against the careless driver who hit you. They might have been distracted by a cell phone or tailgating you. In any event, they are liable for failing to drive carefully.
We can possibly sue the driver or submit a claim on their insurance. You can get your medical bills covered that way. In other situations, you might have a valid claim for a product liability claim when a defective product injures you or a premises liability claim for an accident caused by a hazard.
Pick Up a Phone and Call
On-the-job injuries are difficult to overcome. Workers and their families need income, and they certainly don’t need to pay for medical care which should be covered by a workers’ compensation carrier. The cost of medical care has exploded, and even those with insurance might struggle to cover their deductible or copays.Our legal team will swing into action to protect the rights of injured workers to benefits they are guaranteed under the law. Contact us to schedule a free consultation with our office. We can discuss whether to appeal a denial of your workers’ compensation claim. We can also discuss whether you can bring a personal injury claim for damages.