Medical Appointments Following a Workplace Injury: What You Should Know
Minnesota’s workers’ compensation law covers injuries or illnesses caused or made worse by work or the workplace. Under the law, your employer’s workers’ compensation insurer is required to pay for medical care related to your work injury, as long as it’s reasonable and necessary. The insurer should also reimburse you for travel mileage to get to medical appointments and for certain vocational rehabilitation services.
Many workers’ comp claims are paid without any problems. Workers go to their appointments, get the treatment they need and have their bills paid. However, at Brazil Law Group, we know that things don’t always go as planned—and you should know how to protect your rights regarding medical appointments following a workplace injury.
We hope that this article will help you take some steps in the right direction. Of course, it is no substitute for real legal advice. If you have questions about your situation, talking with a lawyer is the best way to get the right answers.
Make That Appointment. Get Help if You Need It.
It’s easy to put off getting medical help, especially if you’re worried about the costs. But it’s important to seek medical attention if you’re hurt at work or sick because of your job. Don’t tough it out. If you don’t get the help you need right away, the insurance provider may try to dispute the claim, saying that you must not have been that sick or injured; otherwise, you would have seen a doctor sooner.
Tell Your Doctor the Important Things about Your Work Injury
When you do make that medical appointment, make sure to describe your pain as fully and completely as possible. If you think that you’re likely to forget to mention something, write it down and bring your notes with you to your appointment. It’s normal for people to forget to mention key symptoms when they’re sitting under bright lights in a strange exam room.
When you’re explaining your symptoms to the doctor, make sure to mention that the injury or illness happened at work. You don’t need to go into great detail. But it is important that your illness or injury be documented as a work injury in your medical records. If it isn’t documented as such from the beginning, the insurer may push back on providing you with the coverage you need.
Insurers Only Pay for “Reasonable and Necessary” Medical Care
The law says that the insurance provider is required to pay for reasonable and necessary medical care. But things can get tricky, especially regarding the words “reasonable and necessary.” What does that mean? The insurer’s idea of what is reasonable and necessary may differ from yours.
Generally, you can choose your own health care provider under most circumstances. The insurer may pay for mainstream medical care (“Western medicine”), but will probably deny coverage for complimentary or alternative health care—things like acupuncture, biofeedback or naturopathic medicine—even if they help you get better.
When it comes to surgery or hospitalization, your health care provider must tell the insurer before it happens, unless there’s an emergency. Remember, you can’t be forced to have surgery if you don’t want it. And you’re absolutely entitled to a second opinion for any nonemergency surgery. Insurance is required to pay for that second opinion. You should know that the workers’ compensation insurer is also entitled to ask for a second opinion.
Save That Paperwork. Document Everything.
Whether things go smoothly on their own or you need a lawyer’s help to protect your rights, one thing is true: completing and saving the right paperwork is critical. Make sure to document anything that could be important later. It’s better to be safe than sorry.
Save copies of any document your doctor or the insurance provider gives you, including medical bills, letters, forms and benefit checks. Keep track of your mileage and parking fees for medical visits so that you can be reimbursed later.
It’s also a good idea to take notes about your treatment: who you saw, when you saw them and what they said. If things are complicated, and you find yourself making many appointments or dealing with symptoms that persist, you might want to buy a special notepad or mark things on the calendar. That way, you have your own records about your medical appointments, and you are better able to protect your rights if your claim is initially delayed or denied.
