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Medical Expense Payments

If you were injured at work and received treatment by the physician approved by your employer, what happens next? Are you liable for the payments to the physician or is your employer liable?

Who is responsible for medical payments?

If you are injured as a result of a work related accident, you may be entitled to workers’ compensation.  If you seek treatment by a physician approved by your employer or insurance company, any medical payments relating to treatment which the physician deems necessary are to be paid by your employer’s workers’ compensation insurance.  If you have sought treatment, and are receiving bills, you should notify your employer and/or insurance company immediately.  If your employer or insurance company denies liability for making these payments, you should notify the State Board of Workers’ Compensation immediately.  It may be necessary to bring action against them, in which case, you may need to seek the advice from an experienced workers’ compensation attorney.

What type of medical expenses are paid?

Almost all expenses relating to treatment your approved physician deems necessary for your recovery should be approved and paid by your employer’s workers’ compensation insurance.  You must submit any bills to your employer and insurance carrier immediately, so that the expenses may be paid.  Generally, if there are no disputes, these expenses will be paid within 30 days of receipt of the medical bills.The State Bureau Workers’ Compensation delegates a set schedule of fees that all approved physicians and insurance companies must abide by.  If there is a dispute between the insurance company and the physician as to the fee, they will need to contact the State Bureau of Workers’ Compensation and request a peer review of the charges.  If there is still a dispute regarding the medical fees, they may request a mediation conference or an evidentiary hearing.

If you request that your employer reimburse you for mileage to and from your doctor appointments, you must submit the request to your employer immediately.  Any requests for reimbursement of mileage are generally paid within fifteen days of receipt, if your employer and/or insurance company does not dispute the charges.

If your approved physician deems it necessary for you to receive prescription medication, you must contact your employer and/or insurance company prior to filling the prescription, as prior approval may be required in order for you to be reimbursed for the prescription.  If you obtain approval, you must pay for your prescription and then submit your receipt to your employer and/or insurance company.  You should receive reimbursement within 30 days of receipt.  If your approved physician deems it necessary for you to obtain a medical device such as crutches, a walker, a cane, a wheelchair, or any other medical device, you should contact your employer and/or insurance company to notify them of this expense prior to purchase, as, you may need to go through a medical device company of their choosing, in order for your medical device to be covered.  If you are required to make a pre-payment, you should submit your receipt to your employer and/or insurance company immediately, so that you are reimbursed within 30 days.

Let an Attorney Help You

If you or a loved one were injured at work, and are concerned your medical expenses are not being paid, there are many factors you must consider. You need to understand your options, and rules under the law. You will need the help of a skilled Nashville workers’ compensation attorney. Contact an attorney today for help with your case.

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