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Is it possible to receive additional medical benefits under workers’ comp?

On Behalf of | Mar 4, 2024 | Workers' Compensation |

Through workers’ compensation, an employee injured while on the job can claim benefits as compensation. One such benefit is medical benefits, which can pay for employees’ health care treatment for their work injuries.

Let’s say you suffered a work injury, and you’ve filed a claim for it – which your employer and insurer approved. But despite the treatments you’re receiving, your condition hasn’t improved. Moreover, you’ve only received enough medical benefits to cover your initial treatment and nothing more.

Can you still receive added medical benefits through your employer’s workers’ comp?

Eligibility for further medical benefits

State law ensures that your employer or their insurer covers necessary and reasonable medical treatment. If your work-related medical condition requires ongoing care, your employer or insurer must continue to pay for it.

Reasons for extended medical coverage

There are three main reasons why you’d need further medical benefits. They are:

  • Continued care: If your condition hasn’t fully stabilized, you may need continued medical treatments or surgeries.
  • Change in condition: You may need additional medical benefits if your work-related condition worsens.
  • Lifetime benefits: Workers’ comp may also continue to provide benefits if your injury leaves you permanently disabled.

While you may be eligible for additional medical benefits, workers’ compensation doesn’t automatically pay for added expenses. You must submit proof that you require more treatment and thus more benefits.

Process for obtaining additional benefits

You’ll have to accomplish the following to receive further medical benefits:

  • Document: Keep detailed records of your medical condition and ongoing needs.
  • Communicate: You must inform your employer and their insurance carrier of your need for additional medical care.
  • File: You must submit all documentation related to your condition and necessary forms to the state Workers’ Compensation Commission.

While you’re free to request that you need additional benefits, your employer or their insurer may dispute it. In such cases, you have to right to request a hearing with the Workers’ Compensation Commission. A legal professional can represent your interests in this hearing and fight for your right to added medical benefits.

So, yes. It’s possible to receive additional medical benefits. But be prepared to make your case if your employer or insurer disputes your claim.