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What are the rules for medical benefits through workers’ compensation?

On Behalf of | Sep 24, 2021 | Workers' Compensation

Workers’ compensation provides you with protection for work injuries. You know through this program you can expect benefits, specifically medical coverage.

According to the State of New Jersey Department of Labor and Workforce Development, all claims get medical coverage, but it is not without limits.

Basic coverage

From the moment you suffer an injury, workers’ compensation medical benefits kick in. If the insurer later denies your claim, the medical coverage will end. However, even with approval of your claim, you can only expect coverage to be on medically necessary services. Covered items may include prescriptions, treatments, tests, and other related medical services.

Doctor choice

One thing to note about medical services is your employer has the right to choose who will provide you care. The exception is in an emergency when you need immediate care and there is no time to waste on trying to gain employer approval for the treating medical provider. However, you do have to alert your employer as soon as possible that you are receiving medical care.

Another situation is if your employer refuses to provide a medical provider option. In this case, you may be able to choose your own if you must have medical care.

In general, you will always have the right to medical treatment coverage under workers’ compensation for a work-related injury. However, you do need to understand the rules and make sure to follow them to ensure you remain within the requirements to get coverage. Otherwise, your expenses may not fall under coverage, and you could end up with a denial of payment.