Medical Benefits
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Medical Benefits
Medical care is exactly what is sounds like; the Insurance Company needs to authorize and provide medical care for your work injuries and to pay for all associated medical bills. This would include prescription medications. However, you must treat with the authorized medical providers in order to avoid getting stuck with the bill.
Medical Bills
The Insurance Company is be responsible for your emergency room and ambulance bills from the day you were injured.
Please note, once the insurance company gets involved and authorized a facility for you to treat, you cannot treat on your own as they will NOT pay for this care.
However, if the insurance company has not yet authorized care in your claim, please contact our office for a consultation before electing to get medical treatment on your own so as to avoid getting stuck with the medical bills.
If you have received and continue to receive medical bills as a result of your work accident, please contact us so that we can fight to get these bills covered by the Insurance Company before it starts to negatively affect your credit.
Emergency Care
There may be times in your claim after the insurance company authorized medical care, but the pain gets so bad that you need emergency care right away and cannot wait weeks to be seen. What do you do? This decision is a complicated one could result in you having to pay for the medical bill if proper steps are not taken.
At Robert Rivera Law, we can help you navigate this unfortunate situation properly to avoid being stuck with the medical bill. If you’ve had an emergency that required you to get immediate medical treatment on your own and now the insurance company does not want to pay the bill, please call our office so that we can assist.
Medical Mileage
If needed, the Insurance Company could provide you with transportation to and from your medical appointments. If you have your own transportation, the Insurance Company should be reimbursing you for mileage you have driven to and from your medical appointments. Many Insurance Companies and adjusters will merely slip the reimbursement page into a huge packet of papers and never explain this benefit to you.
If you have driven all over for your medical appointments and have not been reimbursed, or, need transportation to get to and from your appointments, please contact our office so we can help.
Psychologic Care
Some injuries result in not only physical, but also mental injuries. These injuries should be taken with as much seriousness as a physical one as they could be with you for the rest of your life, especially if left untreated. Anxiety, depression, PTSD are just some examples of psychological injuries that can occur as a result of your work accident. If you feel you have been suffering from a mental injury as a result of your work accident, it is imperative to advise your authorized doctor so that they can potentially refer you to the proper specialist. If your psychological injuries have not been attended to as a result of your work accident, please feel free to contact us to help.
One-Time Change
You are entitled to a one-time change in physicians only once in your entire case, regardless of the number of specialists you are seeing or the number of injuries you have sustained. Unfortunately, some adjusters will persuade an injured worker to use this one-time change at disadvantageous times. Since you can only use this once in your entire case, this decision needs to be thoroughly thought through and various factors weighed before making this decision. Failure to do so could dramatically affect the trajectory of your claim moving forward. In fact, under certain circumstances, you may actually be entitled to select your own doctor as your one-time change. Thus, it is crucial to speak with an attorney prior to making this decision.
If you:
- Are feeling pressured to change physician’s by your adjuster, or
- Have sent in a request in writing to the adjuster for a new doctor, but have not yet been seen by a new doctor, or
- Are just thinking that you would like a second opinion, please call our office before seeing a new doctor.
This is a crucial step in your case and should not be taken lightly.
For more information:
More Information on Medical Benefits
For further details and information, please see the below posts pertaining to real cases which illustrate the law surrounding medical benefits.
Tractor Trailer Accident
Care Initially Authorized, Then Wrongfully Denied
Knee Surgery Wrongfully Denied
Slipped on the step of a pick-up truck, inuring the left knee. Care was initially authorized, then wrongfully denied based on pre-existing conditions.
Category of Medical
Blurb. Name v Employer. Ruling/Question