NOT YOU! If the workers compensation carrier accepts your claim, ALL reasonable and necessary health care treatment related to your work injury must be paid. Unlike most health care plans, there are no deductibles or prepays involved. Fortunately, with few exceptions, you are entitled to choose your own doctor or health care provider to assist you in your recovery.
These are important facts to keep in mind:
1. Prescriptions and reimbursement for mileage to medical appointments are also payable;
2. The insurer may designate a pharmacy or pharmacies that you must use to obtain medicine for your injury, if the pharmacy is within 15 miles of your home;
3. You may choose your own health care provider under most circumstances; Be sure to advise you doctor or medical provider you are treating for a workers compensation injury and to be sure they sends all bills and supporting information to the insurer. The supporting information must explain how the treatments and charges relate to your work injury;
4. Your health care provider must notify the insurer before you have any surgery or hospitalizations, except in an emergency. You or the insurer may ask for a second opinion for any surgery that is not an emergency. The insurer must pay for the second opinion. You cannot be forced to have surgery if you do not want it;
5. Treatment by certain unlicensed complementary and alternative health care providers is not paid. This does NOT apply to chiropractic treatment. In Minnesota, the employer and insurer must provide up to 12 weeks of reasonable and necessary Chiropractic treatment.
What if my employer has a managed care plan?
Most employers do NOT participate in a workers’ compensation certified managed care plan. A certified managed care plan is an organization that has been certified by the state to manage health care for injured workers. Your employer must tell you if you are covered by a certified managed care plan. Some employers or insurers have contracted with a managed care plan or network of doctors who are not certified by the department. You are not required to receive treatment from a doctor in a plan or network that is not certified. If you are NOT required to participate in a managed care plan, you are strongly urged to obtain medical treatment with your regular doctor or clinic unless it is a medical emergency!
At Atkinson Gerber Law Office, representing injured and disabled workers is ALL we do. We don’t handle slips and falls, write wills or work on family law matters. We have chosen to focus on one area of the law for nearly two decades and that is why his peers have recognized Tom Atkinson as a Super Lawyer!