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What Kind of Medical Treatment Can I Receive Under Workers’ Comp Insurance?

If you’re injured on the job and your workers’ compensation claim is approved, workers’ comp will pay for your medical treatment. That’s great! But what exactly does that mean to you?

That’s a loaded question.

What Is Medical Compensation?

Under the North Carolina Workers’ Compensation Act “medical compensation” can include virtually anything that will cure your pain, give you relief from pain, and/or get you well enough to get back to work.

Treatment can include:

  • Medical
  • Surgical
  • Hospital
  • Nursing
  • Rehabilitative services, such as:
    • Attendant care services: At-home care or physical therapy
    • Vocational rehabilitation: In some circumstances, the insurance company will pay for retraining or for a specialist to help you find another job
  • Medicines
  • Sick travel: Reimbursement for any travel to authorized medical providers or pharmacies more than 10 miles away
  • Other treatment

While it may seem as though you’re entitled to just about anything that will help you get better, who gets to decide what will help you get better. You or the insurance company?

Who Decides What Medical Treatment Is Necessary?

doctor in a lab coat looking at a tablet.If your workers’ compensation case is accepted by the workers’ comp insurance company, they are responsible for paying for your medical treatment. The flip side is: they also have the right to direct your care.

That means the workers’ comp insurance company can send you to the doctor or doctors they choose. Keep in mind, many insurance companies are for profit businesses – not nonprofits. That means if there’s a choice of treatments and doctors who might claim to be able to achieve the same results, but one option is less expensive than the other and may even get you back to work quicker, it would likely benefit the insurance company to opt for the less expensive, get-back-to-work-quicker option. Even if your doctor recommends a more expensive treatment and potentially longer recovery period for you, the insurance company may refuse to authorize it. So what can you do if they refuse the treatment you’d rather have?

How Can I Control What Treatment I Get?

Fighting for the treatment our clients feel they need is something we deal with day in and day out. It’s one of the primary reasons people contact our firm.

If the workers’ compensation doctor recommends treatment the insurance company refuses to pay for, our attorneys can file a motion for a hearing or a motion for medical treatment.

You also have the right to request a second opinion exam with a physician that you and the insurance company agree on. Our workers’ compensation attorneys have years of experience fighting on our clients’ behalf to try to get them the second opinions they may need

If you wish to transfer your treatment to another doctor, our attorneys can file a motion with the NC Industrial Commission (that’s the workers’ compensation “court”) to try to transfer that care for you.

Our NC Workers’ Comp Attorneys Will Review Your Case for Free

If you feel you’re not getting the treatment you need, or that your insurance company may not have your best interests at heart, contact us or call 1-866-900-7078.

Let one of our workers’ comp attorneys – six of whom are North Carolina Board Certified Specialists in Workers’ Compensation Law – evaluate your situation for free. We’re available 24/7 to try to get you the answers you need.

(PS…If you’re worried that you can’t afford us, stop worrying! We work on contingency,2 which means that you don’t pay any attorney’s fee unless we get you compensation.)