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What medical benefits do I get under workers' compensation?

One of the biggest questions that an injured Massachusetts worker will have is how the medical expenses will be covered through workers' compensation. There are certain rules for who qualifies and how the medical costs will be paid. Understanding these factors is important when a person is injured on the job or has a condition or illness related to the work that they do and needs medical care as a result.

A person can get medical care that is considered reasonable and adequate. He or she can also get reimbursed for prescriptions and for travel to and from the medical facility to receive treatment. When the worker first goes for treatment, the employer can select a provider in the system the employer uses to give this initial care. Following the first visit, the worker can pick his or her own medical providers. As the treatment moves forward, the insurance company will have the right to send the worker to its own medical professionals to evaluate the level of incapacity and determine if the medical issues are still in place.

When the worker has reported the claim to the insurer, an insurance card will be provided to the worker. On it will be contact information and a claim number. The doctor must receive the claim number so a bill can be sent to the insurer directly and a pre-approval to provide treatment can be given. It is important to receive this card and if it is not given, the insurer must be notified immediately as medical providers will generally not give treatment without having a claim number. The coverage will only extend to what is required to treat the issue.

Receiving treatment after suffering an injury, illness or condition on the job is essential to getting back to full health. This is important for the employee and the employer. However, many workers might not be aware of how workers' compensation claims deal with their medical benefits. If there is confusion or a dispute, it is imperative to have assistance from a legal professional experienced in clients with their workers' compensation benefits.

Source: mass.gov, "Types of worker's compensation benefits -- Medical benefits," accessed on Sept. 10, 2017

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