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Monday, April 15, 2013

What Medical Expenses Are Covered In A Workers’ Compensation Case?

Today's post comes from guest author Roger Moore from Rehm, Bennett & Moore of Nebraska.

In Nebraska and Iowa, as is the general rule, an employer is liable for all reasonable medical services incurred as a result of a work injury. This is interpreted fairly broadly to include plastic or reconstructive surgery, prosthetic devices, and medicines, among other treatments. 

As long as the treatment is designed to relieve pain or promote and hasten the employee’s restoration to health and employment, the employer is liable. When a treatment meets these conditions, an injured worker should not be responsible for any portion of the medical bill. 


The main difference is in Nebraska, as long as the worker elects a prior treating doctor to treat their injury (for example, the worker’s family doctor), that doctor can dictate the medical care and refer them to others for treatment. If no election is made, then like in Iowa, the employer can choose the doctor to treat a work injury as long as the employer accepts compensability for that injury. 


However, in Iowa, if the worker can establish that the medical care furnished is unreasonable, then the worker can choose another medical provider.  In both states, if a claim for a work injury is denied, the worker can choose their own doctors to treat with. 


If no Petition is filed in Nebraska, an employer continues to be responsible for medical care as long as there is less than a two-year gap in the payment of a medical bill by the employer or insurance company or the payment of temporary or permanent benefits to the injured worker. Also, if the Court enters an order finding the injured worker entitled to future medical care, there is technically no time limit for seeking medical care. 

In Iowa, medical benefits cannot be used to extend the deadline to file a claim for benefits. There is no time limitation in seeking medical care relating to an injury either before or after an Award for benefits. 
      
However, in practical terms, large gaps in treatment will likely be met with skepticism from the employer – and possibly the Court – concerning the relationship between the work injury and the medical care. We recommend you seek consistent medical care where there is a need for it to avoid such issues.

Read more about "medical treatment" and workers' compensation.

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