Who’s in Charge of Your Medical Care After a Workplace Injury?
Deciphering “Reasonable and Necessary” in Workers’ Compensation Claims
If you’ve experienced an injury on the job, or if you’ve developed an illness or disease due to workplace exposure, you’re entitled to workers’ compensation benefits. This applies whether you’re covered by your state’s workers’ comp system or the federal Office of Workers’ Compensation Programs (OWCP). Included in these benefits are payments for “reasonable and necessary” medical expenses resulting from your injury or illness. But who makes the crucial decisions about your medical care and treatment? How much influence does your doctor have on what workers’ compensation will cover?
Seeking Medical Treatment After a Work-Related Injury or Illness
When you’re injured on the job, your health should be your top priority. If you need immediate treatment, don’t hesitate to visit the hospital, an urgent care facility, your company dispensary, or your primary care physician.
In the days or weeks following your injury or illness diagnosis, expect that your employer and/or workers’ compensation insurance company will request a medical examination by a doctor of their choosing. This is standard procedure. However, you have the right to choose your treating physician, although they may need to be qualified or certified to treat you.
After the company examination, your chosen doctor will likely handle most, if not all, of your care. Consequently, your physician’s role can greatly impact the quality and extent of the care you receive. Often, workers’ compensation insurance companies collaborate with your doctor to ensure you get the appropriate treatment. A doctor with experience treating patients receiving workers’ compensation benefits can be a strong advocate for your recovery and help you regain optimal health.
Contact Us to Schedule an Appointment
At Advantage Healthcare Systems, our team has extensive experience supporting men and women injured on the job and eligible for workers’ compensation benefits. Call us toll-free at 1-877-487-8289 or fill out the form provided below to schedule an assessment. With locations across Texas—including Fort Worth, Dallas, and San Antonio—we’re here to help ensure you receive the care you need after a work-related injury.