Medical Benefits in a Workers’ Compensation Claim

Helping Employers and Workers with Workers’ Compensation Benefits

Employers are generally responsible for providing medical care for injured workers free of charge as long as the medical care is related to their workplace injury. However, the methods for doing so vary greatly from state to state. In some states, employees are free to choose their medical providers as long as the treatment is reasonable and necessary. In other states, the employer directs the medical care.

The question of whether certain medical treatment is necessary or related to a work-related injury often arises during workers’ compensation cases and are generally reserved for doctors through utilization review or peer review. The experienced attorneys at Peterson White can help employers and claims professionals with the legal requirements for making these determinations. Missing a deadline or failing to ask the right questions can result in liability for the treatment even if it is not related to a workplace injury.

The length of liability for treatment also varies from state to state. According to the AMA Guides to the Evaluation of Permanent Impairment, maximum medical improvement (MMI) is the point when a condition is well stabilized and unlikely to substantially change within the next year. Even though there may be some change over time, further recovery or deterioration is not anticipated. In some states, the employer must provide treatment only until the employee reaches MMI. In other states, the liability can continue for the employee’s lifetime. For some clients, the possibility of ongoing medical benefits is a reason to settle workers’ compensation claims.

Schedule a Free Consultation with a Workers’ Compensation Attorney Today

Ongoing medical benefits can cause claims to remain open long after reasonable treatment has finished, sometimes costing adjusters significant time and causing employers and insurers significant money, especially when the injury was so long ago that it becomes difficult to assess the reasonableness or relatedness of the treatment. However, medical benefits can often be closed out later via settlement. The team at Peterson White in Tennessee & Kentucky can help negotiate settlement of open medical benefits for a flat fee.

Contact our law office today at (855) 919-4124 to schedule a free initial consultation with one of our knowledgeable workers’ compensation attorneys.