With few exceptions, injuries or conditions that happen at work will result in your ability to file a worker’s compensation claim. There are risks associated with treating your injuries through private health insurance for work-related injuries by state law and you are entitled to these benefits. They cover injury, illness, or any medical condition caused directly by your job or employment.
Ways Other Than Workers’ Compensation to Pay For Injury Treatment
When people are injured at work, you might wonder who pays for work-related injuries. Sometimes they or their employer have other ideas about how they will pay for the treatment. There are three common ways people treat work-related medical conditions or injuries, without . They are:
- The employee decides not to file a workers’ comp claim through their employer and instead attempts to treat their injuries using their private health insurance.
- Instead of filing a workers’ comp claim, the employer does not tell the insurance company and instead offers to pay the medical costs for the employee out of their own pocket (or the business’ money).
- The injured employee decides to pay the medical expenses themselves.
Anyone who is considering the above options should pay attention to the following advice. The repercussions that result from electing any of the above courses of action can be severe and irreversible.
The Difference Between Private Health Insurance and Workers’ Compensation
Worker’s compensation provides payment for lost wages and medical bills related to the treatment of injuries or illnesses that are caused at or because of your job. Because this system exists, your private health insurance is not obligated to pay for injuries you sustain on the job. Not only is a private health insurance company not obligated to pay for your injuries after a personal injury accident, but they will also refuse payment for any treatment they determine to be related to a work accident.
When people elect to treat through their private health insurance for injuries sustained on the job, we often see their insurance company conduct an investigation into the injury. Specifically, they look to see if it was caused, or had a connection with the person’s employment. The insurance companies deal with thousands of claims a day, so they know how to investigate such matters and when an injury seems suspicious like it might be work-related.
Such an investigation can occur as soon as your health care providers (doctors, hospital, chiropractor, etc.) begin submitting your bills to your private health insurance company. Sometimes, the investigation may not begin for a number of months after your private healthcare providers submit bills. The amount of time depends on the health insurance company involved and the injuries you sustained.
Just because the insurance company does not deny the claim right away, or pay the first couple of medical bills, does not mean that they have been duped or that they will continue to pay. Regardless, all private health insurance companies review the bills and treatment note that the healthcare provider creates. This review includes examining the medical records of the kind of scenario that appears to be related to a work accident. Insurance companies can often tell what injuries caused on the job look like.
What If Your Doctor Finds Out You Were Injured at Work?
If someone outright informs their doctor that the injury occurred at work, then most often the doctor will refuse to provide treatment. There’s a simple reason for this: they know that the health , and then they won’t be paid. Keep the following in mind: it’s more a question of when your private health insurance company finds out, rather than if they find out.
When the discovery is made, your private health insurance company will terminate any existing payments and authorization for any future payments. Moreover, they are highly likely to seek reimbursement for any amounts paid in connection with your treatment. They will seek this reimbursement personally from you.
Denial of Lost Wage Benefits
In addition to the above risks, you will not for the time you take off work while treating your injuries if you elect to treat through your private health insurance carrier. If you were using workers’ comp health insurance to pay for your medical treatment, and you are placed on a no-work status or restricted work status, you could be receiving your payments for lost wages.
This money is extremely important to help offset the economic loss that would otherwise result from not working. No such protection exists when treating through private insurance. If you begin receiving income through a short– or long-term disability policy because of an injury you did not report to workers’ comp, that income is also in jeopardy of being terminated. This is not always the case, since it depends highly on the language of the disability benefits, but it is a possibility.
Paying Co-Pays Depends on Your Insurance
If the foregoing reasons are not justification enough, keep in mind that private health insurance requires a co-pay. Of course, the amount of your co-pay depends on your coverage. However, with substantial work-related injuries, this amount can become sizeable. This is especially the case if you have to visit multiple doctors over and over again (requiring you to pay lots of small co-pays). Similarly, if surgical intervention is recommended, it carries a much larger co-pay than a normal doctor’s visit.
When the claim is through workers’ comp coverage, there is almost always no co-payment obligation. Once you reach a point known as m, the workers’ comp carrier may require that you pay a $10.00 co-pay for authorized doctor visits. However, this is often not implemented. You can for a more precise definition of Maximum Medical Improvement.
To receive treatment through a worker’s compensation carrier for the injuries you sustained on the job, you have to comply with certain rules and requirements. One of these requirements involves reporting the accident in a timely manner. This and more information regarding Florida workers’ compensation laws can be found on the Official Internet Site for Florida Legislature. Failure to report an accident or illness can result in you being forever barred from receiving worker’s compensation benefits for that injury.
You may have heard that receiving treatment through a or confusing. It can indeed be somewhat trying. It is also not uncommon for a worker’s compensation insurance carrier to attempt to mislead an injured worker about the nature of the benefits they are entitled to. This is one of the main reasons why those injured on the job are encouraged to speak with a personal injury attorney about their work-related accident.
These companies have legal experts and lawyers working for them around the clock. They also deal with thousands of cases a year, so they know the ends and outs. There is no risk in speaking with an attorney and no fees until they win your case, so you really have nothing to lose and everything to gain by at least consulting with one.
Why a Workers Compensation Attorney is Essential After an Injury
Dealing with the myriad of curveballs that an injury and insurance can throw at you while you are recovering from a work accident is a tall order. The damages inflicted by work injuries can be significant so it is within your best interest to not take a risk and attempt to handle every thing on your own but instead contact a professional invested in a positive outcome for your case. An experienced personal injury lawyer that specialized in workers’ compensation claims can mean the difference between mediocre insurance coverage and full compensation for the damages you have suffered.
For a free legal consultation, call 833-552-7274
Dolman Law Group can assist you in getting back on your feet after a work accident by defending your right to fair compensation. Navigating insurance with an expert at your side will not only give you time to focus on recovery but also provide you with the ability to see pitfalls in the system before they lead to your claim’s value being reduced or your claim being denied altogether. The workers’ comp lawyers of Dolman Law Group are will work with you closely so you can understand every aspect of your claim and what we can do to maximize its value.
Contact Dolman Law Group About Your Workers’ Comp Benefits
At Dolman Law Group Accident Injury Lawyers, PA, on a daily basis. If you have questions about your workers’ comp benefits, or you have been injured at work and are yet to receive benefits, contact an experienced attorney at Dolman Law Group Accident Injury Lawyers, PA.
Even if you aren’t, you have absolutely nothing to lose by attending a free consultation. During the meeting, you’ll be able to explain your workers’ comp circumstances to an attorney and hear their feedback. You’re also free to ask questions about your rights and benefits.
If you have concerns about how attorneys’ fees work for a workers’ comp claim, on how compensation and attorneys fees in a personal injury case work. We strive to provide experienced, personal representation to our clients. To ensure this is possible, Dolman Law Group Accident Injury Lawyers, PA only takes the number of cases that we can handle properly. For us, it is about quality over quantity.
We also strive to provide you with personal service. To do this, we give every client their attorney’s personal cell phone number and email address. We want all our clients to have access to the attorney they are paying for. It only makes sense.
Please contact our office anytime to schedule a free consultation. We can be reached at (727) 451-6900 or by emailing us on our Contact Page. Or, if you’d like, chat with a representative by visiting our website and clicking on the “Live Chat” box in the bottom right corner. We look forward to hearing from you.
*The above information was written and reviewed by either Attorney Matthew Dolman or another injury lawyer at the Dolman Law Group Accident Injury Lawyers, PA which has a combined 90 plus years of experience practicing Florida personal injury law. Matthew Dolman himself has been practicing personal injury law in Clearwater and St. Petersburg for the last fifteen (15) years. The information provided comes from extensive research and years of experience trying legal cases in courtrooms throughout Florida.