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Does Workers’ Compensation Pay Medical Bills?4 minute read

When you suffer an injury at work, you will need medical treatment.  Sometimes, you go to the doctor for workers’ compensation medical treatment but then you end up getting a bill in the mail.

Should you be billed for workers’ compensation medical treatment?

No.  Medical treatment is one of the benefits provided as part of your workers’ compensation claim.  This means that the workers’ compensation insurance company or your employer should be paying for the treatment you need to recover from your injury.

When you see a workers’ compensation doctor, the doctor’s office should submit the bill for their treatment to the insurance company.  The insurance company should then pay the bill.

That is how it is supposed to work.  You should not even have a co-pay or a deductible to pay in your workers’ compensation case.  The insurance company is supposed to pay the bill completely.

Are there limits on workers’ compensation paying for medical treatment?

Yes.  There are some rules that you have to follow to make sure that the bills for your medical treatment are completely covered by workers’ compensation.

First, you have to make sure you are receiving authorized medical treatment.  That basically means that you are treating with a doctor who is authorized to provide treatment in your workers’ compensation claim.

One authorized medical provider in your claim is your authorized treating physician.  You can think of this doctor as your primary workers’ compensation doctor.  This doctor can provide treatment to you or refer you to other doctors when you need specialized treatment.

Other doctors can be authorized as well if the authorized treating physician refers you for treatment or a judge makes a decision that the doctor is authorized.  You just want to make sure the doctor treating you is authorized because otherwise the insurance company may not be responsible for paying the bill.

You also need to make sure that the medical treatment you receive is because of your workers’ compensation injury.  If the treatment is for a condition that was not connected in some way to your workers’ compensation injury, the insurance company will probably not have to pay for that treatment.

What should I do if I get a medical bill for my workers’ compensation medical treatment?

Even though the doctor’s office should deal directly with the insurance company about getting medical bills paid, you may end up receiving a bill for some of your workers’ compensation medical treatment.  This usually means that something has gotten messed up with the process of getting the bill paid.

One problem that can cause this is the doctor’s office failing to get the bill submitted to to the workers’ compensation insurance company.  Instead of billing the insurance company, the doctor’s office may have billed you.

This causes problems because you suddenly have a medical bill for which you should not be responsible.  But, you may have concerns about what will happen if you fail to pay this bill.

A second reason that you may receive a bill is that the workers’ compensation insurance company received the bill but has failed to pay it.  If the doctor’s office does not get paid by the insurance company, they may send the bill to you hoping that you will pay the bill or get it straightened out.

You need to make sure that the bills get to the workers’ compensation insurance company for payment and get paid.  If you do not do that, the doctor’s office may turn the bill over to a collections agency and you may run into problems with the bill showing up on your credit report.

Also, there is a time limit for getting bills submitted to the workers’ compensation insurance company.  This time limit is known as a statute of limitations.  You need to make sure that your bills gets submitted within once year of the date of service to be safe.

Often, people who who hire me to represent them in their workers’ compensation case have unpaid workers’ compensation medical bills.  We do a few things to get these bills straightened out:

  1. We provide the bill to the insurance company and let them know that they need to pay it.
  2. We make sure that the doctor’s office has the workers’ compensation insurance information and let them know that they should not bill our client for workers’ compensation medical treatment
  3. We follow up to make sure the bill is paid

This helps make sure that the medical bills get paid like they should and that our clients do not continue receiving medical bills from their workers’ compensation doctors.  If this does not take care of the problem, then we move forward with requesting a workers’ compensation hearing to get the bills paid.

What if I have other questions about workers compensation?

Georgia’s workers compensation system can be very confusing.  You have to worry about getting the treatment you need and paying your bills while also worrying about not missing any deadlines that could cause you to lose your right to receive workers compensation benefits.

If you have questions, I would recommend that you try to get answers.  To find out more about how to schedule a time to talk to me about your workers compensation questions, just read this short article.

Jason Perkins is an attorney who specializes in representing injured workers.  He regularly publishes videos and write blog articles about Georgia’s workers compensation system and issues that are important to injured workers and their families.

To be notified of Jason’s new workers compensation videos, subscribe to his Georgia Workers Compensation Video Series channel on YouTube by clicking the subscribe button below.

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