When you’re injured at work, workers’ compensation benefits are designed to cover your medical expenses and help you recover without financial stress. However, there are times when workers’ compensation may not fully cover your medical bills, leaving you with significant out-of-pocket costs.
Understanding your legal options in these situations can help you get the financial relief you need. Contact PLBH at (800) 435-7542 for a free legal consultation.
Why Workers’ Compensation May Not Cover All Medical Expenses
Workers’ compensation typically covers medical bills related to workplace injuries or illnesses, but there are several reasons it may not cover all of your costs. These include:
- Disputed claims: Your employer’s insurance company may dispute the extent of your injuries or argue that the medical treatment you received wasn’t necessary.
- Treatment limits: Some workers’ compensation policies have limits on certain types of treatment, such as physical therapy or chiropractic care, which can leave you paying for ongoing treatments yourself.
- Out-of-network providers: Workers’ compensation often requires you to see an approved medical provider. If you visit a doctor or specialist outside this network, you may be responsible for those medical bills.
- Delays in reimbursement: Even if your medical expenses are covered, delays in payment from the workers’ compensation insurer can leave you with temporary financial strain.
Legal Options When Workers’ Compensation Falls Short
If workers’ compensation doesn’t fully cover your medical expenses, you have several legal options to explore. These options can help ensure you receive the full amount of compensation you deserve for your work-related injuries.
1. Appeal the Workers’ Compensation Decision
If your workers’ compensation claim is denied or certain medical bills are not covered, you have the right to appeal the decision. The appeals process can involve:
- Requesting a reconsideration: Submit additional documentation or medical evidence to support your claim for medical coverage.
- Filing for a hearing: If your claim is still denied, you may request a hearing before a workers’ compensation judge, where your case will be reviewed in detail.
Legal representation during the appeals process can significantly increase your chances of success, as an attorney can gather the necessary evidence and present a compelling case.
2. Third-Party Liability Claims
In some cases, a third party—someone other than your employer—may have contributed to your injury. For example, if a defective piece of equipment caused your injury, you may have grounds to file a third-party liability claim against the manufacturer.
These claims allow you to seek additional compensation beyond workers’ compensation, including coverage for:
- Unpaid medical bills
- Lost wages
- Pain and suffering
Filing a third-party liability claim can help fill in the gaps when workers’ compensation doesn’t fully cover your medical expenses or other losses.
Maximizing Your Workers’ Compensation Benefits
To ensure you receive the maximum workers’ compensation benefits for your injury, it’s important to take proactive steps throughout the claims process.
1. Seek Immediate Medical Attention
Always seek medical attention as soon as possible after a workplace injury. Follow all treatment recommendations and keep thorough records of your doctor visits, prescriptions, and any other related expenses.
2. Follow Workers’ Compensation Procedures
Make sure to notify your employer about your injury in a timely manner and follow the appropriate steps to file your claim. Failing to adhere to workers’ compensation guidelines can result in a denial or reduction of benefits.
3. Work With a Legal Professional
Navigating the complexities of workers’ compensation can be challenging. An experienced attorney can help you understand your rights, negotiate with the insurance company, and represent you during appeals or hearings if necessary.
How PLBH Can Help You Get the Compensation You Deserve
If workers’ compensation isn’t covering all of your medical expenses, you don’t have to handle the situation alone. At PLBH, we specialize in helping injured workers get the full benefits they are entitled to under the law. Whether you’re dealing with a denied claim, disputed medical treatment, or potential third-party liability, our experienced team is here to guide you through the legal process.
Contact PLBH Today
Don’t let uncovered medical bills add to the stress of recovering from a work-related injury. Contact PLBH at (800) 435-7542 for a consultation to discuss your legal options and find out how we can help you secure the compensation you need.