Medical Treatment and Workers’ Compensation in Raleigh
A workers’ compensation injury is essentially an injury that takes place at work. It may consist of a fall, an electrocution, a foreign accident if the worker is one who has to travel, or any type of orthopedic injury that results from an accident. Other examples include the possibility of exposure injuries where the injured worker is exposed to a chemical or an aerosol that may cause a reaction or injury, as well as many types of burns that may occur in industrial accidents.
After an injury at the work place, it may be difficult to know what next steps to take, especially if your employer is in control of your medical care. In this situation, you may not receive the amount of care that you need, and could potentially be put back to work too early into recovery. When looking for workers’ compensation and proper medical treatment after a workplace injury, it is important to consult with a Raleigh workers’ compensation lawyer, who will help you evaluate your claim and show you the different options you have. Having an attorney on your side can help to ease the frustrations you may be facing after your injury, and will allow you to focus on recovery while ensuring you are receiving the care and benefits you need.
Seeking Medical Treatment
An injured person must seek medical treatment at the direction of their employer because the employer and the employer’s workers’ compensation insurance company pay for an injured employee’s medical treatment. The employer must direct even the initial medical treatment, unless it is an emergency. Depending on the injury, an injured worker sometimes has no choice but to go to the emergency room. If it is not an emergency, though, the employer and the insurance company direct the treatment and prescribe which doctors the injured worker must see.
Sick Travel Reimbursement
Reimbursement for sick travel may be considered reimbursement for certain expenses related to mileage in Raleigh cases. Specifically, it relates to having to drive over 20 miles to a doctor’s appointment for a worker’s compensation injury. The employer pays for any reimbursement for travel expenses as it relates to medical care.
The reimbursement should be paid immediately upon submitting a 25C. Often, insurance companies delay payment. If there are any delays in your payment, it is best to speak to an experienced worker’s compensation attorney. How much will be reimbursed is based on the federal mileage reimbursement rates. There is not a specific formula to calculate it.
It ends if the claimant has resolved their case via settlement or clincher agreement, or it ends when two years have passed after every final medical bills has been paid. It is often decided by the treating physician when the person has reached what is called maximum medical improvement. It is usually all given once the 25C has been submitted.
Insufficient Treatment
When an injured worker feels their treatment is or was insufficient, they should reach out to an attorney to get an opinion on whether they have any options or whether they should seek any type of appeal of care.
A medical only claim is when the insurance company accepted only the medical portion of the claim and pays for only medical care. They do not accept any disability portion of the claim and are not paying wage replacement.
A Maximum Medical Improvement (MMI) is the point at which the injured worker has plateaued in their symptoms. Their symptoms are not getting worse or better. The doctor believes that care has at least plateaued for the moment. At MMI, the doctor likely gives a permanent, partial disability rating and signs the permanent work restrictions, if any.
Role of Insurance Carriers
The insurance carrier chooses the doctors they want the injured worker to see. This may sometimes be a disadvantage for the injured worker, especially if the insurance company sends him or her to a doctor who is very conservative and not a patient advocate. Many times, this can be the case, and the doctor may return the injured worker to work too soon. Most doctors, however, are fair and balanced.
