I’m Getting Medical Bills, But I Have A Workers’ Compensation Claim

By Charlie Domer posted on June 28, 2012

Question: I’m Getting Medical Bills, but I have a Workers’ Compensation Claim – Do I have to Pay Them?

Answer: No! Well, maybe…

If you have an accepted Wisconsin worker’s compensation claim, the worker’s compensation insurance carrier should be paying all of your medical bills, including prescription expenses.  Under the law, the carrier has to pay for medical treatment that is “reasonably required to cure and relieve from the effects of the injury.”   Therefore, if your claim has not been denied,  you have the right to get your medical expenses and bills paid without a deductible, including prescriptions, physical therapy, occupation therapy, diagnostic testing, office visits, psychological counseling, etc.  You also have the right to have your expenses covered for mileage driving to and from doctor appointments (which is reimbursed at 48.5 cents/mile). 

If you are receiving medical bills after a work injury, you should contact your doctors or medical providers and make sure they bill the worker’s compensation insurance carrier.  You can also forward any bills to your claims adjuster to request immediate processing and payment.  While this can become burdensome in dealing with medical bills and the worker’s compensation carrier, you need to be aggressive and not let bills pile up.  Make sure the adjuster and the medical provider are in communication so that all bills are paid promptly.

From a practical note, you should also make sure that your medical providers also list your own private group health insurance as the secondary payer (list the worker’s compensation carrier as primary).  If the worker’s compensation insurance carrier denies the claim or delays payment, the medical provider can submit the claim to your group health insurance.  While this may not be “fair,” it is far better to have your health insurance company pay the bill now versus having a large outstanding medical bill go into collections.  As part of an application for hearing, you can request reimbursement to your group health insurance and repayment for any out of pocket expenses (stayed tuned for more information).

To find out what to do if you have already paid a medical bill for an on-the-job injury, check in next week for part 2 of this series. 

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