Today’s post comes from guest author Matthew Funk from Pasternack Tilker Ziegler Walsh Stanton & Romano.
While this post deals with NY law, the recommendation on filing is appropriate for WI cases as well.
QUESTION: My employer paid my salary while I was injured and out of work. Do I still have to file a workers’ compensation claim?
ANSWER: Yes. There is more to a claim than payment while out of work.
Joe’s boss, Mike was a great guy. In fact, when Joe got badly hurt at work and was out for weeks, Mike paid Joe’s salary every week. When Joe got back to work, he hesitated filing a Workers’ Compensation Claim. After all, Mike had paid his salary the weeks he was out. And Joe didn’t want to appear ungrateful or greedy. What should he do? File, Joe!! File!!!
If Mike drew Joe’s salary paid from Joe’s accrued sick or vacation time, Joe would not get that time back unless he filed a claim. That means the eight weeks of vacation and sick time Joe had coming to him had been put toward the time he spent recuperating at home. Unless Joe submitted a claim, he’d have to start from scratch to build up vacation and sick time.
“Aside from the monetary award, there is lifetime medical coverage for a Workers’ Compensation Claim.”
The payment of wages is only a small portion of a Workers’ Compensation Claim and NOT the only thing Joe is entitled to. In an earlier column, an injured worker can make a claim for a schedule loss of use if an extremity is injured even if salary was paid. More importantly, Continue reading
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.
Put your money back in your wallet. Your employer's insurance carrier is responsible for medical treatment of work-related accidents.
Today we have a guest post from our colleague Amanda Katz of New York.
Question: I received a bill from my doctor for treatment relating to my workers’ compensation claim. Am I responsible for payment?
Answer: You do not have to pay your doctor for treatment resulting from your work-related accident.
There is often confusion about paying doctor bills related to work-related accidents, but the reality is relatively simple. Take for example Joanna. While at work, a heavy box fell on Joanna’s foot. As a result, she was unable to walk and had to immediately go to the emergency room. Following treatment for her broken foot, Joanna received an expensive bill from the hospital. What should Joanna do?
Joanna should not pay the bill!
Under workers’ compensation law, Continue reading