How Work Accident Compensation Handles Health Care Benefits

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Robert Golan

Galen Jennings fell from scaffolding at work and was injured. Galen’s stay in the hospital and home therapy treatment were paid by workers’ compensation. Health care expenses were covered if she did or did not lose time from work. Benefits for wages for time missed from her job were paid. This step is mandatory for work accident compensation and work injury compensation. The workers’ compensation Board requires that health care providers must be authorized and provide care to all workers’ compensation patients.

You may visit any health care provider, and seeing your regular doctor is equally welcomed. The doctor must be registered. Invoices for services rendered are sent to both the Board and insurer. The Board must first deny your case before you can pay for any related bills yourself. You are also reimbursed for travel costs to your selected health care facility.

If there is a dispute over payment for your health care services the insurer must absorb all costs for the undisputed areas of your claim; it must also document why services were denied payment and request information needed to settle the dispute quickly and efficiently. Also, your health care provider may be required to submit a Form A-9 tax form stating you are required to pay medical expenses if your claim is denied, or should you discontinue claim before acceptance.

Preferred Provider Organization (PPOs)

If you already have a PPO, you must use providers from that network for treatment. The insurer is required to notify both you and the workers’ compensation Board of this situation. If you are unhappy with the care you received from the provider, you have 30 days following treatment to choose a provider outside your network.

Diagnostic Networks and Tests

When filing a claim, your insurer may insist that you use their diagnostic test facilities for treatment. If this occurs, it is important that you notify your doctor as well as any other health care practitioners that your insurer requests you use their centers for diagnostic network tests.

These are just a few things to consider when anticipating filing for Long Island work accident compensation.

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