Does Louisiana Workers’ Comp Cover Medical Benefits?
Lafayette Attorneys Explain Workers’ Compensation Benefits
If you sustained a workplace injury, or if your family member died in an on-the-job accident, contact an attorney as soon as possible. Our workers’ comp attorneys in Lafayette and Lake Charles have helped injured and grieving Louisiana residents obtain medical benefits since 1996. We do not tolerate insurance companies using tactics to deny, limit or delay benefits. Robert M. Martina worked for insurance companies for 15 years: he knows how they respond to different kinds of claims. By anticipating these moves, he can maximize your chances of receiving full medical benefits as quickly as possible.
Do Workers’ Compensation Benefits Cover My Medical Treatment?
Businesses in Louisiana are required to cover workers’ comp insurance or self-insure their employees. As an injured worker, you can choose a doctor to treat your injuries. The law says that your employer, or your employer’s insurance company, must cover “approved, necessary expenses” related to your medical care. If you need to travel for treatment, record these expenses: your employer is supposed to reimburse you for them. Some expenses that need pre-approval from your employer/insurer include:
- Non-emergency medical services costing more than $750
- Non-emergency hospitalization
For these situations, the hospital will fax a request to your employer/insurer for authorization. No response within five days is considered a denial.
Once the Office of Workers’ Compensation Administration (OWCA) Medical Director receives information about the injured workers’ medical care, he or she will decide if the proposed treatments align with state workers’ comp laws and guidelines. You can file a judicial review if you disagree with the Medical Director’s decision. In these cases, the OWCA appoints an independent medical examiner to review the case. The carrier/self-insured employer will bear the costs of the investigation.