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Injuries can be frightening. After an on-the-job injury, most people want to see their own doctor, who is familiar to them and knows their medical history. This is particularly true when a work injury complicates an existing medical condition.
After a work-related injury or illness, you can seek medical advice from your own doctor. However, this treatment may not be covered by Florida workers’ compensation medical benefits.
Workers’ compensation insurance generally pays medical bills for all authorized and medically necessary care and treatment. Items that are covered include doctor’s visits, hospital stays, testing, prescription medications, physical therapy and medical equipment such as prosthetics. Mileage reimbursement is also available for patients who drive to doctor’s visits and the pharmacy.
The first step in having these and other costs covered by workers’ compensation is always to report the work-related injury or illness to your employer. If you need emergency care, you should also tell the emergency room you were injured on the job and provide contact information for your employer. This step opens your workers’ compensation claim and starts the process that allows you to obtain benefits.
When you tell your employer you have been injured, your employer may give you a list of doctors you can see. In order for your medical benefits to be covered by workers’ compensation, you must see a doctor authorized by your employer or, in most cases, by the insurance company.
If your own doctor is on the list of authorized doctors, you can see him or her without trouble. The visits should still be covered by workers’ compensation. But if your doctor is not on the list, it is important to choose a listed doctor instead. If you see your own doctor instead of one of the authorized doctors, the insurance company may deny your claim for medical benefits – leaving you to face some hefty bills.
In some cases, an insurance company or employer will dispute your claim for medical benefits even if you saw an authorized doctor after an on-the-job injury or illness. The employer or insurer might argue that your injury was not job-related or that your illness arose from a pre-existing condition – not from your work conditions.
If you followed all the instructions and are still facing a denial of your claim for benefits, an attorney can help you appeal the denial. While you are not required to have a lawyer in order to appeal, an attorney’s help can be invaluable in gathering evidence to support your claim, talking to witnesses and presenting your case against a workers’ compensation insurer that brings its own team of lawyers to prove its arguments against you.