Section 30 - Medical Benefits

When a worker is injured on the job and goes on Workers Comp, a lot changes. First, there are the physical limitations. This is what keeps a worker out of work and unable to earn a wage for his or her family. But, there are also incidental things that change. Probably the most dramatic are trips to hospitals and doctors offices, and the bills that come shortly after.

Section 30 of the Massachusetts Workers Compensation Statute provides that the insurance company must provide adequate medical services and prescription medication as well as the money to pay for these services. Even though this seems simple, nothing in the law is ever as easy as it seems. Insurance companies and their attorneys do everything they can to deny your medical care. They hire nurses to review your case who often say that the treatment isn’t necessary.

That’s why it’s important that you hire a Workers Compensation lawyer as soon as you can. Even if you are getting your weekly benefits, it’s only a matter of time before the insurance company is cutting corners with your car. An experienced Workers Compensation lawyer can make sure that everything is running smoothly and help you get over any speed bumps that appear on the road.

Generally, yes. An injured employee can select whichever doctor he or she chooses, assuming that the doctor or hospital accepts Workers Compensation patients and will accept Board Rates. Section 30 even allows the injured employee to switch doctors one time, as everyone knows that a particular doctor might not always be the perfect fit for a particular patient.

However, there is one major caveat. The insurance company can require that your first scheduled appointment be with their doctor. This doesn’t apply to a trip to the emergency room. However, if you’ve been referred to an orthopedic surgeon or other specialist, the insurance company can require that you see their doctor first before you see your own. When you see the insurance company’s doctor, know that you only have to see this doctor once; you don’t have to continue seeing that doctor.

It also works a little differently for injured workers who are making a claim with the Workers Compensation Trust Fund. Those patients may be required to select a doctor from a particular network. However, the patient will not have any out of pocket expenses such as copays or deductibles.

Generally, yes. The insurance company will pay for artificial limbs, eyes, or other mechanical devices that allow the injured employee to get back to work, whether in the same job or a different job. To get this approved, a doctor will have to show that the services are medically necessary.

Many injured workers first get a pack of paperwork from the Workers Comp insurance company describing various networks of doctors. This can be daunting, especially when you’re trying to select a doctor that will treat your injury. The reason the insurance company does this is to control costs. If they can agree to a reimbursement rate with the doctor or hospital before the care is provided to you, the insurance company will have certainty as to cost. However, there are certain ways to get treatment from different doctors should your preferred physician be “out of network.”

Getting medical care for a work injury can be frustrating. You likely want to get treatment as quickly as possible so you can get back to work, and you would think that the insurance company wants the same thing. But, that’s not always the case. Appointments are delayed due to red tape, and you’ve likely been blamed.

At Marcotte Law Firm, our Lowell Workers Compensation Lawyers do everything we can to get our clients the medical treatment they deserve. Your attorney can coordinate with the doctors office to make sure they have everything they need to schedule your appointments. Our lawyers know that it’s in everyone’s best interest to get you the treatment you deserve.

If you’ve been hurt on the job and are having trouble getting your medical care scheduled or your medical bills paid, call the Lowell Workers Compensation Attorneys at Marcotte Law Firm for a free, no obligation consultation.