Future Medical Benefits in Workers’ Compensation Cases

At Crocker Law Firm, we represent workers’ compensation clients with a wide variety of injuries.
Depending on the injury’s severity, you may need medical treatment well into the future, including therapy, pain management, or even surgery.

So, how does that work? When you resolve your case through settlement, you may keep your right to future medical benefits open. Or you may waive those rights and receive additional money in exchange. If your case is decided by a judge, future medical benefits are typically left open, meaning they can still be claimed and paid after your initial award of benefits.

Unfortunately, workers’ compensation insurance companies often challenge the relatedness or necessity of proposed medical care. For instance, they could argue that a recommended shoulder surgery is not necessary to treat the original work injury; you should undergo physical therapy instead. They may take the position that the pain you are experiencing is from unrelated arthritis, not the back injury you suffered at work.

Once a workers’ compensation insurer has denied treatment, they are supposed to file something called a medical fee dispute so that a judge can review the records and decide the matter. You have the right
to be represented by your own attorney in a medical fee dispute. If a workers’ compensation insurance
carrier has declined to pay for your treatment without filing a medical fee dispute, an attorney can file one on your behalf.

Workers’ compensation is a complicated process. You should review your case with an experienced lawyer, particularly when future medical care is involved.