If an injured worker has an accepted work injury and has been paid benefits through workers’ compensation for time off work (temporary total disability benefits; temporary partial disability benefits; healing period benefits; or permanent partial disability benefits), the injured worker is entitled to lifetime medical benefits for conditions related to the injury. The workers’ compensation insurance carrier is responsible to pay 100 percent of the medical bills and reasonable transportation costs. It is important to recognize the choice of doctors/care is the employer/insurance company’s responsibility. If an injured worker gets care on his/her own, it may be considered unauthorized and may not be paid for through workers’ compensation.
The normal medical course for an injured worker is to go through the authorized medical care and at some point the doctor is asked to assign a date of maximum medical improvement (MMI). When this happens, the claim benefits for temporary total disability benefits or healing period benefits will end. At that point, a determination is made by a doctor as to whether any further benefits are owed for permanent damage.
When maximum medical improvement (MMI) is assigned, in many cases the workers’ compensation insurance carrier acts as if no further medical care is necessary. Not true! Even though a doctor has released an injured worker from the medical care, that does not mean medical care is over. If an injured worker is still having problems, they should not accept there is nothing more that can be done. If the injured worker knows of other treatment or care that might help their condition, it should be brought to the attention of the workers’ compensation insurance company. If the workers’ compensation carrier refuses the care, it should be communicated by the injured worker that he/she is dissatisfied with the care being offered. If the workers’ compensation carrier still refuses, the injured worker can apply for alternate medical care with the Iowa Division of Workers’ Compensation. It is likely, prior to applying for alternate medical care, the injured worker should consult with an attorney who is knowledgeable and experienced in Iowa workers’ compensation.
The major point here is if an injured worker continues to experience problems, even if the company doctor says no more care is necessary, do not accept this, do not give up. There may be other doctors with more expertise or experience that can provide beneficial care. However, further treatment may be resisted by the workers’ compensation insurance carrier. If this happens, the injured worker would likely benefit from consulting with a workers’ compensation attorney. The attorneys at Wertz & Dake have the knowledge and experience as workers’ compensation specialists to assist in getting the medical care an injured worker deserves. There is no cost to an injured worker to discuss the workers’ compensation claim with a workers’ compensation specialist at Wertz & Dake.