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What medical care does workers’ compensation cover?

On Behalf of | Jul 19, 2024 | Workers' Compensation |

Workers can develop a variety of different medical issues because of their employment. A retail worker could end up suffering a brain injury when merchandise falls off a shelf and hits them in the head. A bus driver could end up hospitalized when an intoxicated passenger punches them in the head. Workers exposed to carcinogens on the job may eventually develop cancer.

Most businesses in North Carolina have to carry workers’ compensation coverage to protect their employees. Workers with job-related health issues may qualify for disability benefits when they cannot work. Workers’ compensation also provides them with medical coverage.

What types of treatment and medical care does North Carolina workers’ compensation cover?

Any necessary treatments may be eligible for coverage

Different medical challenges can lead to a variety of different types of care. Someone who falls off a ladder may require immediate trauma care for a broken bone and imaging tests to rule out or diagnose a brain injury.

Someone with a repetitive stress injury caused by constantly gripping tools on the job may need surgery and physical therapy. Employees with job-acquired illnesses may need medication to treat their symptoms or resolve their infection. In theory, workers’ compensation benefits can cover any type of necessary medical care.

The physician overseeing the worker’s treatment determines what type of support they require. So long as the care is appropriate and necessary, workers’ compensation can pay for it in many cases. However, there are a few scenarios in which coverage may not be available.

For example, if a worker has become medically non-compliant by failing to follow a doctor’s orders, any future treatment they require may not be eligible for benefits. The insurance company could potentially claim that their failure to follow treatment recommendations led to their worsening symptoms.

Doctors can also determine that a worker has stopped responding to treatment. At that point, they may only be eligible for medical benefits to cover symptom management or future flare-ups of their condition as opposed to ongoing treatment attempts.

Workers concerned about their coverage or treatment plans may need assistance as they navigate a workers’ compensation claim. Learning more about the basics of the benefits available can help those with medical issues related to their employment to pursue the compensation that they’re rightfully owed.