Filing and receiving NJ workers compensation benefits is a process. You have to inform your employer of the injury, seek medical attention, and then you file a claim. This claim process could be incredibly straightforward and smooth, with the support of your employer. On the other hand, receiving the NJ workers compensation you deserve might be a frustrating legal battle.
Under the second scenario, it is very common for the medical attention you received to become medical bills that are due and payable. Your doctor, the hospital, or emergency services likely provide somewhere between 30 and 90 days for you to pay your bills. This timeframe isn’t always sufficient to cover the expenses with workers compensation benefits if there is a dispute or disagreement over the claim.
What should you do about seeking medical treatment and paying medical bills as you await approval of NJ workers compensation benefits?
Should You Seek Medical Assistance Immediately?
Many employees wonder if they should seek medical assistance immediately after an NJ workplace injury, or wait until they have confirmation of their NJ workers compensation claim. In all instances, you should obtain the medical treatment you need. This includes accepting emergency services, such as an ambulance or on-site treatment, and seeking out physical therapy or rehabilitation treatment, when recommended by a doctor.
Your choice of medical treatment could be important for approval of your NJ workers compensation claim, but this should never impede on your need for immediate care. If you are seriously injured in the workplace, then you should visit the nearest emergency room. If you are not in an emergency situation, you’ll need to follow your employer’s rules on finding a medical provider.
New Jersey law allows the employer and insurance company to stipulate which medical providers an injured employee can visit for care. In most instances, this means your employer will actually provide the referral to a physician or other specialist. If you would rather see a doctor, other than those on an employer’s pre-approved list, then you’ll likely have to cover the cost of that non-emergency medical treatment.
Who Pays for Your Medical Services Under NJ Workers Compensation?
Your employer, through its NJ workers compensation insurance provider, is responsible for covering the cost of all medically necessary treatment after a workplace injury. Under the law, if you see the specified physician and follow the reporting requirements under NJ workers compensation, your employer should cover the cost of treatment immediately.
If your care is pre-approved or recommended by your employer’s NJ workers compensation insurance provider, then you shouldn’t even receive a bill or report from the doctor. However, there are workers compensation claims each year that don’t fit this usual pattern. Not only are employees sometimes billed directly for emergency services or other unauthorized care, but can also receive a bill when the insurance company questions the source, amount, or medical necessity of your care. In these instances, you may want to seek the advice of an NJ workers compensation lawyer.
Paying Medical Bills When Your Claim Is Denied or Delayed
If the insurance provider hasn’t approved your NJ workers compensation claim, you may have to temporarily cover the costs of medical treatment. The doctor or hospital will submit a bill to your health insurance provider. This could be a group health plan that is also provided through your employer, a plan paid through your personal finances, or a government insurance program, such as Medicare or Medicaid. In a small number of situations, an employee will cover the medical costs out-of-pocket.
When your NJ workers compensation claim is settled, whether through a negotiation process or at a trial, you’ll be reimbursed for any out-of-pocket medical expenses paid. As well, your personal health insurance should be similarly reimbursed.
Other Questions? Ask an NJ Lawyer
If you have other questions about medical treatment, the payment of medical bills, or NJ workers compensation, generally, you can ask an NJ workers compensation lawyer.
At the Law Offices of Albert J. Talone, we encourage you to ask many questions before deciding how to proceed with a denied or delayed workers compensation claim, and provide an avenue for you to do so that is cost-effective. Our legal team provides a free initial consultation to any and all new clients. To schedule your conversation with an NJ workers compensation lawyer, call us at (856) 234-4023.