Medical Benefits Under New York Workers' Compensation Law

Westchester Workers' Comp Attorney

In many workplace injury cases, the largest bills that the employee faces are from the doctor. The costs of medicine have risen dramatically in the last decade and a worker facing x-rays, diagnostic tests, MRIs, radiological tests, or hospital stays may feel overwhelmed by the cost of medical treatment.

The good news is that New York Workers’ Compensation law enables injured workers who are eligible for workers’ compensation to receive all the medical care they need. The cost of necessary medical treatment must be paid by the employer or the employer’s insurance carrier. Hospitals and other health care providers are not allowed to collect fees from the patient. In fact, in many cases, you will be able to collect reimbursement from your employer for any automobile mileage to and from the health care provider’s office.

Physicians are required to obtain advanced authorization for any specialist consultations, surgical procedures, physiotherapeutic procedures, X-rays, or special diagnostic lab tests costing more than $1,000.

In addition, any prescription drugs and medications are covered by Workers’ Compensation. Since July 11, 2007, pharmacies have been able to directly bill the insurance carrier for drug payments.

In cases where the workers’ compensation claim is still being disputed by the employer or the insurance carrier, however, the health care provider may require that worker to sign an A-9 form. This form guarantees that the worker will pay for the medical bills if the Workers’ Compensation Board disallows the later claim.

Selecting a Doctor

Injured workers are allowed to choose any physician, chiropractor, podiatrist, psychologist, outpatient clinic, or health maintenance organization that is authorized by the Workers’ Compensation Board to render health care. To find a health care provider who has been authorized by the Board, click here. If your family practitioner is not authorized or if you are seeking out a specialist and don’t know where to begin the search, you might start with this article from the New York Department of Health on “How to Choose the Right Physician.”