Kentucky Medical Services in Workers’ Comp: How Does It Work?

high blood pressure/hypertension workers compensation claim

Under Kentucky’s workers’ compensation laws, a worker who has been injured on the job or developed a work-related illness may receive paid medical care. All medical payments are the responsibility of the employer and are usually handled by a workers’ compensation insurance administrator. The injured worker is not required to make co-payments for medical treatment under a workers’ compensation claim.

Fees available to physicians, hospitals and pharmacists are set by the Commonwealth every two years. No excess charges or co-pays should ever be billed to the patient.

If your employer is disputing your right to paid medical care for an on-the-job injury or you are being billed for treatment related to your job-related injury or illness, you need to speak to an experienced KY workers’ compensation attorney right away. At Morgan, Collins, Yeast & Salyer in Kentucky, we fight for injured workers. Our mission is to help you receive the proper KY workers’ compensation benefits provided by law.

Workers’ Comp Medical Benefits in Kentucky

Workers’ compensation is state-mandated no-fault insurance coverage provided to almost all full- and part-time employees in Kentucky. Most employers are required to provide workers’ compensation insurance coverage.

To take full advantage of the benefits available to you, you need to understand the breadth of what qualifies as a medical payment in the KY workers’ comp system.

Kentucky law (KRS 342.020) says that “the employer shall pay for the cure and relief from the effects of an injury or occupational disease as may reasonably be required at the time of the injury and thereafter … or as may be required for the cure and treatment of an occupational disease.”

Work-related medical expenses may be payable for life in cases of permanent disability or terminal illness and must be paid within 30 days of receipt by the employer without copayments or deductibles.

Medical expenses covered by workers’ compensation include:

  • Ambulance and emergency room fees
  • Fees charged by doctors and chiropractors
  • Prescription costs
  • Hospital bills
  • Surgical supplies and appliances
  • Costs of nursing care
  • Tests (such as x-rays and MRIs)
  • Durable medical equipment
  • Disposable medical supplies
  • Prosthetics and braces
  • Travel expenses to and from medical appointments
  • Vocational and occupational rehabilitation.

If your employer or their insurer challenges the validity of a medical expense, the employee may appeal to an Administrative Law Judge employed by the workers’ comp system to determine whether the expense is reasonable. There may be workers’ compensation case law that points to the validity of the workers’ claim. However, the ALJ cannot share this information, and it is certainly against the employer’s interests to do so.

This is when an experienced KY workers’ compensation attorney can be of great assistance to you. A Morgan, Collins, Yeast & Salyer workers’ compensation attorney will gather medical evidence, prepare your appeal and advocate for you to receive the full medical benefits available under Kentucky law.

Choosing Your Own Doctor in a KY Workers’ Comp Claim

Injured workers in Kentucky have a right to select the physician who treats them. The designated physician will provide primary treatment to the injured or ill worker and will be responsible for referring the employee to additional medical care providers as necessary.

If your employer participates in a managed health care network, you are required to select a doctor from the list of physicians within the managed care network. Except when emergency treatment is required, your designated physician must be in-network.

A workers’ compensation claimant may change their designated physician once without questions or permission. Additional changes require the employer’s or insurance carrier’s consent or for a workers’ compensation judge to approve the change if the employer/insurer objects.

However, an injured worker may seek a second opinion from an out-of-network doctor regarding major recommendations, such as surgery, at their employer’s expense.

When assigned to a workers’ compensation managed care plan, the injured or ill worker may also go outside of the network for:

  • Emergency medical care
  • Continued care from a physician who provided emergency care
  • Other treatment from a non-network physician begun prior to assignment to the plan
  • To receive treatment from a medical specialist through a referral by the designated physician in the managed care plan
  • Treatment not available through the plan.

These are rights provided to workers’ compensation recipients under Kentucky law. Most workers who find themselves suddenly injured on the job or diagnosed with an occupational illness have no idea how the KY workers’ compensation system works or the range of benefits it is supposed to provide.

A workers’ compensation lawyer from Morgan, Collins, Yeast & Salyer in Kentucky can review your disputed claim at no charge and advise you about your proper benefits. If you are being unjustly denied medical benefits for a workplace injury, our legal team can challenge those decisions for you based on our decades of experience as worker advocates handling appeals in the KY workers’ compensation system.

Contact a Lexington, KY, Workers Comp Attorney

An experienced workers’ compensation lawyer from Morgan, Collins, Yeast & Salyer can give you the Kentucky Courage needed to stand up to an employer or insurance administrator that is disputing your right to workers’ compensation medical benefits.

Most injured workers hire an attorney to file a workers’ compensation claim because of the complexity of the claims process. Don’t leave money on the table that you need. Our law firm is proud to have settled more than $200 million in workers’ comp benefits for hardworking Kentuckians like you.

Contact us today to set up your free legal consultation. We will not charge a legal fee unless we recover money for you. You don’t have to take on the insurance company by yourself. We stand ready to fight for you now.