Does Vermont Workers’ Compensation Cover All My Medical Bills?

If you have been injured in Vermont while on the job, your priority should be your health. However, you may be worried about how you will pay for your medical bills. You may be wondering, “Does workers’ compensation cover all my medical bills?” Simply put, yes. In Vermont, an employee with a valid workers’ compensation claim has the right to have their medical bills paid by their employer’s insurer. Your employer’s insurance company should cover all reasonable and necessary medical treatment that is related to your work injury. However, there are vital rules you need to understand.

What Medical Care Does Vermont Workers’ Comp Cover?

Vermont law requires employers to cover all reasonable and necessary medical treatments that are directly related to an employee’s workplace injury. But what does “reasonable and necessary” mean? This is a broad category that covers several things, including;

• Hospital stays and surgeries
• Laboratory tests
• Diagnostic tests
• Prescription drugs
• Doctor vistas
• Physical therapy
• Assistive devices and durable medical equipment (DMEs) such as wheelchairs and braces

In other words, if your healthcare provider decides that you need the medical care and that the care is related to your work injury, your employer’s workers’ comp insurer should cover it.

The Vital Role of Your Treating Doctor

Your treating doctor plays a vital role in your workers’ compensation case. Your primary physician is responsible for determining what treatment is “reasonable and necessary.” Your employer’s insurance company must pay for all treatment plans and referrals your doctor recommends as long as they are directly linked to your work injury.

In Vermont, you have the right to choose which doctor will treat you after a work injury. However, your employer can direct you to whom you should see for your first visit. To change providers after the initial visit, you simply need to file Form 8 (Notice of Intent to Change Healthcare Provider) with the Vermont Department of Labor and provide a copy to your employer and the insurance company.

Will You Be Required To Pay Out of Pocket?

A major advantage of the Vermont workers’ compensation system is that you shouldn’t have to pay out of pocket for approved medical care. Your medical provider should send the bill directly to the insurance company. You should never get a bill or be asked to pay for something out of pocket. However, if treatment is not considered reasonable, necessary, related to your work injury, or is not authorized, you could be left responsible unless you can prove that the treatment is covered under workers’ compensation.

Is Preauthorization Necessary?

Preauthorization is generally not required for medical treatment in Vermont workers’ compensation cases. However, medical providers may request it to ensure they get paid. If your doctor requests preauthorization, the insurance company has 14 days to respond. If it does not respond within this time, you can request an order from the Department of Labor authorizing treatment.

While all your reasonable and necessary medical expenses are covered under workers’ comp, the truth is that insurance companies sometimes deny claims or dispute treatment, which can leave you stressed and unsure about what to do. In such cases, it’s vital to remember that you have legal rights and options.

Contact Us for Legal Help

If you’ve been injured while on the job in Vermont, you shouldn’t have to fight to get your medical bills paid. Our experienced Vermont workers’ comp lawyer at Sluka Law PLC can help you protect your benefits. Contact us today to schedule a consultation.

Source:

legislature.vermont.gov/statutes/section/21/009/00640