Helping Injured Workers Since 1981

What are my medical benefits under workers’ compensation?

On Behalf of | Sep 22, 2021 | Workers' Compensation

If you got injured or contracted a disease on the job, you don’t need to pay for the medical treatment that you need to heal. Even if it’s your injury or illness, it is your employer’s responsibility. Your employer must compensate you for your medical expenses as you got your injury or sickness while carrying out your work duties.

Self-insuring and state-fund employers

Your employer may pay for your compensation benefits themselves. However, most employers pay an insurance premium to the Bureau of Workers’ Compensation (BWC) to pay the benefits to their workers. Whether your employer is state-fund or self-insured, all employers must abide by Ohio’s workers’ compensation laws. Upon a valid claim, self-insured employers and the BWC must pay the following needed medical expenses for the injured worker:

  • Doctor’s fees
  • Surgeries
  • Prescription drugs
  • Rehabilitation
  • Overall medical treatment

If your employer is state-fund, their Managed Care Organization (MCO) will manage the medical portion of your claim.

Managed Care Organization

Each state-fund employer selects an MCO when they apply for the workers’ compensation policy. The organization of their choice will ensure that their injured workers receive medical care. The MCO is in charge of:

  • Evaluating the worker’s current and future medical needs
  • Approving the injured worker’s treatment
  • Paying the workers’ medical bills
  • Providing rehabilitation referrals

The worker must know the MCO that will take their case when they go to a doctor’s appointment. Their employer must tell them which MCO will pay for their medical care.

Choosing a medical provider

The worker has the right to choose which doctor they want to receive treatment from, as long as the doctor is a BWC-certified medical provider. In emergencies, the first doctor the worker visits does not need to have a certification. However, workers must select a certified doctor for their treatment afterward if they want the MCO to pay for their medical expenses. Workers can also change doctors by filing a Notice to Change Physician of Record with their MCO.

Your right as a worker

Injured workers in Ohio have the right to get quality medical care without a cost. However, sometimes workers’ compensation claims are denied by the BWC or the employer’s insurer for different reasons, including not filing the claim on time. If this happens to you, you can fight back and appeal the decision. You deserve medical treatment for your injuries, and you have the right to ask for it.