Helping Injured Workers Since 1981

When do medical benefits end per a workers’ comp claim?

On Behalf of | May 30, 2023 | Workers' Compensation

Workers who have been hurt on the job or diagnosed with a job-related medical condition often apply for workers’ compensation benefits. If they qualify, employees with injuries or medical conditions related to their job functions can receive full medical coverage that pays for all of their necessary medical treatment. Their employer may also be more compliant when they make requests for certain accommodations to help them stay on the job or return as early in their recovery as possible.

There are no patient responsibility costs that a worker must absorb, which means no deductible or copay to worry about when already dealing with major medical expenses and possibly a loss of income. Ideally, using workers’ compensation can prevent a worker from incurring any medical expenses related to their work injury.

How long can workers expect to keep receiving workers’ compensation medical coverage in Ohio?

Until they fully recover

Many injuries and job-related health concerns will lead to a full recovery. A broken bone, for example, will eventually heal, allowing a worker to get back to their job. Medical benefits will end when someone no longer has the underlying condition or when they have managed to control or eliminate their symptoms. If they experience a flare-up again later, it will usually be possible to resume benefits if they need to receive additional medical care.

Until they reach maximum medical improvement

It would be a poor use of healthcare funds to continue covering treatment costs when someone does not respond to that care. Therefore, if a doctor submits paperwork indicating that a patient has reached maximum medical improvement (MMI), that patient may no longer be eligible for treatment-related coverage.

However, workers’ compensation may still cover other costs, such as the cost of their prescription medication. In some cases, workers may dispute the claim that they have fully recovered or that they are not responding to treatment. In scenarios where a worker fears losing their benefits when they still need medical treatment, it may be necessary to push back against unfavorable determinations and learn more about an individual’s rights when they have a job-related medical condition.

Seeking legal guidance to better understand workers’ compensation coverage in Ohio is the first step toward making optimal use of those benefits after an injury.