Medical treatment rules for Raleigh Workers’ Compensation Benefits

When a Raleigh worker suffers an injury on the job, some employees’ losses are covered directly by an employer or through an employer’s insurance company. Employers in North Carolina agree to provide workers’ compensation benefits for medical expenses and wage losses. There are trade-offs.

By supplying benefits, outlined under the North Carolina Workers’ Compensation Act, employers are largely immune from liability claims for work accidents or occupational illnesses. Employers and insurance carriers also call the shots about medical treatment an injured worker receives. However, the state Industrial Commission can intervene in these matters.

An employee, unhappy with employer-managed treatment, can complain to the Commission. The Industrial Commission has the power to allow an injured worker to see a different doctor than the one chosen. The employer must provide sound reasons to gain approval from the Commission, the insurer or the employer before changing doctors or risk footing costs associated with the new treatment.

Chiropractic services may be approved by an employer. The worker is limited to a 20-visit maximum. The treatments can continue beyond that point, as long as services are reauthorized by the employer before extra chiropractic sessions take place.

Some injured employees under workers’ compensation benefits are forced to travel significant distances to receive medical treatment by doctors picked by self-insured employers or insurance companies. When roundtrip travel to a doctor or other health care provider exceeds 20 miles, employees can be reimbursed for mileage, according to Commission guidelines adjusted annually.

Employees hurt on the job deserve to receive quality medical treatment. Disputes over procedures, doctors or benefit amounts can add to hardships suffered by injured and ill workers.

You may choose to handle these matters yourself, although many employees speak with an attorney before taking any actions, like challenging a denial by the Commission, employer or insurance company. Lawyers also assess cases, in the event added compensation is possible through third-party claims.

Source: North Carolina Industrial Commission, ” Frequently Asked Questions” accessed Feb. 27, 2015