Healthcare Case Management Article on Work Injuries and Healthcare Coverage

Injured on the Job? How Being Injured at Work can Impact Your Healthcare

Please review our healthcare case management program
Please review our healthcare case management program


Being injured on the job has the potential to seriously impact not only your physical health, but also your financial health and well-being. The good news is that state and federal workers’ compensation laws mean that there is a good chance your medical expenses will be covered. In addition, although approximately 75% of workers’ compensation cases only cover medical expenses, you may also be entitled to compensation for lost wages.

Unfortunately, while the workers’ compensation program provides many benefits to those injured on the job, it also has the potential to seriously affect the type and quality of the health care you receive. For this reason, it is essential that you know about the potential impacts to your health care in order to be fully prepared should you be unfortunate enough to experience a work-related injury.

Your Normal Health Insurance Won’t Cover Your Injury
Almost every health insurance policy contains an exclusion for work-related injuries, which means that your normal health insurance won’t cover any medical expenses related to treating injuries you suffered on the job. The reason behind this is that these expenses should instead be covered by your employer’s workers’ compensation insurance. However, your health insurance provider may still be required to pay for your medical expenses should the workers’ compensation insurance deny payment for whatever reason. Of course, it’s always a good idea to seek out workers’ comp lawyers in your area to ensure that your rights are respected.

You May Be Limited in Your Choice of Doctor
Not all doctors and hospitals accept workers’ compensation insurance, which means that you may be limited in your choice of doctors. If your current doctor does accept workers’ compensation insurance, you will still be able to use this doctor in most cases. However, should your doctor not accept workers’ comp, you will usually be forced to begin searching for medical professionals in your area that do take workers’ compensation cases.

You Could Be Forced to Wait for Treatment
Unfortunately, filing a workers’ compensation claim also means that you may be forced to wait longer before you can begin receiving any necessary treatments for your injury. The reason is that all medical expenses generally need to be approved by the workers’ compensation insurer before they can be performed. How this works is that first the doctor must determine whatever medical treatments are necessary to treat your injury. After this, the doctor then sends a request for authorization to the insurer, which then must determine that the treatment is necessary and reasonable before sending final approval back to the doctor. Although the process typically doesn’t take more than a few days, you will still have to wait to begin treatment until this final approval has been received.

American workers’ compensation laws were put in place in order to protect workers and ensure that their medical expenses are covered in case of a work-related injury. While this is definitely a huge benefit to anyone who would otherwise be unable to cover the costs of these medical expenses, it is still important that everyone is also aware of the ways in which a workers’ compensation claim can affect the health care you receive.

About the Author: Lizzie Weakley is a freelance writer from Columbus, Ohio. She went to college at The Ohio State University where she studied communications. In her free time, she enjoys the outdoors and long walks in the park with her 3-year-old husky Snowball.

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