If you’ve been injured on the job in North Carolina or have developed a work-related illness and you are covered by workers’ compensation, you are entitled to medical treatment. Laws vary from state to state, but essentially, in principle, your company’s insurer must pay for 100 percent of all reasonable and necessary medical treatment. These are some common questions and answers about medical care under North Carolina's workers' compensation law.
When you have a qualifying condition, you are entitled to see an authorized primary doctor and specialist(s) when medically necessary. You are entitled to receive all authorized medically necessary care and treatment related to your injury, such as:
You can also receive a mileage reimbursement for travel to and from your authorized doctor.
The employer or the insurance company, subject to orders from the Workers’ Compensation Commission, provides and directs medical treatment. That means you must see a doctor your employer approves. However, if you are not comfortable with a doctor or want to see one of your own, you can ask your employer for written permission to do so. If your employer denies you permission, you can petition the Commission, showing grounds why a change is warranted.
You are entitled to treatment for as long as necessary. However, your treating physician may wish to discontinue treatment before you feel you’re ready. Additionally, if your condition requires long-term care, the insurance company will probably try to negotiate a final settlement rather than continue to pay per session.
As long as your medical treatment is approved by your treating physician or on appeal from the Workers’ Compensation Commission, the insurance company must pay. If you decide to undergo treatment that is not deemed medically necessary, you will have to pay out of pocket.
It is not always easy to get the workers’ comp benefits you’re entitled to. If your claim is denied in North Carolina, trust a law firm with more than 200 years of combined legal experience appealing workers’ comp denials. Call Marcari, Russotto, Spencer & Balaban at (888) 351-1038 or contact us online to schedule a free consultation.
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