New York Workers' Comp: Medical Care

Posted By Katz Leidman Grossman Wolfe & Freund || 17-Oct-2016

If you were recently injured in a work-related accident, or if you just learned that you’re suffering from an occupational disease, you likely have questions regarding medical care. Can you choose your own doctor? Will your medical payments be deducted from your workers’ compensation benefits?

If you are entitled to workers’ compensation benefits, your healthcare will be covered whether or not you actually lose any time from work. Additionally, your medical care will be paid for in addition to the benefits you receive for missed wages.

Can I go to my regular doctor?

In order for your medical care to be covered, you must receive it from a healthcare provider who has been authorized by the New York State Workers’ Compensation Board to treat workers’ compensation patients.

The Board has a list of approved providers who are authorized to treat injured workers. If you are interested in reviewing the list of approved providers in New York, check out www.wcb.ny.gov under Health Care Information. You can receive care from any of the approved providers, or from your own doctor, providing he or she is registered with the Board.

Should I pay my medical bills?

No, you should not pay any medical bills out-of-pocket; the approved provider who treats you will send the bills directly to your employer’s insurer and to the Board. The Board asks that injured workers do not pay any of the bills pertaining to their workers’ compensation case, unless the Board denies a worker’s claim.

Additionally, New York law allows injured workers to receive reimbursement for any trips they make to and from their healthcare provider’s office.

Disputed Medical Bills

What do you do if the insurer disputes a specific medical service that you received? Under New York law, the insurer is required to pay any undisputed portion of the bill. If the insurer refuses to pay for a certain medical service, it must provide you with a written explanation as to why it’s refusing to pay for the services.

Note: When you start seeing your doctor, they may have you sign a Form A-9, which says that you agree to pay any bills that the Board does not allow for your claim. So, if a medical service is not covered, you may be financially responsible for the service.

For further information regarding workers’ compensation and medical care in New York State, contact Katz Leidman Grossman Wolfe & Freund for a free consultation.