You may have heard your physician mention maximum medical improvement (MMI). In workers’ compensation, MMI means that your physician believes you have recovered as much as you are going to. This doesn’t mean you shouldn’t keep treating, rather it means that your physician no longer expects improvement. However, if you are in pain we recommend that you keep treating. Continuing to treat also keeps the carrier aware that you do need additional medical care related to your injury. Ongoing treatment at least a few times a year helps keep your case active with the carrier and with your physician. Once you reach MMI, your physicians may discharge you to return “PRN”, which is treatment as needed. You can (and should) still make an appointment to return to your physician periodically. Once you reach MMI, if you have an injury to an extremity (leg, arm, hand, fingers, etc.) the question of whether there is permanent impairment should arise. If you have reduced range of motion or reduced strength due to your workers’ compensation injury, there may well be permanent impairment. A permanent impairment award is a way to get more money to you, without settling or closing your case. If you are at MMI and believe you have a permanent impairment, please contact us for additional assistance.
After you report your injury (and it is an accepted injury) the employer or carrier is supposed to offer you a panel of three physicians. Picking a doctor is a very important decision because once you choose your doctor, he becomes your authorized treating physician. Many people simply look at the list and choose the one closest to them; however, it is wise to research the doctor you are selecting, as some are better than others. Sometimes an emergency room will also refer you to a physician for follow-up care. In an accepted workers’ compensation case, you are entitled to mileage reimbursement for authorized treatment, so traveling a little further is still covered. After you have selected your doctor, contact the workers’ compensation carrier (or your attorney if you are represented) to get your first appointment scheduled. The carrier will provide the doctor’s office with authorization and carrier information so that all medical billing will be sent to the carrier. If you are not provided a panel of physicians, or your case is denied, please contact us. It is important to treat promptly for your injuries.
With an established workers’ compensation claim, you are entitled to mileage reimbursement for your medical treatment. This includes trips to your authorized treating physician(s), physical therapy, and diagnostic testing. Only medical treatment is covered, so mileage to the pharmacy for prescribed medication is not reimbursed. Many people aren’t aware of their entitlement to mileage reimbursement, as the workers’ compensation carrier will not reimburse mileage without a specific request from the injured worker. The mileage reimbursement rate is currently $0.555 cents a mile. This can really add up, as it is over a dollar for two miles. To obtain mileage reimbursement, you need to send the carrier the dates of your medical treatment, the round trip mileage and where you started and ended (the carriers often check the distance themselves) and the nature of the medical treatment. We suggest making a copy of the documentation you send and give the carrier a month to respond. If after that you didn’t receive the reimbursement, contact the carrier. If you are represented by an attorney, give the mileage reimbursement paperwork to your attorney and let them know if you don’t receive the reimbursement. I have seen numerous cases where the mileage reimbursement amounts owed has been in the hundreds of dollars or even more!
Healthcare is a big issue, and with the high cost of medical care, the need for healthcare is a serious one. However, many people worry about how their workers’ compensation injury will affect their healthcare benefits. Initially, your private healthcare insurance may well not cover your worker’s compensation injury (unless the injury is denied by the workers’ compensation carrier). As with all insurance companies, nobody wants to pay more than they are required to. Your private insurance will usually deny all medical costs that are related to your workers’ compensation injury. They (your private insurance) will expect your workers’ compensation carrier to cover those expenses, just as the workers’ compensation insurance carrier will not cover anything other than the injury you sustained at work. Another common question is “will I be able to keep my private health insurance?” There is no simple answer to this, as each employer is different and businesses have different policies. We have seen people out of work for over two years and their employer still pays for part of the health insurance premium. Unfortunately, we have also seen people out of work for only a few months who have been dropped from their employer’s plan. Workers’ compensation laws do not guarantee your health insurance, and the workers’ compensation carrier will not pay for part of the premium. Federal law does require an employer (if they are large enough) to offer COBRA, which allows you to stay on your health plan, but you have to pay the full premium. If you think your healthcare insurance coverage may become an issue in your workers’ compensation case, you may want to contact your human resources office. For more information on this issue, please contact The Moses Law Firm, PC, by phone or through our website.
There is an important and exciting opportunity now available for students from the ages of 16 – 25 whose parent’s work related injury event has caused a significant decline in family income and circumstances. Kids’ Chance of Virginia, Inc. was founded in 2011 with the goal of awarding academic scholarships to deserving children who have been adversely impacted by the work-related injury of a parent. Kids’ Chance of Virginia is currently accepting applications for scholarships for the 2013 – 2014 academic year, and they anticipate awarding several scholarships. The first Kids’ Chance organization was founded in Georgia in 1998. While Virginia’s chapter is the newest, we are pleased that we have already had clients who were able to obtain scholarship help for their college bound children. Additional information about Kids’ Chance of Virginia, Inc., as well as scholarship applications can be found at www.kidschanceva.org. The deadline for applications is March 31, 2013. You might also like: Seeking Medical Treatment in a Workers’ Compensation Injury Workers’ Compensation Information You Need to Know Immediately After a Work Injury Mileage Reimbursement for Workers’ Compensation Injuries