Maryland Workers’ Compensation Benefits for Medical Treatment and RehabilitationJuly 28, 2023
Your Workers’ Compensation benefits in Maryland are supposed to pay the reasonable medical costs associated with treating your injuries. You are not automatically approved for every medical treatment that you want. Your care must still be approved, which can sometimes be an issue.
The insurance company may pay for both a portion of your lost wages and all of the following that are associated with your injury:
- Doctor bills
- Hospital bills
- Prescription medications
- Physical therapy
- Necessary medical expenses
As an injured worker, you can choose your own doctor in Maryland. However, your doctor must be willing to accept the fee that is outlined in the Maryland Workers’ Compensation Medical Fee Guide. The insurance company is not obligated to reimburse anything more than that.
Your Treatment May Not Always Be Approved
There are times when there is a dispute between you and the insurance company about whether a course of treatment is associated with your injury. You may want some type of experimental treatment or something that may not be a recognized course of care. The insurance company may deny your request for treatment. If your treatment is beginning to cost too much, you may find that requests for medical treatment are being denied more often. There are times when insurance companies may deny orders for MRIs or even surgery.
You may not always have your care approved on time. Cost is often an issue, even when the provider is willing to accept the rate prescribed by the fee schedule. The insurance company may simply not think that care is necessary to treat your injury and may be trying to control costs.
The insurance company is not always bound to accept the recommendation of your treating doctor. The insurance company can send you for an independent medical examination. Your care could be delayed while the insurance company waits for the results of this examination. There are times when the independent doctor disagrees with your treating doctor.
Maryland law requires that your treatment be covered when it is “reasonable, necessary, and causally related” to your injury or condition. There is room for differences of opinion. Your interest is that you receive all the care necessary to help you recover and return to work.
Even if you are denied medical coverage that your treating doctor says you need, you still have legal options. You can appeal a denial of medical coverage to the Maryland Workers’ Compensation Commission (MWCC). An administrative law judge would hear your appeal the same as they would if you were contesting a denial of benefits.
You also have the right to rehabilitation services for your work-related injury. You could need the following:
- Physical therapy
- Occupational therapy
- Vocational rehabilitation
You May Qualify for Vocational Rehabilitation
If you learn that you cannot return to your previous line of work, you may qualify for vocational rehabilitation. This rehabilitation aims to train you to perform another type of work you can, even with your injuries. You should receive the maximum amount of services so you can switch careers and earn money. Your employer needs to pay for this rehabilitation, so they may argue it is unnecessary. The MWCC can order vocational rehabilitation services.
Your Workers’ Compensation claim being approved may be just the start of the process for you. The medical benefits you need are not always accessible, nor does the insurance company always approve them. You may still need the help of a lawyer, even after your initial claim is granted.
Baltimore Workers’ Compensation Lawyers at LeViness, Tolzman & Hamilton Can Help With Benefits
If you have any issues with benefits for medical treatment or rehabilitation, contact our Baltimore Workers’ Compensation lawyers at LeViness, Tolzman & Hamilton today. Call us at 800-547-4LAW (4529) or contact us online to schedule a free consultation.
We have offices in Baltimore, Glen Burnie, Lanham, and Owings Mills, allowing us to represent clients in Maryland, including those in Anne Arundel County, Baltimore County, Carroll County, Harford County, Howard County, Montgomery County, Maryland’s Western Counties, Prince George’s County, Queen Anne’s County, Southern Maryland, and the Eastern Shore, as well as the communities of Catonsville, Essex, Halethorpe, Middle River, Rosedale, Gwynn Oak, Brooklandville, Dundalk, Pikesville, Nottingham, Windsor Mill, Lutherville, Timonium, Sparrows Point, Ridgewood, and Elkridge.