Maryland Workers Compensation case and the use of health insurance.
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If you have been injured on the job in Maryland than you may be wondering if you can use your health insurance rather than going through the workers compensation process. Perhaps the workers compensation insurer has denied your treatment, or perhaps they are attempting to control the doctors with whom you treat. The process can make you feel very uneasy and confused because Maryland workers compensation laws are not easily understood.
Workers’ Compensation Insurance v. Health Insurance
To better understand workers compensation in Maryland it is helpful to view the workers compensation Insurer as another health insurer similar to Blue Cross or Cigna. Workers Compensation Insurance is not accepted by all physicians just as your health insurance may not be accepted by all physicians. Do not interpret this as the Workers Compensation Insurer having the control to send you to only certain doctors. Maryland workers compensation adjuster will sometimes provide a doctor on their “list” that you are able to see. They may phrase it as “you can go and see Doctor X,Y, or Z.”This is not in accordance with the law. YOU and the DOCTOR of your choosing control the situation and you are only excluded from seeing certain doctors if those doctors do not accept workers compensation insurance. Liken this to a doctor not accepting Cigna, Blue Cross, etc.
Use of Health Insurance for a Work Injury
The Insurance provider that is obligated to pay for your treatment is determined by the circumstances of the injury. If the injury took place at work while performing work duties then the health insurer is not obligated to pay for treatment and treatment should be obtained through the workers compensation insurer. This determination is made at the first medical appointment when the explanation of injury is described to the doctor. Best practice is to use the work comp insurance for injuries sustained at work. There would be no co-pays, no deductibles, paid reimbursement of mileage to and from the doctors, and better pay rates for the doctors. With that said there are certain delays that the injured worker will likely endure when treating under workers comp insurance. If delays are the issue then it is time to obtain a Maryland Workers Compensation attorney that is qualified and experience to handle your case.
Occasionally the health insurance company will pay for treatment and later look for reimbursement from the workers compensation carrier. The work injury case can become more complicated for all parties involved if health insurance is used. The injured Maryland worker could end up paying co-pays which can quickly ad up, the injured worker will have expenses which are not ordinarily present when using workers compensation insurance, the health insurer will have to deal with the workers comp insurer and fight to get reimbursed, the workman’s comp insurer will have to review all past medical reports and records and issue payments to the providers accordingly which could be very timely. If your supervisor is attempting to influence choice of insurance they are likely doing it for their own good.
Use of Health Insurance After Settlement
Many injured workers quickly become tired and frustrated with the workers compensation process and just want to settle their case and “be done with the whole thing.” While this is not always advisable it can often be the best thing for all parties involved. In the event your workers compensation claim is settled the health insurer will then be required to provide treatment to the body part injured. It is important to know that health insurance will step in and pay the medical bills in the event that the workers compensation claim is lost however the injured worker may then be obligated to pay past co-pays and deductibles.