The Workers' Compensation Law gives the employer the right to select the health care providers for the injured worker. The employer usually delegates that right to the insurance company. This does not necessarily mean that the insurance company "directs" the medical care; the treating physician selected or "authorized" by the employer/insurer directs the medical care using his or her own independent medical judgment.
Sometimes it is necessary to travel to see a physician. In situations in which an employee is required to submit to treatment at a place outside of the local or metropolitan area from the employee′s principle place of employment, the employer is required to pay the necessary and reasonable expenses. In no event is the employer or insurer required to pay transportation costs of more than 250 miles each way from the place of treatment.
If you are unhappy with your medical treatment, or you think that you need a referral to a specialist or some additional testing, talk to the insurance company about your concerns. If that doesn′t help, you may request assistance from the dispute management unit or ask for a conference with an administrative law judge to discuss your concerns.
If you have sustained an injury or occupational disease covered by the Missouri Workers' Compensation Law, any health care provider selected, approved, or authorized by the employer or the workers' compensation insurance company should not attempt to collect any fee or any portion of a fee directly from you. However, you are protected against such collection efforts only if you notify the health care provider in writing by certified mail that the health care services provided to you involve a workers' compensation case. The notice should include:
When the workers' compensation insurance company refuses to provide treatment at all, or discontinues your medical treatment, it is usually because of one or more of the following:
Section 287.210.1 RSMo states: "after an employee has received an injury he shall from time to time thereafter during disability submit to reasonable medical examination at the request of the employer (or) his insurer". The only restriction on medical examinations is the word "reasonable". Multiple examinations may be reasonable when the employee has multiple injuries or conditions, or treatment continues for several years.
Yes. Under the law, every hospital or other person that provided the medical care and treatment to the injured employee shall allow its records to be copied and to furnish full information to the Division or Commission, the employer, the employee or his dependents and to any other party to the workers' compensation proceeding. The Missouri Workers' Compensation Law does not address the copying costs that may be charged by the hospital or other health care providers.
Under the Missouri Workers' Compensation Law, an employer may allow or require an employee to use accumulated paid leave, personal leave, medical leave, or sick leave to attend to medical treatment, physical rehabilitation visits, and rating evaluations.
Yes. If you have any questions about the issues discussed above, you may consult with a lawyer. If you are unable to locate a lawyer who practices workers' compensation law, you may wish to contact: