The Alabama Workers’ Compensation Law allows for employees hurt on the job to receive compensation for life for the cost of their medical care relating to work-caused injuries. In order to qualify, the injury needs to be categorized as compensable, the treatment needs to be appropriate for the injury or illness and the medical care must be provided by a physician who is authorized.
Sometimes, medical claims relating to work-caused injuries are disputed by the insurance company. When this happens, it is important for injured workers to tell the medical provider that the claim has been disputed and tell them about the reasons for the dispute. The medical provider can then submit a formal complaint regarding the dispute to the Commissioner of Labor.
According to the law, health care providers can get a disputed medical claim re-reviewed, provided that:
— The medical provider was denied payment or only received partial payment.
— The medical provider was denied authorization to receive payment in situations where authorization was required.
— The medical provider was ordered to refund payments already received for medical services.
— The medical provider is a party to a disputed medical charge that still has not been resolved.
Alabama workers who need medical care for their work-related diseases and injuries can, in most situations, receive the medical care they require. However, if any situation arises in which worker is denied workers’ compensation medical benefits, it could be time to fight the matter in court. By obtaining representation from an experienced lawyer who represents workers in workers’ compensation claims, workers defend their legal right to receive compensation in court.
Source: State of Alabama Department of Labor Workers’ Compensation Division, “Basic Claim Handling Manual,” accessed Dec. 29, 2016