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What is Classifed As Unnecessary Medical Treatment by the Worker’s Compensation System?

On Behalf of | Sep 21, 2018 | Workers' Compensation

The worker’s compensation is there to protect injured workers by providing them with funds to cover lost wages as well as to cover the medical treatment for their work-related injuries. While it is a system that protects both employee and employer, it is a system that is not immune from being abused. As such, there is a certain amount of scrutiny given to injuries in the system, but also their treatments. This means that some medical treatments actually won’t be covered by worker’s compensation payments because they qualify as “unnecessary and unreasonable” for the injured party. Knowing what treatments aren’t covered by worker’s compensation can protect you from paying for it with your own hard-earned money.

What Medical Treatments are Considered Reasonable?

Often the worker’s compensation system and injured workers have a very different idea of what is considered reasonable treatment. However, what is typically considered reasonable medical treatment is as follows:

  • Appointments and check-ups with your doctor
  • Diagnostic testing such as X-Rays and MRIs, but only if the test is pertaining to your injury and not searching for other illness or injuries
  • Hospital stays after the injury has occurred
  • Medications administered by your doctor or prescribed for your injury
  • Surgeries designed to fix an injury or potential disability that may result from it
  • Medical devices that assist with rest and rehabilitation such as wheelchairs or crutches
  • Physical therapy
  • Chiropractic care, but only if you have a spinal injury and it is a prescribed method of rehabilitation

What Medical Treatments are Unnecessary?

In many cases, when a medical treatment is considered unnecessary, it is due to lifestyle choices of the client or even perhaps of very obvious fraud to get more coverage from the worker’s compensation system. Even if you are not trying to defraud the system, but simply prescribe to more alternative medical treatments, you should know that they may not be covered. Unnecessary medical treatments under worker’s compensation are:

  • Medical treatment that your family doctor calls unnecessary for your injuries
  • Experimental treatment or drugs not completely backed by the medical community
  • Acupuncture and other areas of what is considered “alternative medicine”
  • Treatment that does not pertain to the injuries you suffered
  • Over treatment of minor injuries
  • Duplicate treatment ordered by different doctors to try to receive multiple coverage
  • Soft tissue injury treatment that goes on for longer than a month

While many of these unnecessary treatments in case of fraud, if you do firmly believe in alternative medicine practices, you may be able to get coverage for it due to your lifestyle practices and beliefs, but you will have to fight very hard to get it. In most cases, you will end up losing anyway since much of what is covered by the insurance company is at their own discretion.

Even if you don’t prescribe to alternative medicine, you might find what you find a very valid treatment to be denied. For this, if it is a treatment you need and your doctor agrees, don’t give up. The worker’s compensation system is better than what little was in place before, but it is not perfect. This is why if you are filing for worker’s compensation, you always want to have a lawyer at your side. Not only can the right lawyer help you get the right amount to cover your injuries, but they can make sure that all your medical treatments are covered by the system so you don’t end up paying huge medical bills for no reason.

If you have been hurt at work and want a worker’s compensation lawyer at your side to help protect you, contact us today. The Law Office of Joshua Borken is dedicated to defending Minnesota’s injured workers.