How to get medical bills covered when workers’ comp has disputed payment.
We believe that access to medical care is one of the most important benefits under workers’ comp. Unfortunately, the employer and its insurance carrier get to pick medical providers during the first 28 days. Our experience shows that people are sent to industrial clinics and receive subpar medical care. Medical treatment can also be unreasonably delayed or flat out denied. A frequent question that we get asked: Can I use my own insurance instead of workers’ comp insurance in Michigan? The answer is yes, but it comes with strings attached.
Individuals hurt on-the-job are entitled to have all reasonable and necessary medical treatment paid regardless of their fault. This includes ambulance runs, emergency room visits, hospital stays, physical therapy, injections, medications, and surgery. There should never be any copayments or deductibles owed. This is an unlimited and potentially lifetime benefit.
The amount paid for medical treatment under workers’ comp is controlled by a state-wide fee schedule and the patient cannot be charged extra. We recommend selecting the best doctor possible once the 28 days have passed as cost should not be an issue. Watch out for workers’ comp insurance company selected doctors because this often leads to a conflict of interest.
If a person decides to see their own doctor before 28 days have passed, they might have to pay out-of-pocket because workers’ comp will not cover their choice of medical provider. In this situation you can use your own insurance instead of workers’ comp in Michigan if the claim has been disputed. If the claim has not been disputed, it becomes more difficult because some insurance companies will refuse work-related injuries.
Can I use my own insurance instead of workers’ comp in Michigan?
In Michigan, employees who find medical treatment disputed under workers’ comp can use their own health insurance. This includes group health insurance policies and government programs like Medicaid or Medicare. Reimbursement will be required if additional money is recovered under workers’ comp through a settlement or award.
We do not recommend having the doctor run a tab. We have seen too many individuals bury themselves in medical debt. Health insurance will usually pay disputed medical bills if you can provide a Notice of Dispute. Sometimes a reimbursement agreement must be signed but it only matters if additional workers’ comp benefits are paid.
Additionally, a person needs medical evidence to be successful with his or her workers’ comp case. Using health insurance to pay disputed medical expenses means they can still see their doctor. This is critical because it allows them to develop medical evidence showing causation and disability. In this scenario, you can use your own insurance instead of workers’ comp in Michigan as it will be necessary for you to do so to win at trial.
Injured while on-the-job in Michigan? Contact our lawyers now
If you were injured while on the job in Michigan and have questions about your workers’ comp claim and what insurance to use, call us now, or fill out our contact form for a free consultation. There is absolutely no cost or obligation. Our attorneys are here for you.
Our attorneys have been exclusively helping injured workers in Michigan for more than 35 years. Our attorneys can help you better understand Michigan work injury laws and what happens after someone has been hurt on the job. To see what our own clients have to say about the caring, compassion, and communication they received from us, you can read in their own words about their experience here on our testimonials page from clients we have helped.
Michigan Workers Comp Lawyers never charges a fee to evaluate a potential case. Our law firm has represented injured and disabled workers exclusively for more than 35 years. Call (844) 316-8033 for a free consultation today.
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