How your expenses and treatment are covered for a workplace injury and what to do if your employer gives you the run around
Many injured employees don’t realize that their Michigan workers’ comp medical benefits cover reasonable and necessary treatment expenses for job-related injuries or illnesses. This includes treatment by healthcare professionals, prescriptions, supplies, and mileage reimbursement. In some cases, you may be able to choose your own doctor if pre-designated or allowed by your employer’s plan.
For help from one of our attorneys now, call (855) 221-2667, or you can fill out our contact form for a free consultation. There’s no cost or obligation, and we can ensure that your expenses and treatment are covered.
Does workers comp cover medical bills in Michigan?
Yes, Michigan workers’ comp covers all reasonable and necessary medical bills related to a workplace injury. This includes doctor visits, hospital stays, surgery, physical therapy, medications, treatment equipment, and even travel costs for appointments. Injured employees pay no deductibles or co-pays, and care must be provided whether or not pre-authorization is obtained, as long as it is related to the work injury. Benefits can continue for as long as the treatment is needed, and if any care is denied, employees have the right to dispute it through the WDCA, ensuring access to the healthcare required for a full recovery.
What are the key aspects of a Michigan workers’ comp medical claim?
Michigan workers’ comp covers all necessary medical care for work-related injuries, including doctor visits, hospital stays, surgery, therapy, medications, treatment equipment, and travel costs. Employees pay no deductibles or co-pays. During the first 28 days, your employer can direct treatment, but afterward, you can choose your own doctor with notice. Reasonable, necessary care is covered even without pre-authorization, and benefits can continue for life if needed. If treatment is denied, you can dispute it through the WDCA to ensure your care is fully supported.
Coverage of all necessary healthcare
Michigan workers’ comp ensures that employees injured on the job receive all necessary medical related to their work injury. This coverage includes doctor visits, hospital stays, surgery, physical therapy, medications, treatment equipment, and mileage reimbursement for travel to appointments. Employees do not pay deductibles or co-pays, and treatment that is reasonable and necessary must be covered, even without prior approval.
Employees are entitled to care for as long as it’s needed due to their injury, and their employer initially has the right to direct treatment during the first 28 days. After that period, injured employees can choose their own doctor while notifying the employer or insurer. If any treatment is denied, the injured worker can file a dispute with the WDCA, ensuring access to the care they need throughout their recovery.
Employer’s right to choose the doctor (first 28 days)
In Michigan workers’ comp claims, the employer or their insurance company has the right to direct an injured employee’s medical care for the first 28 days following a workplace injury. During this period, the employer typically selects the treating physician to ensure that care is consistent with the claim and aligned with state regulations. This approach helps the employer coordinate treatment and monitor recovery while ensuring that all necessary care is provided promptly.
Right to choose your own doctor (after 28 days)
In Michigan workers’ comp medical claims, injured employees gain the right to choose their own doctor after the first 28 days following a workplace injury. Once this period passes, employees can select a healthcare provider they trust for ongoing treatment, while ensuring the employer or insurance carrier is notified of the change. This allows employees to take a more active role in their recovery, while still receiving full coverage for reasonable and necessary care, including doctor visits, therapy, medications, and treatment equipment. Choosing your own physician can provide peace of mind and ensure that care aligns with your personal health needs and recovery goals.
Pre-authorization not always required
In a Michigan workers’ comp medical claim, pre-authorization is not always required for treatment. Healthcare that is reasonable, necessary, and related to a work injury must be covered, even if the employer or insurance carrier did not approve it in advance. This ensures that injured employees can receive timely care without unnecessary delays, including doctor visits, hospital stays, physical therapy, medications, and treatment equipment. While certain procedures may still require prior approval, the law prioritizes the worker’s immediate and ongoing healthcare needs to support a full and safe recovery.
Lifetime Healthcare Benefits
In Michigan workers’ comp claims, injured employees may be entitled to lifetime medical benefits if their on the job related injury requires ongoing treatment. This means that as long as treatment is reasonable, necessary, and connected to the workplace injury, the employer or insurance carrier must continue to cover it. Lifetime benefits can include doctor visits, hospital care, physical therapy, medications, treatment equipment, and travel costs for appointments. This provision ensures that employees receive the long-term care they need to manage their injury and maintain their quality of life without worrying about out-of-pocket healthcare expenses.
Mileage and Travel Reimbursement
Under Michigan workers’ comp, injured employees are entitled to reimbursement for travel expenses related to their medical care. This includes mileage, parking, and in some cases lodging for trips to doctor visits, therapy sessions, or other necessary treatments. The purpose of this coverage is to ensure that employees can access all reasonable and necessary treatment without incurring out-of-pocket expenses for travel. By reimbursing these costs, the system helps employees focus on their recovery while removing financial barriers to getting the care they need.
Dispute Resolution Available
With Michigan workers’ comp, injured employees have access to dispute resolution if their medical treatment is denied or delayed. If an employer or insurance carrier refuses to cover care that is reasonable, necessary, and related to a work injury, the employee can file a dispute with the WDCA. The WDCA reviews the case, evaluates the evidence, and can order the insurer to pay for the required treatment. This process ensures that employees have a formal way to protect their rights and receive the healthcare they need throughout their recovery.
What happens to medical bills when workers’ comp is denied in Michigan?
If a Michigan workers’ comp claim is denied, the injured employee may initially be responsible for their medical bills. However, employees have the right to appeal the denial through the WDCA. During the dispute process, the agency reviews the evidence and circumstances of the injury, and if the claim is later approved, the insurer may be required to reimburse any healthcare expenses already paid and cover all ongoing treatment related to the work injury. It’s important for injured employees to act promptly and seek legal guidance to protect their rights and ensure necessary care is covered.
What other workplace injury benefits can I receive other than healthcare?
If you are injured in the course and scope of your employment, you may be entitled not only to healthcare benefits, but also lost wages, and vocational rehabilitation.
Worker injury benefits are a compromise between employee and employer interests. You don’t have to prove negligence to get compensated, but you are limited in what benefits you can receive.
Pain and suffering is not available under state law. This might seem like an unfair system, but the amount of benefits paid for your workplace injury can be substantial.
Who pays for workers’ comp medical bills in Michigan?
In Michigan, workers’ comp insurance pays for all reasonable and necessary medical bills related to a workplace injury—not the injured employee. This includes doctor visits, hospital care, surgery, physical therapy, medications, treatment equipment, and travel costs for healthcare appointments. Employees pay no deductibles or co-pays, and care must be covered as long as it is tied to the work injury, even if pre-authorization wasn’t obtained. If a dispute arises, the WDCA can step in to ensure the insurer pays for required treatment.
How long do my treatment benefits last?
Treatment for a workplace injury is unlimited and can be paid for life.
What kind of care is covered under Michigan workers’ comp medical benefits?
Michigan workers’ comp medical benefits cover visits to the doctor, surgery, hospital stays, prescription medication and physical therapy. It can also include dental care, prosthetics, eyeglasses, hearing aids, wheelchairs and other appliances necessary to cure or relieve the effects of your work injury.
Whatever treatment is reasonable and necessary is covered for your workplace injury.
What if my home or car needs to be modified because of my work injury?
A. With you workplace injury benefits, you can even get home and automobile modifications. These are changes to your home and/or vehicle to accommodate your injury or disability.
Sometimes it’s cheaper for an insurance company to purchase a new home for you that is handicap accessible than modify your existing residence. But the law only requires changes to a vehicle, rather than purchasing a new vehicle.
What if I cannot take care of myself because of my injury?
Some people are so badly injured at work that they cannot care for themselves. When that situation arises, your work injury benefits provide attendant care. With attendant care (also called nursing services), your employer or its insurance company must pay the cost of a professional nurse or a semiskilled attendant to help you with activities of daily living. This could include wound care, help with mobility, bathing, using the bathroom, eating, dressing and taking medications.
You will usually need to have a prescription for attendant care written by your doctor to receive this benefit.
Your family members can receive pay for up to 56 hours per week for providing attendant care. A spouse, sibling, child, parent, or any combination of these family members can receive payment directly from the employee’s disability benefits system. A family member is generally entitled to the same hourly rate as a professional and should be paid accordingly. If you need more than 56 hours, your benefits cover payment for a professional.
Do Michigan workers’ comp medical benefits cover occupational diseases?
Michigan workers’ comp medical benefits also covers occupational diseases. These are illnesses that are directly related to your work. Treatment is available for injuries caused by repetitive work activities, exposure to chemicals, or from repeated bending and lifting.
What if my employer tells me to use my own health insurance?
Many employers in will refuse to take responsibility for an injury and tell you that you can’t file a claim and to use your own health insurance. This is not correct and can cost you significant money in the form of deductibles and co-pays.
You should not owe any money for treatment for your workplace injury.
If you are being told that you must use your own insurance for your at-work injury, it’s important that you contact a Michigan lawyer to discuss your rights. Call us at (855) 221-2667.
When can I choose my own doctor?
Under Michigan workers’ comp law, employers are given sole authority to select the provider for medical treatment during the first 28 days after your injury. After 28 days from the commencement of treatment, you have the right to choose your own doctor.
Your employer can recommend a doctor, but you have the right to choose for yourself. Be careful treating with doctors recommended by your employer or the insurance company because of a potential conflict of interest. You want a doctor who has your best interest in mind.
What if my employer/insurance company disputes my treatment expenses?
Employers or insurance companies will often dispute what is reasonable and necessary treatment. They may tell you that your injury is not work-related or that you do not need any more care.
Know that you cannot be forced to follow a specific plan of treatment or to use their doctors. If your employer or insurance company is giving you a hard time about covering your work-related injury expenses, it’s best to call an experienced lawyer to protect your rights.
Why have I been assigned a nurse case manager?
The law states that a nurse case manager is hired by your employer or insurance company to help you get better. But this is not always the case. These nurse case managers are really hired to control treatment costs for the insurance companies.
Nurse case managers are usually not on your side, and they will try to control your treatment.
You have the right to privacy in the examination room and to let your doctor make appropriate decisions about your treatment.
Injured on the job in Michigan and need help with your workers’ comp medical claim? Call our attorneys now for a free consultation
If you were injured on the job in Michigan and you need help with your workers’ comp medical claim, call now at (855) 221-2667 or fill out our contact form for a free consultation with an experienced lawyer. There is absolutely no cost or obligation. We’re here for you.
For more than 40 years, our lawyers have been helping people like you who have suffered from on-the-job injuries in Michigan. We understand the physical, emotional, and psychological hardships you are experiencing from your accident. We also have the skill, experience, and know-how to protect you and get you the best possible payout amount for your case.
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.
Remember, every work injury claim and settlement is different and must be negotiated on its own merits. Do not accept any payout amount without fully understanding your legal rights.
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