Saturday, September 26, 2009

Who Pays For The Medical Bills For My Workers Compensation Injury?


Under Minnesota's workers compensation laws, an employee sustaining a work related injury is entitled to reasonable and necessary medical treatment. Given this rule many injured workers assume that the Minnesota employer and workers’ compensation insurer will automatically pay for the injury and the related medical expenses. This is unfortunately often not the case.

Many injured workers then go without treatment which allows the same employer and workers compensation insurer to allege that the lack of treatment is an indication you were NOT injured or injured that bad. Given some cases can take anywhere from a few months or even up to a year before a judicial determination is made on the dispute, it is VERY important that you find some way to get the treatment you deserve and need.

If you have private health insurance and your workers compensation claim or treatment has been denied, Minnesota law requires the health insurer to provide coverage under their policy and seek reimbursement from the workers compensation insurer. Many of my clients have overlooked this right as nobody who works for the insurance company is willing to share this secret.

If, however, you are without health insurance you are not alone. Nearly 700,000 Minnesotans receive health care through the state’s three publicly funded basic health care programs — Medical Assistance (MA) — Minnesota’s Medicaid program, General Assistance Medical Care (GAMC) and MinnesotaCare. For more information click here. Even with these programs in place,over 453,000 Minnesotans go without health insurance according to the U.S Census Bureau.

The Minnesota Department of Human Services (DHS) administers these programs and pays all or part of enrollees’ medical bills for:

Medical Assistance (MA) (Minnesota’s Medicaid program) is the largest of the health care programs, providing health care coverage and prescription medication coverage for a monthly average of 507,000 low-income senior citizens, children and families, and people with disabilities in fiscal year (FY) 2007.

General Assistance Medical Care (GAMC) provides medical care for a monthly average of 33,000 (FY 2007) low-income Minnesotans who don’t qualify for MA or other state and federal programs — primarily low-income adults, ages 21 and 64, who do not have any dependent children.

MinnesotaCare is a publicly subsidized program for Minnesota residents who don’t have access to affordable health care coverage. In order to eligbile you must meet the following:

  • Have a Social Security number or be willing to apply for one (unless you have religious objections);
  • Live in Minnesota;
  • If you are an adult and do not have children living with you, or if your children are over age 21, you must have lived in Minnesota for six months;
  • Be a U.S. citizen or non-citizen lawfully residing in the U.S.;
  • Not have other health insurance now or have had health insurance (including Medicare), for at least four months except for Medical Assistance enrollees whose health insurance premium was paid for by Medical Assistance; and
  • Not be able to get health insurance through an employer who offers to pay at least half the monthly cost.

Assistance in applying can be found here.

The only way an injured worker can get back to work is to get the necessary medical treatment. If you find yourself without medical insurance and the workers’ compensation insurer refuses to pay for your medical treatment, look into contacting the state and/or county for assistance. MinnesotaHelp.info is another great resource for help.

If you have been injured at work, attorney Tom Atkinson is more than willing to discuss your claim. There is NO obligation and he is willing to review your case to ensure you are properly receiving all the benefits you have coming to you. Contact him directly at 651-324-9514 or visit his web site at www.mndisability.com