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How medical care influences workers’ compensation claims

On Behalf of | Jun 24, 2024 | Workers' Compensation |

Medical treatment is a cornerstone of the workers’ compensation program in Minnesota. People with job-acquired medical challenges can file claims seeking benefits for medical coverage. The workers’ compensation program can pay for their treatment without making them responsible for co-pays or deductibles.

Care ranging from surgery to physical therapy is typically eligible for coverage. The treatment that someone receives can also have a direct impact on other aspects of their benefits claim.

Limitations make people eligible for disability benefits

When a physician determines that a worker cannot safely perform their job due to their condition, that employee can take a leave of absence or request alternate work. If the company cannot accommodate them or if absolute rest is necessary for recovery, then the worker may qualify for disability benefits. If someone can go back to work but can’t perform the same functions, partial disability benefits can help reduce the drop in their income. A doctor communicating with the state and an employer about a worker’s functional limitations can make them eligible for disability coverage until they recover.

Recovery determines the duration of benefits

Typically, the goal in the workers’ compensation case is to get someone back on the job as quickly as possible. The doctor overseeing someone’s treatment formally acknowledges when they fully recover and can return to work. They can also decide that a worker has achieved maximum medical improvement (MMI). A designation of MMI means that a worker is unlikely to see many benefits from additional treatment. When that happens, the state may limit the medical coverage for a worker to symptom management coverage. Their disability coverage may end or may convert to permanent disability benefits instead.

In cases where a doctor believes that a patient has failed to comply with medical instructions, that could also lead to the termination of someone’s benefits. Occasionally, workers may disagree with the decisions made by the doctors providing their care. They may need to seek a second opinion or even appeal the termination or conversion of their benefits.

Learning more about the way that medical treatment influences the overall workers’ compensation claims process can benefit injured and sickened employees. Workers’ compensation claims can be very difficult for people to manage without support due to the complexity of the program. Workers who seek out help early in the process may have an easier time accessing benefits.

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