Medical Benefits for Injured Nurses

Chicago Lawyers Helping Healthcare Professionals

Nurses face many different kinds of injuries while on the job. Common injuries include repetitive stress, back injuries, needle sticks, violence, and head injuries. Medical benefits for injured nurses may be available through the workers’ compensation system if you were injured on the job. Sometimes valid workers compensation claims are denied. You should meet with our experienced Chicago workers’ compensation attorneys if you are seeking representation for your claim.

Medical Benefits for Injured Nurses

The nature and extent of medical care you’ll need depends on your injury. Job-related injuries could include herniated disc, work-related heart attack, work-related stroke, or broken bones. Nurses can sustain a range of injuries from minor to catastrophic. If they’re work-related, you can obtain medical benefits that are reasonable and necessary.

Patients are usually not subject to a deductible for medical benefits through the workers’ compensation system. Payments are made until the physician has finished the treatment or you have completely healed. Your doctor will send the bills directly to your employer’s workers’ compensation carrier.

If your employer belongs to a preferred provider program (PPP), you will need to use a doctor from that program. You have two choices of provider through a PPP. If you don’t like the first doctor, you can choose a second. Any referrals made by one of the chosen doctors count as part of your choice. However, if your employer belongs to a PPP and you do not choose a doctor from that program, you will only have one choice.

Your medical benefits through the workers’ compensation system will include not only the costs of the reasonable and necessary medical care related to the particular injury, but also payment for your mileage to and from the treating doctor. In some cases, medication or special equipment will be needed. They should be provided as part of the medical benefit.

Prior Authorization

If your work-related injuries are serious, you may need to be seen by a specialist or undergo expensive diagnostic testing such as a CT scan or an MRI. Often, hospitals and clinics that provide these services need to obtain authorization from your employer’s insurer before you’re allowed to see the specialist or undergo testing. Medical providers seek authorization to ensure that the bill will be paid.

In some cases, an insurer will ask you to undergo an independent medical examination (IME) by a doctor it has chosen. This request may be made because the insurer is skeptical of the claim or the extent of treatment recommended by your doctor. As a nurse, you may assume you will be taken seriously. There are some IME doctors who are neutral, but many of these doctors have been chosen specifically because they regularly write reports that support insurers’ denial of claims. They may be selected because they are known to recommend only conservative treatment even for serious, life-altering injuries. The IME doctor is not a treating physician and may not be on your side.

When medical benefits for injured nurses are denied by the insurer, consider speaking with a lawyer to protect your legal rights and request a hearing before an arbitrator at the Illinois Worker’s Compensation Commission. It is wise to keep an Application for Adjustment on file with the Commission, even if you are getting some benefits in case the insurer stops paying your provider or won’t authorize a necessary procedure.

Retain a Chicago Attorney

If you’ve suffered injuries as a nurse, you may be able to obtain medical benefits. You should discuss your situation with the experienced Chicago lawyers of Katz, Friedman, Eisenstein, Johnson, Bareck & Bertuca. We also represent nurses with workers’ compensation claims in Champaign, Rockford, Quincy, and Aurora, as well as Sangamon, Winnebago, Kane, Cook, and Adams Counties. Call us at 312-724-5846 or complete our online form.