In Iowa, workers’ compensation is supposed to pay for the “reasonable and necessary” medical care that is needed to treat your work injury. While this seems straightforward, what is “reasonable” and what is “necessary” is often disputed. You can protect your rights by knowing what medical care you should receive, who should pay for it, and what to do if there is a dispute between you and your employer or your employer’s insurance company.
There are different parts to providing reasonable and necessary medical care.
First, there is your direct medical care. This includes appointments with your doctors, medical procedures, prescription medications, and medical supplies (such as crutches). Your employer has the right to choose your medical providers and must provide medical providers that will provide medical care that is reasonable for your injury. These bills should be paid directly by your employer’s insurance company and should not come out of your pocket.
However, medical care may require more than doctors’ appointments and medical procedures. You may be reimbursed for costs incidental to your medical care, such as:
- Transportation costs to and from medical appointments.
- Meals and lodging if they are incidental to medical treatment.
- Lost wages if you miss work for medical treatment (under some circumstances).
A medical provider cannot ask you for payment during a dispute between you and your employer, or your employer’s insurer, about the reasonable of medical services.
How to Handle a Dispute About Medical Benefits
If you believe that your employer or your employer’s insurer is failing to provide you with reasonable and necessary medical services, then you can clear up the problem by:
- Discussing the issue with your employer or your employer’s insurer. You have the right to know why your employer or your employer’s insurer has made certain decisions, and you have the right to request alternate medical care.
- Contacting an Iowa workers’ compensation compliance administrator in the Workers’ Compensation Commissioner’s Office to discuss the dispute and to get advice on resolving the dispute.
- Filing a contested case proceeding with the Iowa Workers’ Compensation Commissioner.
You have the right to work with an experienced Iowa workers’ compensation lawyer at any stage in the proceedings. An attorney can advise you of your rights to medical benefits. Also, your attorney can represent you before your employer, your employer’s insurance company, or the state so that you can get fair medical benefits after a work-related injury. To learn more about your workers’ compensation benefits, please contact us any time—24/7/365—via this website or by phone to schedule a free consultation.