Wolf, Baldwin & Associates, P.C.

Employee stuck with $14,000 medical bill

Workers' compensation has a substantial set of rules when it comes to filing for benefits and getting the medical care the injured worker needs. These are generally inflexible, so it is no surprise that an employee of a Home Depot in Kansas is now stuck with a substantial bill. According to several news reports, the employee sought reimbursement for medical expenses involving doctors that were not authorized by her employer, but a three-judge panel ruled in favor of the commission because the medical care was not preauthorized by her employer or an administrative law judge.

The employee originally slipped and fell in 2007 while working at Home Depot. She suffered injuries to her neck, back and right arm at the time. From 2007 to 2013, she filed nine applications for preliminary hearings, while participating in four of them. Finally, in 2013 she settled for 28-percent impairment to the whole body injury settlement with the option to get additional care in the future related to the original injuries if she applied for care through workers' compensation.

New treatment and expenses at issue

The woman then began treatment in 2014 from a podiatrist, neurologist and an unauthorized doctor who recommended a muscle biopsy. Since none of the care had been authorized, the woman applied for reimbursement of these medical expenses related to medical mileage. An administrative law judge and the Kansas Workers Compensation Board both denied her request for reimbursement of $14,000. Additionally, a three-judge compensation board found that the woman had admitted that she did not get approval for the treatment, and also admitted that she had been injured after being hit by a car while training for triathlons. She appealed to the Kansas Court of Appeals, which affirmed the other rulings.

Legal guidance would have saved her money

Based on this story, it seems clear that the woman was not getting good advice about the nature of her settlement and what she was entitled to. Breaking or bending the rules involving workers' compensation is risky and can be expensive, as this woman found out. Pennsylvania workers' comp claims are much different than Kansas, but in any state attorneys who understand the workers' compensation process and outcomes can be a tremendous asset to the injured with applications, hearings and even after during the recovery process.  Don't try to go it alone.

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