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Fort Smith Workers’ Compensation Lawyer

Fort Smith Workers Compensation Medical Coverage Benefits

Fort Smith Workers Compensation Medical Coverage Benefits

If you sustain serious injuries during your work shift, you must take proper steps to have your injury taken care of.

You must seek medical treatment and report your injury to your employer as soon as possible. The stress of the situation and your new pain from your injuries can cloud your judgment. You may make mistakes while filing a Fort Smith workers’ compensation claim or miss important deadlines. Also, the last thing you want to guess about is your medical coverage benefits.

We know you have questions. Who is going to pay the medical bills? When can you return to work? What happens if you need surgery? What happens if you cannot return to work in your normal position? How are you going to pay for the rest of your expenses? We’ve got answers. Our Fort Smith workers’ compensation medical coverage benefits attorneys are here to explain the next best steps for your unique situation. The Law Office of Jason M. Hatfield isjust one call or one chat away.

Table of Contents

What Is Covered Under Workers’ Compensation?

Arkansas workers’ compensation covers accidental injuries arising out of and during employment that cause internal or external harm, are caused by a specific incident/accident, and are identified by the time and place of occurrence. The three exceptions to this rule are: 
  • Hearing Loss
  • Rapid Repetitive Motion Injuries
  • Gradual Onset of Back Injuries
These three exceptions are compensable only if the resulting condition is the primary cause, more than fifty percent, of the need for treatment, death, or disability. Heart attacks and mental injuries have specific statutory provisions.

Arkansas has one of the highest worker injury and death rates, as outlined by the Bureau of Labor Statistics. In 2019, over 24,000 workers experienced an accident, resulting in more than 10,500 employees missing at least one day of work or being transferred to another position.

What does Arkansas Workers' Compensation cover?

How To Determine Whether You Need Emergency Care If You Are Hurt on the Job

Typically, it would be advisable to seek emergency care if you experience any of the following:

Man with amputated leg working at jobsite

This list is not exhaustive but provides a good outline for the wide range of accidents or situations that may send a worker to the emergency department.

  • Difficulty breathing or choking
  • Head, spine or neck injuries with a loss of movement or feeling
  • Serious burns
  • Fainting without warning
  • Pressure or severe pain in the chest, arm pain with shortness of breath, or jaw pain with chest pain
  • Intense headache that comes on suddenly
  • Being unable to move, speak or see
  • Broken bones
  • Smoke or toxic chemical inhalation
  • Weakness or drooping on one side of the body
  • Deep wounds, heavy bleeding
  • Severe, debilitating pain in any location on your body
  • Severe allergic reactions that affect your breathing/cause swelling
  • Electric shock/burns
  • A high fever that medication does not relieve

Workers' Compensation Medical Coverage Benefits

We will break down some of the medical coverage benefits you receive if you are hurt on the job in Fort Smith and apply for workers’ compensation.

Generally speaking, if you need to go to the emergency room, you will need to check in with a triage nurse, who determines who is seen in the order of medical severity. After checking in, you may proceed through the following four steps:

  • Treatment
  • Doctor’s Examination
  • Testing
  • Diagnosis and Treatment

Emergency Room Treatment – Emergency room treatment is required to prevent a patient’s death or serious health impairment. There is a difference between urgent and emergency care. Urgent care is the middle ground between your primary healthcare provider and the Emergency Department. The emergency department treats life or limb-threatening conditions for those who need immediate medical treatment.

healthcare workers' compensation lawyer

Steps for Treating Work Injuries

Follow-Up Doctor Appointments –It’s no secret that workers’ compensation claims can be complex and complicated. The number of rules and regulations to be followed to file for benefits after a work accident can be confusing. In general, Rule 30 is applicable when it comes to covering costs for follow-up visits to the doctor.

An employer is responsible for providing reasonable hospital, medical, and surgical services. An employer shall also give medications or aids to help cure the injuries. Common aids include crutches,
hearing aids, artificial limbs, and other appliances. If you have any questions while filing your workers’ compensation claim, we can answer them.

Rehabilitative Physical or Occupational Therapy –This may seem like a vague area. However, it covers three kinds of workers’ compensation benefits to be protected, including rehabilitative physical and occupational therapy. Three benefits for injured workers are:

  • Medical Treatment for the Injuries –Includes doctor’s invoice, medications, hospital charges, lab test fees, medical equipment, such as crutches, x-rays, and other tests ordered by the doctor. There is no deductible. All services costs considered reasonably necessary are paid to the provider.
  • Rehabilitation Services –This may be a continuation of medical treatment, such as physiotherapy for muscle rehabilitation. You may qualify for vocational rehabilitation if the injury is severe enough to result in a permanent disability.
  • Cash Payments –Made in the form of Temporary Total Disability (TTD). These payments are given to workers during their recovery time. If the impairment is permanent, the worker is then paid Permanent Partial Disability (PPD). PPD may include wage loss if the impairment affects the wages earned before the injury. If wrongful death occurs, it would mean that a surviving dependent could be paid.

Prescription Drug Coverage

In 2015, Arkansas set up a pharmacy program to provide workers’ compensation pharmacy benefits; the first is a 15-day first fill program, and the second is a subsequent fill program. The forms used in this program do not replace the worker’s health insurance card. They are to be used only for treating a workers’ compensation injury. There are over 700 pharmacies in Arkansas participating in the network.An injured worker first reports an injury. 

A physician must fill out a temporary pharmacy form, and the worker must take it to the pharmacy. A copy is made and sent with the initial claim forms to the Public Employee Claims Division. The temporary form provides the worker up to a 15-day supply of required medication listed in the Formulary. The card works for 10-days from first use. From this point on, after the prescription is filled with the temporary form, a permanent card is then mailed to the worker to use for their workers’ compensation injury claim.


Back Injuries that May Require Surgical Intervention

While some back injuries may require time off, rest, and prescribed medications, others may need surgery. Possible back surgeries can include:
Herniated Discs
Herniated discs require discectomy surgery to remove the ruptured portion of the disc. Depending on the location of the disc, part of a vertebra may be removed to access the disc.
Spinal Fractures
Spinal fractures can be the result of a fall. This may require spinal fusion, joining two or more bones to stabilize the spine.
Spinal Stenosis
This occurs when the column that protects the spinal cord narrows and injures the spinal cord nerves. This may require a laminectomy, which involves removing the bone surrounding the spinal canal.
Surgeries Should be Covered
You should receive workers’ compensation benefits if you reported the injury promptly, sought treatment as required, followed up with the doctor, took your medications, did your rehabilitation, and had needed surgery (pre-approved).

Contact The Fort Smith Law Office of Jason M. Hatfield Today

Even if your claim is denied, other options are still open, and we can help you get together what is required to move forward. Medical documentation and detailed records can compel an insurer to rescind its refusal. Or, the workers’ compensation attorneys at the Law Office of Jason M. Hatfield can file an appeal for you. Our Fort Smith workers’ compensation lawyers have decades of experience handling cases like this, and we understand what is at stake.

We represent injured workers across Northwest Arkansas, including Springdale, Rogers, Berryville, Bentonville, and Harrison. To learn more about our services and schedule a free consultation, call us today at (479) 361-3575. You may also connect with us through our online contact form.

Workers’ Compensation Frequently Asked Questions

A. This is pretty straightforward. An injured worker is entitled to reimbursement for mileage expenses relating to the medical treatment of their claim. The injured worker must submit a mileage form monthly.
A. An injured worker can be reimbursed for prosthetic devices.5A prosthetic device is external and used to replace a missing body part to restore body function to a patient. It is typically custom-designed, created, put together, and fitted/adjusted to the patient before delivery. A prosthetic device does not include the following:
  • An artificial ear;
  • An artificial eye;
  • A cosmetic device;
  • A dental appliance;
  • An artificial facial device;
  • A device used solely for athletic purposes; and
  • Any device that does not impact neuromusculoskeletal body functions, musculoskeletal or neuromuscular body functions.
However, there are certain restrictions applicable in each case. Discussing these details with your attorney and determining the best treatment plan with a doctor is best.

A. Any surgery you could imagine is possible in the aftermath of a workplace accident. The most common accidents on the job involve falling, which affects the back, neck, shoulders, knees, and other appendages. If you are seriously injured and need surgery to get back on track, you are likely entitled to Fort Smith workers’ compensation benefits in your medical coverage.

Generally speaking, your employer is required to cover your medical expenses so you can return to work. However, there are instances where an employer or the insurance carrier does not do what is required. An example would be if the insurer did not want to pay the cost of expensive surgery, they may refuse the claim and state it is unnecessary. If you run into a situation like that, call our workers’ compensation attorneys at the Fort Smith Law Office of Jason M. Hatfield. We’ve got your back.

Workplace accidents involving the back can be debilitating. Workers’ compensation should cover this type of injury and the treatment it requires. However, if you are having difficulties filing a claim or are not receiving the treatment you need, call us.

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