Work-related medical conditions exist on a broad spectrum. Some people sustain deadly injuries on the job. They fall from a significant height or end up involved in a fatal crash while on the clock. Other workers sustain minor injuries that may only disrupt a single day’s work and may require minimal medical intervention.
Workers’ compensation provides support for employees and their surviving family members regardless of the severity of a medical condition. Provided that employment was the cause of the condition, the worker may be eligible. Workers’ compensation benefits include full medical coverage.
Employees can receive benefits that pay for treatment ranging from surgery and prescription medications to physical therapy and assistive technology. In some cases, workers make a full recovery. Doctors set a broken bone, and they return to work eight or 10 weeks later. Other times, they may have lingering symptoms that treatment does not resolve.
What happens when workers don’t make a full recovery?
Benefits change with a worker’s prognosis
The medical benefits available through workers’ compensation are highly-valuable in part because they provide full coverage for treatment. There are no patient responsibility costs as there are with standard medical insurance policies. Workers don’t have to pay a deductible or cover coinsurance obligations.
The treatment that they received must be medically necessary. They also need to respond to the treatment for it to continue. There are many work-related medical conditions that may not result in a full recovery. For example, an employee may have developed a repetitive strain injury, such as carpal tunnel syndrome.
Treatment, symptom management and even surgery may be necessary. The worker may be able to improve their symptoms but not fully eliminate them. If a doctor determines that a patient has stopped responding to intervention, then that may influence the worker’s benefits going forward.
They may not be able to continue receiving treatment that is ineffective. However, benefits may continue covering symptom management care. They may also be eligible for permanent partial disability benefits if their lingering symptoms affect their earning potential.
Communicating with an employer, getting a second opinion and seeking available benefits can be challenging when workers have lasting medical issues related to their employment. Employees trying to navigate a complex workers’ compensation claim involving permanent functional limitations may need help understanding and making use of their rights, and that’s okay.