When you see a doctor in the wake of a workplace injury, they may prescribe a variety of medications to help you manage pain, treat an infection, or treat other medical issues. Since health insurance does not pay for workplace injuries, you cannot use your health plan to cover the cost of prescriptions related to your work injury. However, workers’ compensation is required to cover all prescriptions at 100 percent.
Workers’ Compensation Does Pay for Prescriptions
Per Florida state law, your company’s workers’ compensation insurance provider must pay the full cost of prescription medications prescribed by an approved doctor. Some insurance companies make it difficult for injured employees to get the benefits they’re entitled to, and many employees aren’t fully aware of their rights when receiving workers’ compensation. In some situations, workers’ compensation may refuse to pay for a prescribed medication.
Working With a Participating Pharmacy
Under Florida Statute 440.13, your employer or workers’ compensation provider cannot interfere with your freedom to choose a pharmacy or pharmacist. This does not mean that you can go to any pharmacy you choose, though—pharmacies are not required to participate in the workers’ compensation program. If your pharmacy of choice doesn’t participate in the program, you may have to choose another pharmacy.
Seeking Care from an Approved Doctor
You must see a workers’ compensation-approved doctor for all of your workplace injury care and treatment. If you choose to see a different care provider, you may not receive the medical benefits you are entitled to. If you see your own personal doctor after your injury and they prescribe you a medication related to your workplace injury, workers’ compensation is within their rights to refuse payment until the medication has been prescribed by an approved physician.
What to Do If Workers’ Compensation Refuses to Pay for Medication
In many situations, refusal to pay for prescription medication is due to an error on the part of the workers’ compensation insurance company, the prescribe, or the medication delivery service. Some employees are forced to pay for their own medications, particularly if they have debilitating pain or a life-threatening condition that cannot wait until the issue is resolved. Others simply go without the medication they need, risking further illness or injury.
If your pharmacist tells you that workers’ compensation has refused to pay for your medication or you receive a notification that the insurance company has challenged the claim, you need legal assistance. Working with an experienced workers’ compensation attorney allows you to focus on healing while your lawyer advocates on your behalf. If you are forced to pay for your own prescriptions due to the insurance company’s error, we can help you seek reimbursement and ensure that additional prescriptions are covered by workers’ compensation.
Have an Experienced Workers’ Compensation Attorney on Your Side
The team at Sternberg | Forsythe, P.A. strives to protect workers’ rights after a workplace injury. Schedule a consultation at our West Palm Beach office by calling 561-687-5660.