A workers’ compensation fee schedule is a tool used by states to determine the maximum amount providers can charge for a service when dealing with people covered under workers compensation insurance. Most states, including Massachusetts, have their own fee schedule.
The fee schedule dictates the maximum amount that a provider can charge for their services. If there is a need to charge more than the required amount, the provider needs to provide proof that the additional costs are necessary.
What are the Most Common Work Place Injuries?
The National Safety Council reports three types of work place injuries and they include:
Slips and Falls
These types of accidents can occur anywhere on the job site. They include falling down a flight of stairs, tripping over work tools, falling from a ladder, slipping on spilt liquid among others. Slip and fall accidents account for nearly 27% of all workplace injuries and they range from severe head injuries to minor contusions. Recovery period could last anywhere between several days to months of medical care and treatment.
Contact with Equipment and Objects
About a quarter of all workplace accidents include getting struck by equipment or objects. The accidents can result in severe injuries to the head, back or limbs. Accidents can also result against a surface. For instance when you bend to pick something from the floor and then you strike your head on a table when you get up. Other accidents include being pushed against an immobile surface by equipment such as a forklift.
Over exertion
Over exertion is caused by doing repetitive tasks or picking up heavy equipment. An example of a repetitive task includes typing on a computer for long hours which can lead to injuries such as carpal tunnel syndrome. More than a third of all workplace injuries are caused by over exertion.
Workplace injuries usually require employees to seek treatment from different specialists and this means they can’t go to work.
If you are eligible for workers compensation, your doctor is aware of the workers compensation fee schedule. They cannot refer you to another specialist without approval for the referral. This process is usually very frustrating for most people seeking treatment.
Below are examples of potential injuries and the policy for reimbursement for each.
Workers’ Compensation Fee Schedule Reimbursement Policies
A physician will first inspect your injuries to determine their extent. According to guroo.com, below are the average cost for some of the procedures you might have to go through:
- X-ray tests: average cost for a chest xray is $130
- Evaluation by a physician: Doctor visit for back pain costs an average of $95
- Chiropractor visits: an average of six back pain chiropractor visits costs an average of $209
- Steroid injections: an epidural steroid injection costs an average of $3, 208
- Physical therapy: for back pain average cost is $585 for six visits
The total cost for all the above procedures is $4, 227. These are just basic care needs and this is assuming you won’t need surgery. If you were to receive reimbursement via the workers’ compensation fee schedule, the amount will be far less because your care givers have agreed to those prices set down by the state.
According to the Massachusetts workers’ compensation fee schedule, there are codes that doctors must adhere to.
Always Keep Track of Each Procedure and Each Doctor’s Visit.
The last thing on your mind after a work injury is how much your doctor will be reimbursed. You should, however, be aware that you do not need to make co-payments on any treatments that you receive.
Workers’ compensation treatments have complex rules so your employer’s insurer will cater for all expenses. These expenses may include:
- Surgical procedures
- Physical therapy
- Pain control medication
- Tests and x-rays
- Emergency care
The amount of information you will receive during this process can be overwhelming and frustrating. This is why it is a good idea to contact a workers’ compensation attorney immediately you suffer a workplace injury.
Seek an Experienced New Bedford, MA, Workers’ Compensation Attorney.
If you live in New Bedford, you can contact our offices by calling us at 508-999-0800 to schedule your free initial consultation. We can answer any questions that you have, help you negotiate a fair settlement and more importantly, ensure that your rights are protected at all times following your workplace injury.
