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If I have an on-the-job injury, what percentage of my medical bills are paid?

Posted by Katie Phipps | Nov 15, 2021 | 0 Comments

If you have an admitted workers' compensation injury, the insurance carrier should pay 100% of all your associated medical bills. Coverage will include surgeries, prescriptions, doctor's appointments, testing, medical equipment, therapy, etc. You should not have to pay co-pays or deductibles. You should be able see the type of specialist you are referred to by the authorized doctors.

The tradeoff for the carrier covering all related medicals is that you are required to treat with the doctor(s) they choose. Additionally, the carrier often sets the appointment dates and time. Medical compliance is extremely important to maintaining your benefits. If you fail or refuse to present for authorized medical treatment, you could lose your right to weekly benefits, unless the circumstances of refusal can be justified. S.C. Code Ann. §42-15-60 The only exception occurs when the employer refuses to provide care and an emergency arises then “a physician other than [the one] provided by the employer is called to treat the injured employee the reasonable cost of such service shall be paid by the employer if so ordered by the Commission.” S.C. Code Ann. §42-15-60

If your workers' compensation injuries are denied, then the carrier will not pay for your medical treatment. Always consult an attorney to learn your rights.

About the Author

Katie Phipps

For more than 17 years, Katie had a successful practice at two of South Carolina's largest workers' compensation defense firms. During that time, she realized her favorite part of the job was helping Pro Se claimants navigate the settlement process. As a lawyer for the insurance carrier, she ofte...


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