Hassle-Free Health Coverage: Benefits
Workers' comp laws provide for the payment of four types of benefits:
- medical benefits;
- income benefits;
- death benefits; and
- rehabilitation benefits.
For the purposes of this book, we will focus on the medical and rehabilitation portions of workers' comp benefits. The others do not directly impact health coverage issues.
Medical benefits provided under workers' comp are unlimited. If you have an injury or disease, you are entitled to receive all necessary medical and surgical treatment to cure or relieve the condition.
Certain maximums or limits may apply to a type of care or a particular medical item -- for example, stress-related psychotherapy may be limited to a specific number of visits -- but overall benefits are unlimited.
Rehabilitaiton benefits have become recognized as a valuable tool for reducing workers' comp costs and returning disabled employees to their jobs, as soon as possible. These benefits cover physical therapy, alternative-medicine treatment and related treatment that does not necessarily fit in a strict definition of medical service.
Rehabilitation benefits under a workers' comp policy will usually provide coverage for services such as therapy, vocational training, devices such as wheelchairs, and certain costs connected with travel, lodging and living expenses while you are being rehabilitated.
Rehabilitation also aids the insurance company. It helps to restore the injured worker to his former earning capacity. Today, insurance companies are among the leaders in providing rehabilitation for the industrially injured.
Most states offer rehabilitation benefits. Some states have set up a special fund to provide these benefits, while others have not. Various states impose weekly limits, maximum limits and special limits for specific types of rehabilitation.
The laws -- and the benefits provided -- vary somewhat from state to state. But benefits tend to be low -- about $300 a week at the most.
If you are seriously injured, you might need to see a specialist for follow-up care. These costs are typically covered by your employer under workers' compensation benefits. However, your employer might have a say in deciding what specialist you see.
