What are the pros and cons of workers’ comp medical coverage?

Workers’ compensation helps to protect people from some of the medical risks inherent in working. There are two main types of benefits available to workers with injuries or job-related illnesses in New Jersey.

If an employee requires time away from their job, disability benefits can help them avoid major financial setbacks due to a loss of income. Workers’ compensation also provides medical benefits. The medical benefits alone can be a valid reason to inform an employer of an injury and seek workers’ compensation benefits. Yet, there are some drawbacks or limitations to the coverage as well.

The limitations of medical coverage

There are a few drawbacks or limitations for the medical benefits available through New Jersey workers’ compensation. The fact that the employer or their insurance company selects the doctors that provide treatment can be a drawback for many people.

Additionally, a physician overseeing someone’s care makes most of the major decisions about their benefits. Doctors decide what treatment someone requires and what accommodations employers should provide. They also decide when people are ready to go back to work or if they have stopped responding to treatment. Many employees worry about giving one individual that much authority over their future recovery and financial stability.

The benefits of medical coverage

Perhaps the most obvious and important benefit of medical benefits through workers’ compensation is the full coverage that the program provides. Workers typically don’t need to pay anything for their own treatment. Those using health insurance to pay for treatment often have to cover large deductibles or pay coinsurance of 30% or even more for certain types of care. Those who qualify for medical coverage through workers’ compensation do not have to worry about covering any costs of their treatment.

The benefits can potentially persist for the rest of a worker’s life if they have permanent symptoms from a significant injury or job-acquired medical condition. Workers’ compensation pays for everything from surgery and prescriptions to physical therapy.

Employees need to understand the benefits available to recognize the importance of filing a workers’ compensation claim. Learning more about the systems in place to protect New Jersey employees can benefit those coping with work-acquired medical challenges.

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