Your insurance carrier will pay for work-related treatment
If you have a work-related injury or illness, you may be able to get medical benefits. Your employer's workers' compensation insurance carrier pays these benefits to the doctor or facility that provides your medical treatment.
The insurance carrier will not pay for treatment that isn’t work related.
Your employer must tell you if your claim is in a healthcare network:
If your claim is in a healthcare network you must use a doctor in that network. If you get treatment from a doctor who is not in the network without getting approval from the network, you may have to pay for the treatment.
If you are not covered by a network:
You have the right to choose a doctor. Make sure the doctor is not on the list of doctors who are not allowed to provide workers' compensation health care. If you need help finding a doctor, refer to TXCOMP.
If you want to change doctors:
DWC must approve any change in doctors when your claim is not in a healthcare network. If you or your treating doctor relocate, or the doctor becomes unavailable, you can choose another treating doctor without getting permission from DWC. This is considered an exception, not a request to change doctors. If you want to change treating doctors for other reasons, you will need to provide good reason for your request.
You must complete the DWC Form-053, Employee's Request to Change Treating Doctors - Non-Network and send it to DWC. If your request is approved, DWC will send a letter of the change in treating doctor.
In an emergency you may get treatment without permission or approval from DWC or the insurance carrier.
Will you get billed?
A doctor can't bill you for treatment of a work-related injury or illness. The doctor may send you an information-only copy of the bill.
If you have any questions, call 800-252-7031, option 1.
Getting back to work as part of your recovery or treatment plan will help you heal faster and retain your job skills. There is no specific end date for medical treatment for your work-related injury or illness if the treatment is reasonable and necessary.
Injured employees who don't return to work once they are medically able to do so are more likely to:
- take longer to recover and need more treatment;
- become depressed;
- lose important job skills while they are out; and
- focus too much on their pain and injury.
Many employers offer return-to-work programs that will make changes to your regular job or place you in a temporary or alternate work assignment that fits your abilities. Ask your employer about return-to-work programs, and make sure your doctor agrees that the program you choose is right for you.
If you have questions about return to work, call 800-252-7031, option 1.