Workers’ Compensation Medical Benefits

If you’ve been injured on the job in Florida, understanding your right to medical benefits under the state’s workers’ compensation system is critical. The medical care you receive after a workplace injury can significantly affect your recovery, your ability to work in the future, and your financial well-being. At The Law Firm of Kevin A. Moore, we know how overwhelming the workers’ compensation process can be, especially when you are in pain and worried about your future. This page will help you understand the medical benefits available through Florida’s workers’ compensation system, how those benefits are accessed, and what rights you have if something goes wrong along the way.

What Medical Benefits Are Covered by Florida Workers’ Compensation?

Under Florida Statutes Chapter 440, injured employees are entitled to have all medically necessary care covered by workers’ compensation, as long as the injury arose out of and in the course of employment. In simpler terms, if you were injured while doing your job, you are entitled to medical care, and you shouldn’t have to pay for it out of pocket.

Medical benefits under Florida workers’ compensation include a wide range of services. These can include emergency care, doctor visits, hospital stays, surgery, diagnostic testing (such as MRIs and X-rays), physical therapy, chiropractic treatment, and prescription medications. In many cases, the benefits also extend to durable medical equipment, such as crutches or wheelchairs, and transportation to and from medical appointments if you are unable to drive.

However, there is a catch that many injured workers don’t initially realize: all medical care must be authorized and arranged through the workers’ compensation insurance carrier. This means you cannot choose just any doctor, and you generally cannot seek care on your own and expect reimbursement. If you do, the insurance company may deny payment.

In Florida, your employer–or their insurance company–gets to choose the treating physician. If you’re unhappy with the care you’re receiving, you can request a one-time change of doctor, but that request must be made in writing. If the insurer fails to provide a new doctor within five days, then you may choose your own.

Authorized Treatment and the Importance of Following the Rules

It’s important to understand what “authorized treatment” means under Florida workers’ compensation law. This term refers to medical care that is pre-approved by the insurance company and provided by doctors within their network. If you see an unauthorized provider, the insurance company will almost certainly deny payment for those services, even if they were necessary.

For example, suppose you sprain your back while lifting equipment at work. If your supervisor files the injury with the insurance company and they send you to a clinic for evaluation, that visit is covered. But if, on your own, you visit a different doctor or specialist, that visit may not be reimbursed unless it was an emergency. Florida law allows for emergency treatment without prior authorization, but only if it was truly an emergency and only for the initial stabilization of your condition.

If your injury requires ongoing care, like physical therapy or follow-up visits, you will need continued authorization from the insurer. This is why it’s so important to communicate with your employer and the insurance carrier about every aspect of your medical care. Documentation is also critical. Keeping a copy of every appointment, referral, and prescribed treatment can protect your rights later on.

Some injured workers experience delays in receiving care. Sometimes this happens because the insurer questions whether a certain treatment is necessary or related to the work injury. If that occurs, you have the right to file a Petition for Benefits with the Florida Division of Workers’ Compensation. A skilled Florida workers’ compensation attorney can help you take this step and push back against unfair denials or delays.

Reimbursement, Mileage, and Related Medical Expenses

Medical benefits go beyond just covering the cost of seeing a doctor. In Florida, you may also be entitled to reimbursement for mileage expenses related to medical treatment. This includes travel to and from authorized medical appointments, pharmacies, and physical therapy. The mileage reimbursement rate changes periodically, so it’s important to keep receipts and log your miles accurately. The law also allows reimbursement for tolls and parking, if applicable.

In addition to transportation reimbursement, the workers’ compensation carrier must also pay for all reasonable and medically necessary ancillary services. This includes diagnostic testing ordered by your authorized treating physician, such as MRIs, CT scans, or blood work. If your condition requires surgery or hospitalization, the full cost should be covered–again, as long as those services are authorized.

One area that can cause confusion is prescription medication. In Florida, injured workers are entitled to receive medication prescribed by their authorized physician, but there are strict rules about where you can fill those prescriptions. In many cases, the insurer has a network of approved pharmacies. If you go outside that network without prior authorization, you may be stuck with the bill. Be sure to confirm that your pharmacy is within the workers’ compensation network before filling any prescriptions.

You should also know that you’re not just entitled to treatment for the injury itself. If you experience complications or related conditions as a result of the original injury, those can also be covered. For instance, if a foot injury leads to problems with your back due to a change in how you walk, treatment for your back may be covered as well.

When You Need Help Protecting Your Medical Rights

Unfortunately, receiving all the medical benefits you’re entitled to is not always a straightforward process. Insurance companies are focused on limiting costs, and they often challenge the necessity of certain treatments. They may delay authorization for testing, question whether a surgery is truly needed, or deny a referral to a specialist. That’s where legal representation can make all the difference.

At The Law Firm of Kevin A. Moore, we understand the frustration that injured workers face. You should not have to fight for the medical care that is legally owed to you under Florida law. If you are experiencing delays, denials, or feel like your care is being limited without justification, we are here to step in and take action.

We Are Here to Help You Get the Workers’ Compensation Medical Benefits You Need

Our firm has years of experience advocating for injured workers across Florida, and we know the intricacies of the workers’ compensation system. From filing a Petition for Benefits to representing you in front of the Judge of Compensation Claims, we are ready to fight for the care and coverage you need to heal.

If you’ve been injured at work and are unsure of your rights to medical benefits, don’t wait. The sooner you take control of your case, the better your chances of receiving proper treatment and avoiding unnecessary financial burdens. Contact The Law Firm of Kevin A. Moore today for a free consultation, and let us help you secure the medical benefits you deserve.